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Old 02-12-2005, 03:28 PM   #1
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Question Excessive Clenching/Grinding- PLEASE HELP!!!!!!!!

Hi Everyone. First off I want to say how touching it is to see everyone helping each other and caring for each other. I've read many of the threads where one poster is simply asking about another to see how they are doing. That is how I know i'm in good company. From what i've read it seems like most people here have been on an uphill battle against many dentists, surgeries, pain, suffering, etc. I feel for everyone and am frightened to be headed down the same road. I'm hoping one of you veterans can offer advice to stop my TMJ in it's tracks. To make a long story short, i believe my TMJ is clenching/grinding induced. I've been on Zoloft for depression/anxiety the last 4 years and noticed about 3 years ago my jaw popping (but no pain) , which quickly led to painful popping which led to minimized opening etc. The only steps i've taken thus far is to get a mouthguard from my dentist which made things WORSE.. i don't know why. I tried to stick w/ it but would wake up and my mouth would be excruciatingly sore (I think b/c my muscles weren't used to grinding in the new position that the mouthguard made). I grinded right through it almost.. and thought to myself, "how would this possibly help.. it's not controlling the grinding at all....""? So I really don't want to talk to my dentist anymore about it b/c she doesn't seem to know too much about TMJ and i was frustrated in the mouthguard that did no good (AND WAS EXPENSIVE AND MY INSURANCE DIDN"T COVER). SOOOooooo... i'm wondering if there are any compulsive clenchers/grinders out there (that didn't even know they were until these symptoms started) that have been able to control it. I get this "TMJ" newsletter that has said the only proven success for clenching/grinding is a biofeedback device (i.e grindalert, oral sensor, etc?). So my question was if anyone here has tried a biofeedback or if you have any suggestions what other avenue i might take? The downfall is if someone has tried biofeedback and had it work, they probably no longer post here? I'm not sure. If I ever try anything and it works i promise to post it to help others! Any insight you can provide I would covet. If it matters to help anyone answer my question, i'm a 26 year old female and am afraid to get off of the Zoloft (the anxiety/depression was even worse than the TMJ pain currently is) but am open to trying to reduce the dosage. I have constant popping/cracking, I can not open my mouth very far (i.e eating a hotdog would be impossible w/out pain), and sometimes have the beginnings of headaches from it. it's all on one side (the left) and my face hurts to the touch. I also feel that my bite may have changed, but i'm not sure. I had braces and have straight teeth and thought i had a symmetrical bite. Doesn't feel like it anymore. It makes me depressed too b/c I just don't see the TMJ getting any better and want to do what's best. Any advice and/or anyone else had the same situation? (I'm also afraid of the splints as i have heard from your posts that they leave your bite open or misaligned? -- I don't know if this is the answer to clenching/grinding but I am still open to all advice). PLEASE HELP!!!! Thanks very much! I hope all of you are doing as well as you can be and I will be praying for you. Regards, monkeykitty

Last edited by MonkeyKitty; 02-15-2005 at 07:28 AM. Reason: Forgot to add info

 
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Old 02-15-2005, 07:29 AM   #2
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Re: Excessive Clenching/Grinding- Please help!!!

Can anyone help?

 
Old 02-15-2005, 08:35 AM   #3
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Re: Excessive Clenching/Grinding Cause of TMJ - can anyone advise?

Hi,

Your question is one that is so difficult to answer which is probably why you have a lack of responses. Many of us would not be here if we knew the answer to stopping clenching.

There were some threads about the grind-alert if you search the threads you should be able to find them. Some people grind more with the upper nightguards as perhaps you do as you are grinding through them. A possible side-effect of anti-depressants (SSRI'S) can be clenching - I would search Zoloft on the internet and see if bruxism is listed as a possible side effect.
Anti-anxiety drugs rather than Zoloft might be a better choice for you. Elavil , an antidepressant, is said to help clenching for some at low doses at bedtime. It is an older drug so very inexpensive. However, there are more side effects that the newer antidepressants. Elavil has helped me. The NTI is designed to stop clenching, people have reported success with that device; however some developed an open bite from it. Biofeedback is another option. If you are clenching during the day, try to remember -lips together, teeth apart, tongue resting on first half of your palate. Relaxation exercises before bedtime can also help - yoga or deep breathing exercise. Also,stopping caffiene and/or nicotine intake in the evenings could help if you are a user of either of those.

Good luck to you, I hope you find the answer - as we all hope we do. Personally for me it has been yoga, and Elavil.

Ann

Last edited by Ann123; 02-15-2005 at 08:38 AM.

 
Old 02-15-2005, 11:56 AM   #4
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Re: Excessive Clenching/Grinding Cause of TMJ - can anyone advise?

Ann, thank you so much for your knowledgable response. You are very sweet. Just having someone take the time to reply makes me feel better. I looked online for the Zoloft bruxing connection as you suggested and it was confirmed that one of the side effects is indeed bruxism. I must confess that I am afraid of changing my antidepressent Zoloft. I think back to how I felt before the Zoloft and am terrified that the debilitated anxiety/depression feelings will resurface if I try to alter or change drugs. That of course makes me feel weak and dependent. Did you take Elavil first for depression or as a potential control for clenching/grinding? I ask as I am wondering if the Elavil alleviated your depression/anxiety.

