How it Started
My TMJ disorder story began one day as I was sitting in my car eating chocolate-covered pomegranate seeds, when I felt a shift and sharp pain in my jaw. I had never had an issue with my jaw prior to that moment. For weeks afterward, I was unable to eat solid food or eat around other people. Even sipping a smoothie was painful sometimes. My primary care doctor suggested over-the-counter pain relievers and several weeks of rest.
How was I supposed to rest my jaw? The jaw joint is essential for eating and speaking. For a professional singer and vocal instructor, it’s even more complicated. TMJ disorder can be exceptionally destructive to the lives of singers and other musicians and is one of the top two most common vocal dysfunctions worldwide. Often, TMJ disorders do not impair normal vocal function, but serious symptoms emerge under the demands of professional singing (Osman, 2023).
Singing – something that had always brought me joy, and on which my livelihood and identity depended – became physically painful. My voice teacher at the time understood what TMJ disorder can mean for a vocalist and provided support and helpful exercises, but beyond that I had little guidance on how to manage my symptoms. I talked myself out of auditions and even turned down opportunities, telling myself that I just needed time to rest so I could show up fully for my existing commitments.
For months at a time, I was able to control my symptoms and lifestyle well enough that no one would have known anything was wrong. It wasn’t easy to find providers willing to treat me, but once I did, I tried everything: physical therapy, nightguards, acupuncture, medications, orthodontic work. I was even scheduled for surgery at one point, which I didn’t go through with. I never stopped believing that eventually I would recover, just like any other injury in the past. In truth, that day has never come – and recovery has looked different than I once imagined.
New Direction
My experience with TMJ disorder was one of several factors that led me to change careers. I returned to graduate school to study clinical mental health counseling. At the same time, I had been saving for years for orthodontic treatment to realign my bite. My misalignment was considered complex and I found only one orthodontist in my area willing to treat me. I had to pay for it entirely out of pocket. I showed up for my first day of class at Rutgers University in my late 30’s with braces and rubber bands which my orthodontist made as discreet as possible.
My journey living with a TMJ disorder – experiencing the fragmented health system, with significant gaps in provider knowledge and support (of which I am only scratching the surface here) – inspired me to do my own research during my studies. Fortunately, during my final year, the counseling department allowed me to pursue an independent study on TMJ disorder and mental health.
What I Learned from My Research
While conducting my literature review, I came across studies linking certain Selective Serotonin Reuptake Inhibitors (SSRIs) with nocturnal bruxism (teeth grinding) (Gadd et al., 2024; Garrett & Hawley, 2018; Geniş & Hocaoğlu, 2020). I had been taking one of these SSRIs for years. These medications are sometimes prescribed to TMJ sufferers who clench or grind their teeth in an effort to decrease anxiety that may contribute to these habits.
By this point, I had completed my orthodontic treatment. With my bite realigned, I regained a lot of jaw function, yet I was still waking up every morning with pain and soreness. I had always thought of SSRIs as safe and thoroughly tested, which made it hard to accept the findings I was reading. After sharing the articles with my advisor and a peer, I decided anything
was worth trying and pursued a medication change. Within a few weeks, I consistently stopped waking up with jaw pain. It was the most significant improvement I had experienced in nearly 10 years.
All of my providers knew that I had TMJ disorder and that I was taking this particular SSRI – and none were aware of SSRI-associated bruxism. If I had not pursued a graduate-level independent study, I might still be coping with this pain every morning.
Where to Go from Here
Now that I have begun working as a therapist in the mental health field, I hope to provide support to other individuals living with chronic pain and share what I have learned about TMJ with other clinicians. I am grateful for The TMJ Association for their commitment to advancing TMJ research, their advocacy for patients, and for taking the time to listen to me and be a support as I find my next steps.