Assessment of muscles, joints and teeth
We palpate the jaw muscles, measure how far you open, listen to the joints and map the wear, cracks and cheek ridging that tell us how heavily you are loading your teeth.
About this treatmentDental condition · Wimpole Street, Marylebone
Jaw clenching: the silent habit behind sore muscles, headaches and worn teeth
Clenching is bruxism without the noise. Instead of sliding the teeth against one another, the jaw muscles simply squeeze, often for seconds at a time and hundreds of times a night, or through a long afternoon at a desk without the person having any idea they are doing it. The forces involved are large: the closing muscles can generate loads far beyond anything used for chewing, and they are applied to teeth, joints and muscles that were designed for brief, intermittent work. The consequences accumulate quietly. Muscles ache and shorten, morning headaches start at the temples, teeth develop fine cracks and their edges chip, fillings fracture, and the jaw joint becomes tender. Because there is no grinding sound, partners do not notice and patients are frequently surprised to be told. At Wimpole Street we look for the physical evidence, help you become aware of the habit, and protect the teeth from the forces we cannot fully switch off.
Recognising it
How it usually feels
Aching cheeks or temples on waking
The masseter and temporalis muscles have been working through the night.
A dull headache that starts around the temples or behind the eyes
Referred pain from overworked temporalis muscle, often mistaken for tension headache.
Teeth that feel tender or “tight” in the morning
Sustained compression of the ligament around each tooth.
Bulky, squared-off jaw muscles
Masseter enlargement from repeated loading, sometimes visibly asymmetric.
Fine cracks, chipped edges or fillings that keep breaking
Enamel and restorations failing under loads they were not built for.
Behind the symptoms
What's going on
- 01
Stress and concentration
Clenching is a physical expression of mental effort or tension. Many people clench while focusing at a screen, driving in traffic or working out, and daytime clenching is commonly the part patients can learn to control once they notice it.
- 02
Sleep arousals
Night-time clenching is linked to brief, partial awakenings from sleep, during which the jaw muscles fire. It is more frequent in people with disturbed sleep, snoring or sleep apnoea, and treating the sleep problem sometimes reduces the clenching.
- 03
Stimulants and medication
Caffeine, nicotine, alcohol and recreational stimulants all increase muscle activity during sleep. Some antidepressants, particularly SSRIs, are well documented to provoke or worsen clenching as a side effect.
- 04
Bite discrepancies
A high filling, a crown that meets first or teeth that have shifted can give the jaw an uneven landing, and some people respond by clenching to find a comfortable position. The evidence that the bite causes bruxism is weaker than once thought, but it can certainly aggravate it.
- 05
Posture and screen habits
Hours spent with the head forward over a laptop or phone alter the resting position of the jaw and load the neck and jaw muscles together. Neck tension and jaw clenching are frequent companions.
Before your appointment
What you can do today
- Practise the resting position: lips together, teeth apart, tongue lightly on the roof of the mouth. Set a reminder on your phone to check your jaw every hour during the day.
- Apply a warm compress to the cheeks for ten minutes in the evening and gently massage the muscle in front of the ear and along the jawline.
- Cut back on caffeine after midday and on alcohol in the evening; both increase night-time muscle activity.
- Avoid chewing gum, pen lids or fingernails, which keep the muscles primed.
- Stick to softer foods while the muscles are sore and cut hard items rather than biting into them.
These are holding measures, not a substitute for an examination. Use any pain relief exactly as directed on the pack and check with a pharmacist if you take other medicines.
In the chair
How we treat it at Wimpole Street
A custom occlusal splint
A precisely fitted hard acrylic guard worn at night spreads the load evenly, protects enamel and restorations from fracture and lets the muscles work at a slightly longer, more relaxed length.
About this treatmentHabit awareness and muscle training
Daytime clenching responds to conscious retraining. We teach a set of simple exercises and cues that most patients find reduce the habit noticeably within a few weeks.