So I guess my best options are to keep the Zoloft and try a biofeedback (grindalert, oral sensor, etc.), or try the Elavil or maybe lower the Zoloft dosage. I would like to hear someone who has tried a biofeedback but again, if it has worked they are probably no longer here.

Ann is your TMJ under control (I hope)? How long have you struggled with it and do you know if there are long term effects aside from pain to having it? (Jaw problems, etc?). It's really scary. I'm 26 and I already feel like i'm stuck in a vicious circle (take medicine for depression/anxiety which causes TMJ which causes pain, depression and anxiety which requires medicine which causes tmj... etc, etc, etc). Did/do you ever feel that way? I never knew there were so many people out there that dealt with this (until of course I started having symptoms) and my heart goes out to you. Thank you again for your response and advice and god bless you.

 
Old 02-15-2005, 02:13 PM   #5
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irys HB User
Re: Excessive Clenching/Grinding Cause of TMJ - can anyone advise?

You might want to look into seeing a chiropractor/massusse for some relief. I've been seeing a chiro for almost a year now and my problems have reduced somewhat, but only a little. It's helped relax me either way, and when I would clench/grind my shoulders and upper back would become rock hard with stress. They don't do that as frequently now, though now I think I'm dealing with a more muscular TMJ rather than specific joint problems..

 
Old 02-15-2005, 03:56 PM   #6
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Re: Excessive Clenching/Grinding Cause of TMJ - can anyone advise?

Talk to your doctor and see if you can try a benzodiazepine type drug for nightime use, like valium, xanax or ativan. These help reduce clentching and may provide some relief.

 
Old 02-15-2005, 05:46 PM   #7
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Re: Excessive Clenching/Grinding Cause of TMJ - can anyone advise?

I can sypathize with you-went thru same thing, Thank goodness I just started working at an orthodontic office when all this happened. There are so many symptoms that can go with TMJ problems. I had migrains, pain, popping, clicking, muffled hearing in my ear and it was all from TMJ. I did wear a splint for some time, that helped alot-it is not that it stops you from grinding but It allows you jaws to slide on the acrylic (flatter surface) instead of your teeth being locked toegther. It realy is hard to describe in words how it all works effectively. If a splint is made correctly it is a great help. I also see a chiropractor and she is a tremendous help too. good luck

 
Old 02-16-2005, 07:39 AM   #8
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Smile Re: Excessive Clenching/Grinding Cause of TMJ - can anyone advise?

All of you are so sweet.. thank you for your invaluable input. It's a tough thing and even tougher knowing what to do/try. It's also VERY frustrating when the medicine you take for depression seems to be causing the TMJ which causes depression! Having you here to understand, sympathize and provide advice and support is half the battle. I thank you all!

 
Old 02-17-2005, 10:06 PM   #9
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Re: Excessive Clenching/Grinding Cause of TMJ - can anyone advise?

Quote:
Originally Posted by MonkeyKitty
Did you take Elavil first for depression or as a potential control for clenching/grinding? I ask as I am wondering if the Elavil alleviated your depression/anxiety.

.
HI Kitty,

No I did not take the Elavil for depression. That would be a much higher dose than I take. I am on a low dose for the bruxism. I don't think docs prescribe it much for depression anymore as there are more effective options.
You could ask the doctor about a non-SSRI anti-depressant.

I still struggle with some tmj symptoms but it is much better. I think it is important to treat it so it does not get out of hand. I have a night splint made by an oral surgeon which is a flat plane but with little "hills" to keep me from grinding on my back molars which is where I feel the most pain.

Try some of the suggestions given here, they should help. Take care and try not to worry about it too much.

Ann

 
Old 02-20-2005, 10:16 PM   #10
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Re: Excessive Clenching/Grinding Cause of TMJ - can anyone advise?

I have been watching this post, and decided to give the Elavil a try. I was prescribed Zoloft about 6 months ago for depression. Of course, most of my depression was due to the fact that I was in constant pain from tmj, but my regular family practitioner thought it would help anyway. When I went in to my tmj specialist a few months later, he warned me about the Zoloft, but I was so amazed at the results with the depression, I was afraid to get off of it. However, it's now been almost 3 weeks since my surgery, and I find myself clenching all the time. I wake up in the morning in even more pain than usual, so I know I'm grinding. I have an NTI, but since the surgery, it has added to my pain. So, tomorrow, I start Elavil. I had to slowly wean off Zoloft so my body could handle it. I will keep you posted on how well the Elavil works compared to Zoloft. And, Ann, thanks for the advice.
Tandy
p.s. another great thing about Elavil, it's tons cheaper than Zoloft! Always a good thing.

 
Old 02-27-2005, 10:15 PM   #11
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Re: Excessive Clenching/Grinding Cause of TMJ - can anyone advise?

