I knew I was in trouble when the drill came out. “We’ve got an issue,” my dentist told me. “You’ve been clenching your jaw so hard you’re killing your tooth. Possibly multiple.” Killing?! Surely he was exaggerating: My dental records are historically cavity-free! And after a bout of COVID-era stress-grinding, I wear a night guard. “Pressure kills the nerve,” he explained, pointing at my X-ray and a cloudy molar interior. “You’ve been clamping down, probably at night, but also probably during the day. Were you aware of that?” Reader, I had a baby seven months before this conversation, and I read the news. Was I aware that I was tense? I sure was! I just didn’t think my teeth knew.
I’m not alone. Two partial crowns later, during a visit to my Los Angeles endodontist for the prescribed curative root canal required for a third, I learned that more and more patients are coming in with clenching and grinding calamities versus the traditional cavities that used to be the endodontist’s bread and butter. And then these patients are coming back. Since COVID, my endodontist had seen people cracking through fillings and crowns made out of material that’s supposed to be diamond-hard. He was considering offering masseter Botox injections to temporarily paralyze the largest jaw muscle for the worst repeat offenders. “I don’t think it’s a dentist’s place to give Botox, but I’m running out of ideas,” he told me.
In that, he is alone. It seemed that everywhere I looked, new businesses were cropping up to tackle the growing problem of our propensity to grin and bear it. A week later I was trying Emface, a high-intensity muscle-stimulation device that uses electromagnetic waves purportedly to retrain overactive facial and jaw muscles through a course of repeated sessions. What that looks like in practice is two stick-on pads attached to wires that cause your face to painlessly spasm for 20 minutes straight while you scroll on your phone. While I was lying there, a friend aware of my situation texted a link to a video of what appeared to be a woman being tortured but was in fact LeAnn Rimes getting her jaw worked on by a fascial maneuver coach. (These are experts in body work that targets the connective tissue which wraps around the body’s muscles and organs.) I watched the singer bawl hysterically in—I guess—relief while I twitched, supine, behind a scrim in a Beverly Hills store window. Perhaps this all sounds ridiculous? There was a time I would have thought so. But that was before. I emailed LeAnn’s fascia guy to see if they had any available slots. They did, but not many. “We’re shooting our new TV show!” a rep wrote back.
He wasn’t the only one who knew fascia. I enlisted sports medicine chiropractor Jenna Lagana, DC, for help. She specializes in performance rehab and has worked with multiple performing artists; singers, she told me, get jaw issues like baseball pitchers get elbow ones. Night guards intended to prevent grinding can sometimes compound clenching, she said. If presented with something to grip, even unconsciously, many jaws will. She assessed my situation manually: no clicking or popping or pain while chewing meant it wasn’t a joint problem, but my jaw muscles were tight and aggrieved from overuse—a soft tissue issue. She applied pressure at various points around my skull and shoulders and did a sharply painful but ultimately relieving maneuver inside the upper corners of my mouth to get the hyperactive muscles there to relax a bit.
Once her hand was out of my mouth, I asked what she thought about Botox—would that let me skip a future of painful manual maneuvers? “I do not recommend that as an option,” she told me. “It’s not viable, it’s not affordable long-term, and it’s not a solution at all. I’ve never met anyone who’s like, ‘Oh yeah, I got Botox one time and my jaw is totally better.’ What you need to do is find out what your stressors are,” a.k.a. what’s making me clench, “and how to mitigate those stressors and to improve the overall tone of your head, neck, jaw, all of that musculature.” She recommended twice daily gua sha along the masseter, preferably with heat. And, you know, trying to not clench. “When you catch yourself doing it, put your tongue behind your upper teeth,” Lagana’s wife, Natazia zu Stolberg, a licensed acupuncturist, offered on my way out the door. “Remember, your teeth aren’t supposed to touch unless you’re chewing!” I practiced on my way to the car and realized that my teeth were always touching—a long-held horror of appearing slack-jawed may be subconsciously working against me.
