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Blog Post

Is PTSD connected to TMD?

Apr 02, 2021

Although the human brain has a fantastic ability to overcome trauma’s devastating effects, everyone reacts differently. Some of us develop post-traumatic stress disorder (PTSD) as a result, with around five percent of Americans—more than 16 million people—having PTSD at any given time. The long-term effects of PTSD can manifest mentally and physically, resulting in a host of problems, including temporomandibular joint disorder (TMD). TMD causes jaw joint pain that may radiate to the surrounding muscles and tissues, creating various symptoms that often make TMD challenging to diagnose.



Below we explain how the temporomandibular joint (TMJ) works, review TMD symptoms, explain how PTSD affects the body, why it’s linked to TMD, and highlight effective solutions for treating TMD.

How the TMJ Joint Works

The TMJs, located on each side of the head just under the ear, connect the jaw (mandible) to the temporal bone of the skull. They work as sliding hinges that move in multiple directions—side to side, up and down, forward and backward—enabling us to open our mouths and chew, talk, laugh, drink, and yawn. Pain in one or both TMJs can signify TMD.

TMD Symptoms

TMD symptoms vary from person to person, and the same individual can experience different symptoms during different flare-up occurrences. Pain in the jaw joint and chewing muscles are the most common, but other symptoms include:


  • Clicking of the jaw. TMD sufferers may hear popping or clicking sounds in their jaw when opening or closing their mouth. This is usually caused when the articular disc inside the joint shift out of and back into place.
  • Facial pain. Inflammation caused by TMD can spread to other areas of the orofacial region, including the face.
  • Reduced jaw motion. Misalignment or damage to the ligaments, tendons, or cartilage that move the jaw may cause difficulty when opening or closing the mouth, including jaw lock.
  • Dizziness. Balance can be affected when TMJ inflammation travels into the middle or inner ear.
  • Headaches. Migraines and headaches may occur when TMD-related pain spreads to the top of the head.
  • Earaches. The TMJs are located within millimeters of the ear canal and middle ear. Pain originating in the TMJs can easily spread to these areas causing earaches.
  • Neck and should pain. Overworked jaw muscles can cause TMD pain that may spread from the jaw down the neck and into the shoulders.
  • Chewing pain. Inflammation and swelling in and around the TMJ can result in painful chewing.

What is PTSD and How Does it Impact the Body?

Post-traumatic stress disorder may occur after you experience or witness a traumatic, terrifying event. Although we often connect PTSD to war and combat experiences, it can also be linked to natural disasters, terrorist acts, violence, serious accidents, and more. Emotional symptoms include irritability, sadness, depression, anger, and anxiety. Physical symptoms include increased perspiration, changes in blood pressure, difficulty digesting food, and tiredness.


A terrifying or traumatic experience affects the immune system, the autonomic nervous system, and the endocrine system, which are all interdependent. In response to acute stress, a sudden release of hormones activates the sympathetic nervous system, invoking the “fight or flight” response, also known as the acute stress response. It triggers the adrenal glands to release
catecholamines, which include adrenaline and noradrenaline. When in fight or flight mode, heartbeat and breathing quicken, and the entire body becomes tense, ready to take action. 


For those who have PTSD, merely the thought of the traumatic experience activates the fight or flight syndrome, keeping the body in a state of perpetual tension. In addition to the immediate effects of PTSD, over time, it may be associated with ongoing brain tissue loss, putting those who suffer from PTSD at
greater risk for future cognitive impairments and dementia.

How PTSD Links to TMD

When our bodies become tense under stress, we naturally tend to clench our teeth together and tighten our jaw.  Although you may not be aware of it, this can occur for extended periods. The continual pressure on the TMJ and tension in the surrounding muscles can result in TMD, causing pain, swelling, and inflammation.

How Could You Seek Help?

It’s essential to be correctly diagnosed and treated for both PTSD and TMD. 


Some people can recover from PTSD on their own by connecting with family and friends, practicing relaxation techniques, journaling, and refraining from using certain drugs and alcohol. Often, however, more help is required. Cognitive-behavioral therapy (CBT) for PTSD aims to change patterns of behavior, thoughts, and feelings. Cognitive processing therapy, a type of CBT, helps people living with PTSD modify and challenge unhelpful beliefs related to the trauma.


