Masks, Clenching and COVID, Oh My!

Posted by POS Course Adviser on 11/3/20 9:30 AM

This blog is kicking off the start of TMJ Awareness month!

What’s the hottest fashion statement in 2020? Masks are, of course! Whether it’s a homemade cloth mask, high-end designer mask, no-sew, with or without a filter, surgical disposable or Harry Potter reversible, people are expressing themselves with masks these days. In fact, thirty-three states and the District of Columbia mandate face-covering in public.

This new and necessary accessory may be helping us save money on lipstick, breath mints and razors, but as many people have started to notice, it is not natural to have our ears pulled on with tension for extended periods of time. As dentists, we are accustomed to wearing masks when treating patients, but most of us previously tossed them the second we got up from our chairs.

If your patients have noticed more frequent headaches, neck and jaw pain since the onset of the pandemic, rest assured it’s not “all in their head”. Dentists and physical therapists are hearing more and more complaints regarding aches and pains related to mask-wearing. Some patients are reporting new symptoms, while others who had previously-resolved symptoms are seeing them return.

Wearing a mask can actually place stress on the temporomandibular joint (TMJ), as the wearer may be tensing their jaw or holding it open and mouth breathing to keep the mask on. They may also find themselves clenching their jaw, (with or without the mask) due to the stressful time we’re all experiencing. The ear loops on some masks tend to pull down on the wearer’s ears, putting pressure on the disc situated inside the joint complex. And finally, the ear loops can pull the whole head forward, leading to poor posture and neck pain.|

Fortunately, we can give our patients some tips for managing and trying to prevent “mask-aches”:

1. Fit:
The phrase might be “fits like a glove”, but masks should fit just as snugly. A properly fitting mask should not slip up toward the eyes, as this can cause the wearer to clench or protrude the jaw to keep it in place. Adjustable straps or masks with ties are helpful in reducing the downward ear pull common with other styles. That pull can cause the trigeminal nerve to become excessively excited, causing pain and tension in the muscles, as well as temporal headaches.

2. Posture:
Advise your patients to check that they’re not sticking their head too far forward when wearing a mask. Teach them a simple chin tuck exercise: have the patient pull their head straight back, elongating the back of the neck to reset the posture. This can be repeated several times throughout the day.

3. Mouth:
To soften the jaw, have your patients practice TATU: teeth apart, tongue up. At rest, they should keep their lips together, but teeth apart, to avoid clenching. This will help prevent overworked jaw and facial muscles, which causes an accumulation of lactic acid and results in pain.

4. Stressors:
Patients who are experiencing jaw pain when wearing a mask should try to reduce any additional stressors to the TMJ. This includes gum chewing, nail biting, very chewy or crunchy foods.

Wearing a mask may be part of the foreseeable future, but it doesn’t have to be a pain. We can help our patients learn how to stay safe and comfortable at the same time.

Written by:
Suzie Bergman, DDS

Dr. Suzie has a special interest in Temporomandibular Disorders, and is teaching a series entitled Twenty-First Century TMD Protocols. She is involved with infrastructure initiatives for patient-generated data and digital health solutions.

November is National TMJ Awareness Month. If you would like to learn more about TMDs and the link to sleep disorders, check out our TMD courses on 



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Topics: Orthodontic News, Video, Dentistry during COVID-19, TMJ

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