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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 masticate than 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—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 seven 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 quipped. “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 (a.k.a. Temporo-Mandibular Joint Disorder, or TMJ), excessive enamel wear and extreme bruxism—a.k.a. jaw-clenching. What, you might be thinking, have these conditions to do with multiple sclerosis? A group of researchers made a small preliminary study to rule out a connection with MS. Here’s how it went:

In 2010, a tiny cohort of 10 MS patients plus 11 non-MS patients serving as a control group were studied to quantify the change in intracranial diameter between the… surfaces of the temporal bones during jaw clenching, using an ultrasonic pulsed phase locked loop (PPLL) device… A sustained jaw clenching force of 100 lbs was used to measure change in acoustic wavelength (ÆL) as the measure of intracranial distance between the temporal bones. The increase in magnitude of bi-temporal bone intracranial expansion was approximately six times greater in subjects with MS compared to controls. Therefore, jaw clenching/bruxism is associated with more marked displacement of the temporal bones and expansion of the cranial cavity in patients with MS than in control subjects.1

Researchers used this significant difference between MS patients and the control group to postulate some other connections with MS as well. For example, we know that Vitamin D deficiency is a risk factor in developing MS. Vitamin D is also essential in metabolizing calcium, so a deficiency can decrease bone density, thereby exacerbating the increased distance between the two cranial plates.

What’s more, investigators surmise that an increase in temporal bone displacement can cause periventricular BBB (Blood Brain Barrier) leakage, thereby allowing lymphocytes to enter the cerebrospinal fluid and attack the white matter. This could characterize jaw clenching-induced temporal bone trauma/displacement as one possible “trigger” that can activate the disease in a person that is genetically predisposed to developing MS.

To take that idea even further, ICP (Intracranial Pressure) brought on by jaw clenching could also affect periventricular venous blood flow, causing iron deposits and lesions to accumulate in the white matter. This makes a tenuous connection to Chronic Cerebrospinal Venous Insufficiency (CCSVI).

The authors of this study express their uncertainty about whether bruxism (jaw clenching) comes first and activates MS, or whether active MS causes jaw spasms, TMJ and jaw clenching. Either way, however, they stress the importance of dentists paying close attention to TMJ and bruxism issues, considering it a possible red flag for the onset of MS.

This is why I think we’re gonna need a bigger boat. By that I mean two things…

… It’s a clear indicator that we with MS require an integrative medicine model for our health care. Info sharing between our dentists and neurologists is as important as that of our urologists, primary care docs, endocrinologists, rheumatologists, cardio-vascular specialists, gynecologists, pharmacists, and anyone else directly involved with our care. Study investigators also posited that there is some solid science behind the notion that tooth decay can activate MS. Therefore…

… 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 for sure how gum disease can directly cause serious heart damage if the patient isn’t treated with a prophylactic dose of antibiotic prior to having a dental procedure. Moreover, dental insurance coverage is not nearly as generous as medical insurance. Restorative procedures, gum surgery, root canals and abscess treatment are only covered at 50%. Our pocketbooks are empty enough as it is; I think we’ve all foregone 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 night time jaw clenching and teeth grinding? Gnashing your pearly whites at night has been noted as a familiar symptom among MS patients.

Have you had a discussion with your neurologist and/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.

This article represents the opinions, thoughts, and experiences of the author; none of this content has been paid for by any advertiser. The MultipleSclerosis.net team does not recommend or endorse any products or treatments discussed herein. Learn more about how we maintain editorial integrity here.

  1. Williams DE, Lynch JE, Doshi V, Singh GD, Hargens AR.Bruxism and Temporal Bone Hypermobility In Patients with Multiple Sclerosis. Cranio: The Journal of Craniomandibular Practice. July 2011; 29: 3.

Comments

  • HouseOfEnoch
    1 year ago

    Was this the breakthrough study that was ignored, buried, or misunderstood?