Left untreated or undertreated, TMD symptoms and pain can worsen, negatively affecting your life and potentially causing other problems over time. It may
eventually lead to arthritis, nerve damage, and permanent TMJ dislocation. For mild cases, physical therapy, hot and cold therapy, at-home exercises, and taking over-the-counter drugs to reduce pain and inflammation, such as NSAIDs (nonsteroidal anti-inflammatory drugs), may help.


It’s wise to see a TMD specialist like Dr. Katherine Phillips. She can treat TMD with a
variety of solutions, including those mentioned above, prescribe muscle relaxants, and create custom-made TMJ appliances. They include:


  • Dental splints (bite plates, bite guards, stabilization splints). These appliances are designed to prevent contact between the teeth and reduce jaw pressure to break the pain and inflammation cycle. Splint therapy can be painless and easy to comply with when the appliance is created, fitted, and adjusted by a dentist who is a highly experienced TMJ specialist.
  • Mouthguards/nightguards. Guards such as these may address teeth grinding, but they typically don’t help with clenching that causes an extreme loading force on the TMJs.

Conclusion and Next Steps

Seeking expert diagnosis and TMD treatment is essential to relieve pain associated with TMD and reduce the probability of other health-issues arising due to TMD. 


Dr. Katherine Phillips
specializes in diagnosing, treating, and relieving pain caused by TMD. She is double board-certified in orofacial pain and dental sleep medicine and has spent most of her career in these two fields instead of general dentistry. With extensive experience and education, she uses mainstream, evidence-based medical science to identify the contributing factors causing your pain and will offer a TMD treatment plan that best fits your needs.