Hello!
Do you think you could have been a grinder before you began taking the antidepressant meds? I was a heavy grinder yet I never knew it until I got in with a really good Oral Surgeon. I tried the bio feed back and got NO results from it but maybe someone else in the group had or knows someone who had a positive result from it. I to would grid holes in my guards until the dx started making them out of acrylic (not sure about the spelling) the same material they make fake nails out of, then I stopped putting holes in them. I stopped grinding once my jaw joints were takin out and did not grid for almost three years until I had my implants put in then I started up again. I do self affermations before I go to bed at night, I talk to myself and remind my body and jaws that it is NOT good for me to grind and it is hurting me and I go through relaxation exercises right up until I fall asleep. I really do not know if this is working but my husband is not waking me up in the middle of the night any longer telling me to stop grinding. I hope you find some relief!
Shirlett

 
Old 02-28-2005, 10:24 AM   #12
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Re: Excessive Clenching/Grinding Cause of TMJ - can anyone advise?

Thank you Rubato, Ann, Shirlett.

Shirlett, i suppose it is possible that I was a grinder prior to the Zoloft and it's just now caught up to me. I'm really not sure, but it seems like everything i've been hearing is that Zoloft causes grinding? I also heard that type "A" personalities tend to suffer more b/c we are tensed up.

Rubato, please do let me know how the transition from Zoloft to Elavil goes. You said you have noticed that the Zoloft has made your clenching/grinding worse, but that your depression was most likely due to the TMJ to begin with. It feels good to know you can relate to being "afraid" to come off the Zoloft for fear of recurring depression. Was your depression bad or did you pretty much take it on the advice of your Dr.? I ask b/c I'm extra scared to abandon the Zoloft -- I would say (for me) the depression was much worse than the TMJ, if you can compare such a thing. I have also heard that once you get off some AD meds, if you become depressed and try to get back on them AGAIN, your brain doesn't respond as well as it remembers the medicine and builds up a tolerance against it. My question to you Rubato is how did you come off the Zoloft? Did you just shave some off the pill each time or take less dosage or what?


Thanks again everyone... you're the best.

 
Old 02-28-2005, 01:25 PM   #13
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Re: Excessive Clenching/Grinding Cause of TMJ - can anyone advise?

Hi. So far, so good with the switchover. I did 4 days of half tablets on the zoloft before I switched. I noticed some mood switch around day 3 or so, but not as bad as I thought it would be. Another thing about Zoloft that I liked was that my anger was lessened. I have a bit of an issue with that, and it was a lot better with Zoloft, so that's the thing that started to change. Elavil seems to be taking care of all of that for me. Plus, it helps with pain a bit. Some people actually take it for pain. I take one tablet at night, and a muscle relaxer because I was having some muscle issues after the surgery, and I am sleeping straight through without waking up in pain. I am so relaxed, instead of clenched, that I am sleeping on my bad side. But, even waking up that way, my jaw isn't as tight as it was. I'm going to go to bed tonight without the muscle relaxer to see what happens. I know that my depression is totally in control right now. But, I can't say whether it's from Elavil or because I'm on the road to recovery. I think it might be worth it for you. What's the worst that can happen? It doesn't work and you have to go back on Zoloft. If you're anything like me, I know that it's a scary thought. I remember what I was like before I got on Zoloft, and don't want that again. But, so far, to wrap up a VERY LONG answer, yes, the Elavil is working!!! I hope you're able to figure out what to do. Good luck.
Tandy

 
Old 03-16-2005, 10:10 AM   #14
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Re: Excessive Clenching/Grinding Cause of TMJ - can anyone advise?

There are a few threads about biofeedback, and the grindalert device -
one was titled: brux-care Grindalert
another: Anyone tried Grind Alert??
another: home biofeedback device

Basically no one has said that it's helped or been successful, only that it keeps them up at night so they wake up tired and unrested. There have also been complaints about the company (it's not really a 100% guarantee if they won't return your calls).
The methods I've found to be helpful are just basic stress-relieving activites, since grinding, for most people, stems from stress. It just makes sense to me to get to the root of the problem, instead of just fighting the symptom. It's like if a child sucks his thumb, you don't hit his hand every time. You find out why and try to find other ways to divert his behavior. Both behaviors are very similar - it's a way humans relieve stress orally (like smoking, overeating, chewing gum).

 
Old 03-16-2005, 01:50 PM   #15
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Re: Excessive Clenching/Grinding Cause of TMJ - can anyone advise?

Hi...I too take Zoloft and am deathly afraid to discontinue it. Life was at a standstill prior to the med (constant panic attacks.) Three years ago I came down with fullness, clicking, soarness and lots of vibration in my ear when I heard a noise. Then came the dizziness. And just as quickly as it started it stopped - three months total. An ENT said TMJ with severe arthritis in jaw. Well, it's bbaaaaccckkk. I hate this. I actually was thinking I might need to go up in Zoloft to help with anxiety that might help control the spasms. Who the heck knows? Reihki and accupuncture are my next options, I guess. I'm already doing the Ibuprofen/Klonipin/moist compresses thing around the clock. I have a 2 1/2 year old who I cannot and will not let down. Sorry, no major help here except the Zoloft understanding. I'm not ready to face that.

 
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