Jaws: TMJ, Bruxism, Their Relation to MS – And Why We're Gonna Need a Bigger Boat
In my mid-1960s youth, a jawbreaker was a newfangled kind of gumball that was not a regular on my candy store wish list. Every Saturday afternoon, I’d walk or bike up to Holliday’s five and dime in the quiet hamlet of Sylvania, Ohio, and buy penny candy, most of which was comparatively easy to chew compared to those hard-shelled, swirly-colored, mini-bowling balls with the soft chewy centers.
The first time I ever tried to break through the granite-like outer shell of a jawbreaker – initially by using my sharp incisors (to no avail) and then the crushing force of my molars – I heard a loud pop on the left side of my jaw followed by soreness that lasted the rest of the day.
In an uncharacteristic moment of child-stage common sense, I decided not to tempt fate again and stuck with the much safer Smarties, Sweetarts, chocolate coins, candy necklaces and buttons, Slo-pokes, colored wafer flying saucers, wax pop bottles, and Pixie Sticks. I wish that wise move could have prevented what would happen later on – and I don’t mean the 7 cavities I developed from eating all that sugar.
By age 12, I’d developed such severe molar sensitivity after eating lemon drops or drinking a Coke that I couldn’t bite down on anything for hours. My complaining prompted no particular interest from the adults in my life, nor any explanation from my childhood dentist. Then at age 29, during a first appointment with a new dentist, I was told my molars were worn down to the dentin, that soft, yellow layer below the enamel.
“You have the teeth of an 80-year-old,” he said. “Do you grind your teeth in your sleep?” It took every fiber of restraint to keep myself from sarcastically shooting back: “Dude, how could I possibly know that if I’m ASLEEP?”
By young adulthood, I had developed a popping, painful jaw (aka temporomandibular joint disorder, or TMJ), excessive enamel wear, and extreme bruxism (aka jaw clenching). What, you might be thinking, do these conditions have to do with multiple sclerosis? In a 2011 study, a group of researchers made a small preliminary study to rule out a connection with MS.
Research on jaw clenching and MS
The study included 10 people with MS plus 11 people without MS serving as a control group. The researchers used special tools to measure the difference between the temporal bones during jaw clenching. The temporal bones form the sides and base of the skull. They protect the brain's temporal lobe and surround the ear canal.1
They found that the difference between the temporal bones during jaw clenching was 6 times greater in people with MS compared to those without MS. Jaw clenching also expands the cranial cavity in people with MS.1
The researchers think that these bone issues caused by jaw clenching may cause leaks in the blood-brain barrier (BBB). This barrier regulates the movement of cells between the blood and the brain. A breakdown in the BBB can lead to nerve damage and MS symptoms. This means that jaw clenching may be one possible trigger that activates MS in a person who is already genetically predisposed to developing it.1,2
To take that idea even further, intracranial pressure brought on by jaw clenching could also affect blood flow to the brain. This may cause iron deposits and lesions to build up in the brain's white matter.11
The researchers also used this difference to make some other connections. They point out that many people with MS have low vitamin D levels. Since vitamin D deficiency can lead to reduced bone density, this could be another factor in jaw issues in people with MS.1
The authors of the study are unsure whether jaw clenching comes first and activates MS, or whether active MS causes jaw spasms, TMJ, and jaw clenching. Either way, they stress the importance of dentists paying close attention to TMJ and jaw clenching since they are possible red flags for the onset of MS.1
The need for a bigger boat
This is why I think we’re gonna need a bigger boat. By that, I mean 2 things.
It’s a clear sign that people with MS need integrative healthcare. Info-sharing between our dentists and neurologists is just as important as sharing between anyone else directly involved in our care.
Second, the study also found data to support the idea that tooth decay can activate MS. It’s high time that dental care is invited on board the big medical care boat. Conventional medicine and health insurance still won't sink their teeth into the idea despite the fact that we know how gum disease can directly cause serious heart damage if people aren't treated with antibiotics before having a dental procedure.1
Plus, dental insurance coverage is not nearly as generous as medical insurance. Restorative procedures, gum surgery, root canals, and abscess treatment are often only covered at 50 percent. Our pocketbooks are empty enough as it is. I think we’ve all skipped dental work at some point because we couldn’t handle the debt or cash outlay. Those days really need to end soon.
Some questions to ponder
Do you suffer from nighttime jaw clenching and teeth grinding? Gnashing your pearly whites at night has been noted as a familiar symptom among people with MS.
Have you had a discussion with your neurologist or dentist about which of your dental issues might impact your MS?
Jaws. It’s not just a scary movie. It’s one more body part to monitor in managing your MS.
Were you misdiagnosed with something else before receiving a MS diagnosis?