Bruxism and Clenching Can Increase Headache Pain

While there has been a recognized association between bruxism (grinding) and temporomandibular disorders, this has not been well-studied.

Clenching has been associated with anxiety disorders, and may be highly comorbid with migraine as well. The trigeminal nerve, which is associated with migraine, also innervates the masseter muscle, which is the muscle responsible for clenching the jaw. It is felt by many headache experts that activation of the trigeminal nerve—which happens in migraine—will result in activation of the masseter muscles during a migraine.

Awake bruxism – clenching during the day – is present in about 20% of the population, and is usually stress-related. Bruxism at night affects about 8% of the population, and has been classified as a sleep-related movement disorder.

Clenching is also a possible adverse effect of the SSRI antidepressants.

Clenching, grinding, or temporomandibular dysfunction (TMD) can trigger any type of headache, or make it worse.

If you have a tendency toward clenching, awareness of the condition can help you reduce clenching. Physical therapy and relaxation training can be helpful. If you have a tendency toward clenching or grinding, you should avoid chewing gum. Some people may benefit from an oral device. Read more about that in TMD/TMJ.

1. Lavigne GJ, Khoury S, Abe S, Yamaguchi T, Raphael K. Bruxism physiology and pathology: an overview for clinicians. Journal of Oral Rehabilitation. 2008;35(7):476-494.

by Christina Peterson, MD

updated January 10, 2012