clenching

Clenching refers to tightly contracting muscles, most commonly the jaw or the fists, often without full awareness. It can be voluntary or involuntary and occurs in everyday situations such as concentrating, experiencing stress, or during sleep as bruxism when teeth are clenched.

In the jaw, clenching mainly involves sustained activation of the masseter and temporalis muscles, with little to no movement of the temporomandibular joint. Persistent clenching can strain the jaw and neck muscles and may contribute to temporomandibular joint disorders.

Health effects may include tooth wear, chipped or fractured teeth, tooth sensitivity, jaw and facial pain, headaches (especially in the temple area), and neck, shoulder, or back stiffness. Sleep-related clenching can disturb sleep for the person or their partner.

Diagnosis is typically based on patient history and a dental or medical examination. Signs include jaw tenderness, restricted jaw movement, and evidence of tooth wear. Nocturnal clenching may be observed by a partner or inferred from worn dental surfaces. In suspected sleep bruxism, sleep studies can be used in some cases.

Management focuses on reducing clenching and protecting dental tissues. Strategies include stress management and relaxation techniques, habit-reversal training, physical therapy, and the use of mouthguards or splints at night. Warm compresses and gentle jaw exercises may help some individuals. In some cases, botulinum toxin injections into the masseter muscles have been used under professional supervision to reduce clenching.

Prognosis varies; with appropriate management, symptoms often improve, though chronic clenching can require ongoing dental and medical care to prevent complications.