“Oh, that could totally factor in,” integrative and functional medicine expert Sarah Corey, ND, told me on a call later that week. “Think about the messaging we get” about being strong and unflappable: stiff upper lip, set your jaw, all of that. “People are stressed,” she said, and she pointed out that the jaw is historically a place where we feel the strain. Animals in high-intensity situations—being chased on the savanna, say—will physically shake or tremble as a stress response once they’ve reached safety; people who get a horrendous work email or are cursed out by a driver on the freeway don’t have anywhere to dump all of that cortisol and adrenaline. And not to stress anybody out further, but high cortisol suppresses your immune system and increases inflammation, both of which lead to things like quicker aging and poor long-term health outcomes.
“I think we need to look at this as not just what’s happening in that specific muscle,” Corey told me. “Are there things that you feel like you’re not saying or you’re holding back? Are there boundaries that we’re not creating? I think that’s a big one for women.” (To be fair, I hadn’t slept uninterrupted in over a month, but how was I going to lecture my baby about boundaries?) “When you’re stressed and worried you’re in sympathetic overdrive, which means you stop being able to rest and digest,” and your body can’t repair itself or reset its nervous system. Breath work, she advised me, is actually the only way we can force ourselves into the parasympathetic. (And it’s free!) She directed me to breathe in through the nose for four seconds, hold for seven, and exhale through the mouth for nine. (You don’t even have to count or hold, a breath work coach told me later, you just have to exhale longer than you inhale.) Corey also recommended significantly upping my intake of omega-3s for mood and joint health, and nightly magnesium glycinate for improved sleep.
So I had a plan. But what about the things that had already gone haywire? “Dr. Annie! She changed my life,” stylist and wellness fanatic Djuna Bel told me. Bel glows with a kind of rude Californian health and goes once a week for chiropractic adjustments, including of her jaw. At Glendale’s Healthwise Chiropractic clinic, Annie Issagholyan, DC, took a series of X-rays and measurements to show me that the problem was actually not in my head. It was in my spine. Nervous system dysregulation plus postural problems lead to a whole suite of dysfunctions, Issagholyan explained. Two thirds of the patients who come to see her are there because of jaw dysregulation, she told me, though the specifics can vary widely. “With temporomandibular joint (or TMJ) dysfunction, it’s very rare for just one thing to be the cause.” Poor sleep positioning plus “tech neck” (a forward tilt so-named because it aims the eyes downward at a device) was putting exponential volumes of pressure on my spine, which was showing up in my jaw, but also in my shoulders and hips.
Issagholyan built out a 24-session plan to course-correct, involving twice weekly visits in which I would be chiropractically adjusted, my jaw cold-lasered to promote cellular regeneration and my back muscles stimulated by electrodes. I would also do a neck traction exercise where I was yoked to the wall for 20 tilted squats. She would manually release the medial and lateral pterygoids, the small muscles inside my mouth, which were the worst offenders. She would also adjust my mid-back, where some shoddy form while baby-lifting was showing up, and finish by realigning my neck. On the way out after that first visit, I received ice packs for my face and was measured for a new, carefully designed pillow that promised to keep my head level.
I followed the plan. Results were tender but steady. I found myself newly aware of how I was positioning my head on my neck and holding my phone while I looked at it. I took my supplements and began and ended the day with intentionally deep breathing. And I realized one day that I was getting better. On one visit, Issagholyan painlessly snapped my head back and forth and, as the volley of pops of my neck vertebrae realigned, I felt something relax at the top of my skull; when I got off the table it took me a minute before I realized my teeth weren’t touching. Hours later they still weren’t.
Partway through the program, I asked what the future held. Was there ever a point when I’d be done? “We will get you stable,” Issagholyan said. But cured? It doesn’t work like that. “You don’t go to the gym for three months and then say, ‘There, I did it!’ ” A former dancer with a physical job in a very stressful world, she herself gets adjusted once a week and sees it as an important part of what keeps her healthy and able. “But maybe if life gets less stressful we won’t need all of this intervention.” For that, I won’t be holding my breath.