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Dr. Kathrine Phillips
About The Author
Dr. Katherine Phillips, DDS, MS received her undergraduate degree from the University of Michigan and her dental degree from the University of Detroit Mercy School of Dentistry. She currently serves as the Secretary/Treasurer on the American Board of Dental Sleep Medicine (ABDSM) Board of Directors and treats TMD and sleep disordered breathing at Restore TMJ & Sleep Therapy in the Houston, TX area. 
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Teeth grinding is the most common cause of jaw pain. Grinding your teeth also results in fractured teeth and the destruction of dental work, which can even change how you look. People who grind their teeth during the day can make conscious changes to reduce their teeth grinding for those who grind their teeth at night . Fortunately, with a visit to Dr. Phillips, you can discover how to stop grinding your teeth. What is Teeth Grinding, and What Causes it? Grinding or clenching your teeth, or bruxism , is a common condition affecting millions of people and, if left untreated, can lead to broader health issues. According to the American Dental Association (ADA), a 2020 ADA Health Policy Institute report stated that half of the dentists saw a rise in clients with stress-related dental problems, primarily due to teeth grinding and jaw clenching. It can happen during the day or night and often goes unnoticed until the person is alerted by a partner or family member. Treating bruxism can prevent further damage to the teeth and relieve any symptoms associated with the condition, and there are several steps you can take to stop grinding your teeth and protect your oral health. People grind and clench their teeth for various reasons, including stress and anxiety, misalignment of the teeth and jaw, or an abnormal bite. In adults, teeth grinding is often caused by emotional tension and stress and can become a subconscious habit. In children, teeth grinding is usually due to an immature bite and can be triggered by new teeth erupting or the recent placement of braces. How Do You Know if You're Grinding or Clenching Your Teeth? Grinding or clenching your teeth can be challenging to identify since it usually happens when you are unconscious or sleeping. However, several signs could indicate you are grinding your teeth. Common symptoms of teeth grinding include: Waking up with a sore jaw Frequent headaches Increased sensitivity or pain in your teeth Tired or tight jaw muscles Pain that feels like an earache, but there is nothing wrong with your ear A locked jaw that is difficult to open or close completely Neck or face pain Noticing that your teeth feel different or worn down You or your sleep partner may also notice that you make clenching or grinding sounds during the night. At a dental appointment, your dentist may suspect teeth grinding if you have the following: Teeth that are chipped, loose, flattened, or fractured Worn enamel on your teeth Gum recession Possible Causes of Teeth Grinding Many people grind their teeth and tighten their jaws without realizing it, especially at night. Although stress and anxiety can lead to teeth grinding, other common causes are: Posture. Poor posture is not only horrible for your back; it's also bad for your teeth. When the body's joints aren't in proper alignment, it can result in jaw clenching and grinding. Misaligned teeth. If the upper and lower teeth don't fit together correctly, the misalignment may result in the tendency to grind teeth or clench jaw muscles. Sleep disorders. Sleep habits and sleep disorders can lead to teeth grinding at night. Chronic obstructive sleep disorder , also known as sleep apnea , is a known cause of sleep bruxism. Resolving sleep apnea can help stop teeth grinding. Sleep terrors and insomnia may also result in grinding teeth at night. Joint disorders. The temporomandibular region is around the jaw, mouth, and ears. This area contains the temporomandibular joints and jaw muscles, which allow the jaw to open and close. Disorders in this area can affect teeth grinding and a sore jaw. Stimulants. Stimulants like caffeine, nicotine, and alcohol can trigger teeth grinding. Avoiding these can help prevent teeth grinding. Stress. Stress is a common cause of teeth grinding and clenching. Finding ways to manage and reduce stress can help decrease teeth grinding. These can include relaxation techniques such as progressive muscle relaxation, yoga, deep breathing, meditation, and guided imagery can help relax the jaw muscles and stop teeth grinding. Chewing on Objects. Chewing on objects such as pencils or fingernails can trigger teeth grinding. You may also need to avoid chewing gum, which can exacerbate teeth grinding. Finding out how to stop grinding teeth at night takes getting to the root cause of grinding. Discovering the cause provides clues, pointing to the appropriate solutions. Prevent teeth grinding during the day. It is crucial to identify triggers that cause teeth grinding if you intend to stop grinding them during the day. Pay attention to your habits during the day and see if you notice when and if your grinding or clenching is worse. A TMJ specialist or dentist specializing in bruxism can provide you with exercises or relaxation techniques you can do throughout the day if you notice yourself clenching and, in some cases, offer medical treatment like muscle relaxants or Botox for bruxism. Prevent teeth grinding and clenching at night/in your sleep. You'll have to make changes during the day to stop grinding or clenching your teeth at night or in your sleep. Start by talking to your dentist or doctor to determine if you have underlying medical issues that could be causing the grinding. Additionally, your dentist may suggest you wear a mouthguard, splint, or other oral appliance. At the same time, you sleep to protect your teeth from further damage and keep your mouth in the proper alignment, helping your TMJ to relax. A custom-fitted mouthguard also helps lessen the impact of teeth grinding by covering the teeth to create a physical barrier that reduces damage. How To Stop Child/Baby Grinding Teeth Many children grind their teeth at night, but most grow out of it. If your child or baby grinds their teeth, the first thing to do is identify what might be causing the behavior. Stress, anxiety, or an underlying medical condition can cause your child to grind their teeth. If the grinding is stress-related, identifying and addressing the source of the stress, such as an overly demanding school schedule or peer pressure, may help. If a medical or dental condition causes the grinding, your child's dentist or doctor can help you determine the best action. If the grinding results from a habit, it can help redirect your child's attention when they start to grind and provide them with other activities that may help reduce their stress and anxiety. Side Effects of Teeth Grinding Grinding your teeth may seem like a harmless habit. After all, it's easier to notice this behavior if you're not on the lookout for it. And unless your significant other or family members complain about the noise from your nighttime teeth