Newsletter May 2026

Rethinking Classic TMJ Disorder

Classic TMJ disorder may not be a disease or condition at all. It is best understood as nighttime clenching — a normal part of sleep — that has become excessive enough to overload the muscles and inflame the joints.

This reframing matters. Clenching during sleep is increasingly viewed as physiologic rather than pathologic. It is common in children, many of whom outgrow it, and it tracks closely with normal sleep arousals and nervous system activation throughout the night. In fact, the International Classification of Sleep Disorders estimates that 85–90% of people clench or grind their teeth at some point in life, while only about 5% develop a clinical problem from it. In other words, most people clench. The question is how much, and at what cost.

When clenching intensifies — driven by stress, poor sleep, airway resistance, or obstructive sleep apnea — the downstream effects can be dramatic: headaches, temple pain, facial pain, perceived toothaches, ear pain and sinus pressure, morning jaw fatigue, and joint soreness. But the underlying story is simple: it is muscle overuse and joint inflammation from a normal behavior gone into overdrive.

Seen this way, classic TMJ disorder is not abnormal clenching. It is normal clenching that has become too much.

Warm Regards,