    I spoke with the principal author on the phone and he said any further investigation along these lines was mysteriously terminated by the manufacturer of the PPLL. After publication of this paper, the manufacturer inexplicably gave him the cold shoulder after a good working relationship during the study. When he attempted to purchase one of these devices for his own private use, they sold him a non-functioning lemon. Sounds like a powerful influence shut it all down. Was he getting too close to the truth?

    Here is a model of MS incorporating this study’s findings and many others:

    http://houseofenoch.com/diseases/multiple-sclerosis/

    Is MS even autoimmune at all? Doesn’t look like it.

  • HouseOfEnoch
    1 year ago

    I should add that our conversation took place years ago.

  • Hvcard
    2 years ago

    As practicing general dentist I’ve noticed that one of the first symptoms on undiagnosed yet patients is sudden dental occlusion ( bite) changes. They develop often pretty severe TMD ( temporomandibular disorder) symptoms. Sometimes occlusal guards we make don’t fit next day. Referral to check on MS usually confirms diagnosis. I cannot find much literature about it. Is there any research in this area?

  • alfdoc1
    2 years ago

    The principle investigator’s work (both published and not) is very unique in demonstrating a unique cranial bone/suture pattern in MS, ALS, PD, and Alzheimers, and there needs to be a broad multi-clinical (bypass corporate) study to elucidate what comes first. InterFACE is a group of skilled practitioners of varied backgrounds (dentistry, osteopathy, physical therapy, chiropractic, myofunctional therapy …) that have learned to abandon personal agendas for the sake of the patient (this is a bigger deal than one would think). We are working on examinations and monitoring technology to try to understand the underlying mechanism and sequencing. Our goals are to be able to both predict and prevent, as well as stop the progression of MS. Of course that doesn’t sound unique, but consider that this research and the anatomical findings are getting closer to the source than any other at this time. I say again: this is closer to the source than any other findings, and can explain why other (seemingly different symptoms, observations) are truly inter-related.

  • alfdoc1
    2 years ago

    We are hopeful that the pending CBVT from 3Shape Denmark will have the resolution to help us visualize the cranial bone, suture, cervical differences between these different types (MS, ALS, PD, Alz.) and non-symptomatic patients (we can’t really call them normies). That doesn’t solve the problem any more than an MRI, but it is much closer to the cause. At the same time, we are looking into gathering sleep data (HRV, Bruxism/clenching cycles, intensity), Pulse, O2, etc.) on these patient types.
    at this time it is tedious because we are doing it on our own ‘nickel’ and time.

  • DavidA
    3 years ago

    Hi everyone I know this is an older post but I was wondering if anyone out there stunned a link between TMJ disorder and MS? The reason I ask is because I know there is no knowncause of a mess but the link between TMJ D and MSseems like a possibility to me. My father and his father both died from brain tumors at young ages.so I get brain MRIs from time to time to make sure I don’t have a brain tumor. I got an MRI of my brain into thousand 14 and there were no lesions and new tumors. Then in December 2014I got a full set of the New Year’s because my wife works for a dentist and he gave them to us for free for Christmas that year.from January to March 2015, my veneers fell off every week and I had to go to this dentist to the three times a weekto get them re-cemented because walking around with no front teeth can be quite embarrassing. By March I dentist was so frustrated that he can get them to stay on so he ripped all the veneers out and shaved all my teeth down to put on crowns. My real teeth were not that bad at all because that’s a New Year’s were free I thought why not. But I ended up losing all my real teeth and now I have these ugly looking crowns. Anyways, when he did this he screwed up my bite in my occlusion which lead to severe TMJ disorder and for those of you who suffer from severe TMJ D you know the pain I’m talking about with the migraines and I pain, neck, shoulder, back pain, I can’t chew, can’t speak and so on and so on. The pain was so intense and the migraines were so painfulthat it started to affect my work performance. Then I started to lose my memory and cognitive function. I thought it was due to the TMJ disorder but in 2015in August I went in to get a brain MRI to see if maybe I had a brain tumor like my father.it came back with 20 lesions on my brain and 15 on my spine. So in 2014 I had no lesions on my brain MRI and then I got TMJ disorder with horrible pain in my head neck and back. And in less than a year I developed all these lesions and was diagnosed with MS. I can’t help but think that it was caused by the TMJ disorder. And I know there’s no causethat we know of for MS but I can’t help but think there is a link between the TMJ D and my MS. Has anyone else had this experience? I am so desperately looking for someone else who’s had the same thing. So please let me know so I know that I’m not the only one out there that thinks this. Thank you so much I really do love you guys and appreciate all your advice