grinding, it's difficult to find proof of the act. However, long-term grinding of teeth at night can lead to significant side effects like: Pain in the jaw. The pressure and movement from teeth can lead to tenderness in the muscles, causing jaw pain . For some people, the pain may become chronic and severe. Headaches. The constant back-and-forth movement and clenching can impact the muscles around the neck and head, resulting in headaches due to muscle fatigue and tension. Wearing down teeth. Like sandpaper eventually smooths a surface, the repetitive motion from teeth grinding can flatten teeth and wear the enamel down over time. Teeth grinding can change the appearance of your teeth, causing them to look shorter and making chewing more difficult. Damage or fractured teeth. Grinding can destabilize teeth, making them shift and feel wobbly. The force from grinding may also crack teeth, causing pain and affecting oral health. Misalignment and cracked teeth can result in gum disease, cavities, and tooth loss — leading to poor overall health. Chronic ear pain. The temporomandibular area is closely connected. If the muscles around the ear become affected due to teeth grinding, chronic ear pain may occur. Facial muscle changes. Most people need to be aware that teeth grinding can change the shape of your face. Long-term bruxism can cause shorter teeth. Shorter teeth, in turn, change the structure of the face and jaw — leading to a sunken appearance. In addition, other muscles around the face can enlarge to compensate for dental changes. If you're concerned about your appearance, you may want to note that chronic teeth grinding can change the way you look. Remedies for Teeth Grinding The methods for how to stop teeth grinding at night versus teeth grinding when you are awake are typically the same. Although some treatments aren't quite possible when you're asleep, their benefits can last even after you've gone to bed. Reductive coronoplasty. Reductive coronoplasty directly involves changing or leveling the biting surface of teeth. This procedure reshapes crowded or crooked teeth, improving teeth alignment. Conversely, additive coronoplasty can add to the surface of teeth to help treat bruxism. Dental Appliances: Mouthguards, night guards, and splints. A mouthguard does just that — it guards teeth. Typically used for sports, a mouth guard keeps teeth from injuries sustained during activity. A night guard protects teeth from grinding at night. Lastly, a bit splint guides jaw movement, enabling the jaw to land in the appropriate position. These appliances protect teeth differently, and finding the right one for your situation is essential. Biofeedback. Biofeedback allows a person to train themselves by monitoring auditory and visual stimuli from the body. Although biofeedback needs a person to be alert, the technique can still help sleep bruxism by reducing overall stress. Stress reduction techniques. Though implementing stress reduction techniques such as yoga, exercise, and meditation requires a person to be awake, they can also help with nighttime teeth grinding. Allowing muscles to decompress and relieve tension alleviates stress-induced teeth grinding, even at night. Tongue and jaw muscle exercises. Most people don't stop to think about it, but their faces and mouth are a team of tissue, muscles, bones, and joints that closely affect each other. The tongue, for example, affects how the jaw moves. You reduce teeth grinding by exercising the right muscles — like the tongue and jaw. Behavior changes. Behavioral modifications like changing your posture and avoiding environments that cause stress can reduce instances of teeth grinding. Cognitive Behavioral Therapy (CBT) can help change behavior and thought patterns that lead to teeth grinding. Medications. A doctor can prescribe medication to help treat bruxism if all other treatments don't work. When used for short periods, muscle relaxants can relieve tension in the temporomandibular area. In severe cases of teeth grinding, botox injections can alleviate muscle tension. Antidepressants and anti-anxiety medications assist in decreasing anxiety, allowing jaw muscles to relax and reduce bruxism. How Can a TMJ Specialist Help with Teeth Grinding and Clenching? A TMJ specialist is a dentist board-certified in orofacial pain and conditions affecting the TMJ. TMJ specialists have extensive knowledge and experience regarding the structure, function, and pathology of TMJ. In addition to more thorough diagnostic evaluations, they can often provide more effective and long-term solutions for teeth grinding than your doctor or dentist alone. This is because TMJ specialists use a holistic approach to treatment, focusing on the underlying causes of the teeth grinding, such as stress, anxiety, or misaligned teeth, rather than just treating the symptoms. They often work with other medical experts like dentists or sleep physicians for more comprehensive care and treatment. Protecting Your Oral Health Protecting your teeth is critical to taking care of your overall health. Chronic teeth grinding can result in costly dental work, poor oral health, and chronic pain. If you're experiencing a sore jaw, headaches, or cracked teeth, seeking an expert diagnosis to find the cause is the first step to finding a solution. Get the answers you need on how to stop grinding your teeth at night or keep from grinding in the daytime to protect your oral health. As a TMJ and sleep apnea dentist, Dr. Katherine Phillips specializes in diagnosing and treating bruxism. With her Master of Science in Orofacial Pain From USC and extensive experience in TMJ therapy, Dr. Phillips utilizes proven and effective evidence-based medical interventions to identify bruxism and help find the right treatments to suit your needs. Get in touch today for more information.
By manager 16 Dec, 2022
The temporomandibular joint, or TMJ, is an anatomically complex joint, composed of muscles, joints, ligaments, bones, and discs. Proper jaw movement requires a high level of interaction and coordination among all these components, especially the articular disc (which absorbs stress), the adductors (jaw-closing muscles), the abductors (jaw-opening muscles), and jaw ligaments. This makes diagnosing problems or dysfunction with the TMJ extremely difficult. Properly diagnosing disorders of the TMJ—collectively referred to as TMD—requires both clinical examinations and medical imaging in order to develop an accurate assessment of the joint, its function, and its surrounding bone and tissue. If you are experiencing pain, discomfort, or dysfunction in your TMJ, you will first have a clinical evaluation. This is when your doctor or TMJ specialist will discuss your symptoms with you and examine your jaw, pressing on areas around it to identify any sensitivity. He or she will also observe the range of motion of your jaw and listen to and feel around your jaw while you open and close your mouth. In some cases, the doctor’s clinical findings are enough to diagnose a TMD and begin treatment. Other times, additional diagnostic imaging will be necessary to confirm the presence of a TMD.
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