About this treatmentMuscle relaxant injections
Small doses of botulinum toxin into the masseter muscles reduce their maximum force for around three to four months, which relieves pain and can slim an enlarged jawline. Suitable for persistent cases that a splint alone has not settled.
About this treatmentRepair of damaged teeth
Chipped edges are rebuilt with bonding and cracked or heavily worn teeth are protected with onlays or crowns, ideally once the clenching is being controlled so the repairs last.
About this treatmentBite review
Where a recent filling or crown meets before the other teeth, a minor adjustment removes the trigger. We are conservative here and do not reshape healthy teeth in the hope of stopping the habit.
About this treatmentFees
Costs to expect
An examination at Wimpole Street that includes a muscle and joint assessment is expected to be £95. A laboratory-made Michigan-type splint is indicative at £795, which includes the fitting appointment and one adjustment visit. Softer guards are cheaper but tend to encourage clenching in heavy bruxists, so we recommend them selectively.
Masseter injections are quoted after assessment and are typically repeated every four to six months if they help. Repairs to damaged teeth are priced individually: composite bonding from £395 per tooth and crowns or onlays from £995. A written plan distinguishes what is protective and what is restorative so you can prioritise.
Figures are indicative prices for Wimpole Street and are confirmed in a written plan once a dentist has examined you. Fees match our South Kensington and St Paul's clinics.
Don't wait if
When to see a dentist
- You wake with aching jaw muscles or a headache more than once a week.
- A tooth has chipped or a filling has broken without an obvious cause.
- Your teeth feel tender or loose on waking.
- The jaw is stiff in the morning or does not open as far as it used to.
- You have noticed your face looking squarer or one side bulkier than the other.
FAQ
Common questions
Clenching is silent, so hearing nothing proves little. The evidence is in the mouth: flattened or chipped enamel, cracks visible under a bright light, a ridge along the inside of the cheeks, scalloping of the tongue, tender enlarged muscles and sometimes small bony bumps along the jaw. Together these make a confident diagnosis.
It does not switch the habit off, and for some people the muscles work just as hard against it. What it reliably does is take the force off the teeth so that enamel and fillings stop breaking, and for many patients it reduces muscle pain by changing the jaw position slightly. Think of it as protection first and treatment second.
The temporalis muscle, which closes the jaw, fans across the side of the head above the ear, and when it is overworked it aches in the same way any strained muscle does. The pain is felt in the temples and sometimes behind the eyes, and it is often worse in the morning after a night of clenching.
Botulinum toxin has a long safety record in the masseter and is given in small, precise doses. Chewing strength is reduced for a few weeks, which most patients barely notice. Over repeated treatments the muscle slims, so the lower face can look narrower; some patients welcome that and others prefer to limit the dose, which we discuss beforehand.
Sustained compression can inflame the joint and, over years, contribute to disc displacement and clicking or locking. Not everyone who clenches develops joint problems, but joint tenderness or clicking alongside muscle pain is a reason to act rather than wait.
Marylebone, W1
Wimpole Street opens 1 October 2026
Leave your details and we will be in touch when the Marylebone diary opens. If the problem cannot wait, the same clinicians are already seeing patients in South Kensington and at St Paul's.
Related conditions
Opening 1 October 2026
Wimpole Street is not yet seeing patients. Until then, please book or call our South Kensington clinic on 020 7183 2362 or our St Paul's clinic on 020 7183 3709. Questions about the new clinic: wimpolestreet@md.co.uk.
Until we open
Need an appointment before 1 October 2026?
The same clinical team already works from two other Medical & Dental clinics. Book at either one now and, if you prefer, move your ongoing care to Wimpole Street once the doors open.
South Kensington
- 20 Old Brompton Road, London SW7 3DL
- Open seven days a week
- 020 7183 2362
St Paul's, City of London
- 5 Ave Maria Lane, London EC4M 7AQ
- Open Monday to Friday
- 020 7183 3709