  • north-star
    4 years ago

    Interesting– I have no idea if I clench my teeth, I do sometimes have deep neck and shoulder pain after a “good” nights sleep. I also bit down on something and my upper and lower teeth collided, I’m not sure how, but one tooth was chipped slightly.

    Very timely– I’m taking this article to my dentist, thanks! Is there any part of the body MS doesn’t screw up?

  • Grammy
    4 years ago

    Loved this article!! And totally agree that our dental health should play just as much a role in MS as other body parts do.
    I’m having dentures put in soon. My teeth are just breaking apart! My dentist (who’s also familiar with MS) wasn’t surprised. Our bones get brittle and function is greatly affected. So what are our teeth?! Yep! These little ‘bones’ do a lot of work. And I’m reassured by my dentist the extraction of my teeth and dentures will help me also with my lockjaw that comes and goes.
    Brilliant article! Thank you!

  • MaryG
    4 years ago

    I used to clench my teeth at night, and dream I couldn’t stop and my teeth were falling out. This started around age 13. When I was 20, I was diagnosed with TMJ and had two surgeries. It wasn’t until age 42 that I was diagnosed with MS. I keep trying to figure when the MS started, but cannot pinpoint anything specific. This link between MS and TMJ is quite interesting.

  • itasara
    4 years ago

    I found out I clenched my teeth in my early thirties. I’ve worn a night brace for over 30 years now. I did not find out I had MS til age 57. I may have had it earlier but had no difinite clue. It is hard to really now what the MS triggers are/were. Interesting study but not scientific enough to know for sure. I have children who have bruxism but they don’t have MS at least not yet. I know others who grind or grit at night and do not have MS. I don’t know if I ever had a Vit D deficiency or maybe i could have had a virus that was involved in influencing MS. But I do think that medicare should include dental as a preventative measure for many diseases, especially heart disease. Night guards can be pricey without insurance. I have never yet had a root canal and I have all my teeth except they were ground down a lot before I ever wore a night guard.

  • @masbrautigam
    4 years ago

    Yes i too suffer with jaw clenching but not every night.it started more in my 30’s when i already had MS but i have just been diagnosed 3 yrs ago.Had a few root canals too and i look after my teeth well?Eat healthy so makes sense

  • itasara
    4 years ago

    To Mascha- how would you really know if you do not have clenching all the time at night? I had no idea I did because when asleep one don’t always know. I did not but the damage was getting worse and I could not take that chance. My dentist at the time said to my question what do I do about it – nothing right now – so eventually I switched dentists and got a night retainer but I had already lost a lot of tooth mass and enamel. I prefer the retainers from the dentist but they’re also available at drug stores. You shape them to your own mouth structure. I have tried one or two and I do not like them myself.

  • Lisa
    4 years ago

    I’ve posited for quite some time that there was probably a relationship here. I’m glad to see that this small study was conducted. I do clench my jaw and have done so for years. I’ve also worn a night guard for years. Cavity-wise, my teeth are pretty healthy, but I’ve had to have more root canals than the average person. I asked the endodontist once if he thought there was a relationship, and he seemed to think it was reasonable of me to think there might be one since it’s all nerve related. I know how important dental care is for everyone and am quite frustrated that it is so separate in our healthcare “system.”

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