Connection between Eagle and TMJ/bruxism/clenching/tight SCM?

Hi all – I always feel like I ask the most random questions! But I was going back through old posts today, and I found one that mentioned potential relief of tight SCM muscles after styloidectomy, because the SCMs are trying to protect the ligament or something. That really got my attention. I have had horrible problems with nocturnal jaw clenching for years. I think it started as a side effect of Zoloft. But the first several years I was on it, it wasn’t a problem. But then my jaw locked open at a dental appointment, and since then EVERYTHING makes me clench. Medications, supplements, hormone replacements. Of course my jaw joints are trashed. And I’ve been through four rounds of splint therapy. I don’t clench too badly now if I’m not taking any medications. But my SCM and pteragoids, etc are still crazy tight.

Soooo, all that to ask – does anybody know if styloidectomy can impact nocturnal bruxism/clenching? Or does anybody have any experience with is? That might tip me toward surgery.

Hi Bopper,

More often it’s the clenching/bruxism that can potentially cause ES or add to ES symptoms than the other way around i.e. having surgery generally doesn’t stop clenching or teeth grinding. It can help with a tight SCM though as that problem can be caused by an irritated accessory nerve & ES can be the cause of that.

I speak from experience w/ the clenching/bruxism as I believe my very first ES symptoms started close to the time we had to have our dog put to sleep in 2009. I was clenching like crazy in my sleep due to the stress of that, & my hearing got all crazy in my left ear. It was diagnosed as “allergies” & I was told to take Sudafed (which of course didn’t help). I knew it had something to do w/ my tight jaw muscles, TMJ & clenching but it was 5 years later that the worst of my ES symptoms started & I was finally diagnosed.

Since I had surgery (2014/2015), I still struggle w/ clenching when I sleep or am stressed, but all my ES symptoms are pretty well gone now.

I’m sorry this isn’t what you wanted to hear. You’ll know it’s time for surgery if your symptoms become bad enough that you can’t do the things you love because of them.

I’m actually a bit curious to know it’s it’s possible that IIH from vascular eagles could cause clinching.

It doesn’t seem like a logical consequence of IIH, but many of the symptoms we get from ES are not “logical” so I can’t dismiss it as a possibility.

Hi Bopper,
I tend to agree with Isaiah although I do think they are tied together with one worsening the other.I have been dealing with TMJ worsening for years re: clenching/tight SCM. Lots of neck issues I think from whiplash in my late teens. I only recently found out I had significant bone loss in one TMJ side due to osteoarthritis causing a major jaw out of alignment / dysfunction. One side has been jamming back against the trigeminal nerve that has been the cause of major Temporalis muscle /skull pain that caused me to seek out a neurologist in 11/2020. I have been getting quarterly botox and steriod injections. The pteragoids were a definate target for botox. This doc suggested a possible Eagles and a month later a CT scan confirmed it with about 3.2 / 3.5cm. In April 2021 I had one side done causing a major TMJ flair (I was warned it could happen). It took a good 5-6 mths to calm down w/ injections. 2nd surgery was in Dec 2021. I’m about 4.5 mths out. Im generally feeling pretty good although a 3 hour stint at dentist doing 2 crowns caused a huge flair in TMJ. Ive only noticed the past 2 weeks some TMJ issues creeping up but not bad. I truely believe the botox and steriod injections help.
I bit the bullet and got fitted for a $2K special bite appliance last week to help realign the jaw. I also get another round of injections next week too as well as 1 more crown. I think I’m looking at a root canal in my future as well.I wont get the appliance for a few weeks so the jury is out on that one. I chose to do eagles surgery, then appliance (Ive tried them before many years ago). Im attacking this from all angles.
Surgeon mentioned after Eagles surgery #2 that my neck was really tight. If you follow the science behind acupuncture, dry needling and/or proliferan injections…the insertions of anything into tight muscles helps to disrupt muscle tension. I wonder if just by cutting a very tight neck open, it may have the same impact. Botox serves to paralyze the muscle in hopes of getting the muscle to release.
My TMJ doc told me about One theory of when you have calcified ligaments / elongated styloid process and your neck muscles become very tight, they clamp down on the calcifications causing pain.
I think it is a vicious cycle of both interacting with each other. My pain is substantially reduced overall since having surgery #2. I do know the eagles surgery is not going to correct the major jaw alignment issues and ongoing TMJ problems. The only medication I take is Zantax at night but only 1/2 dose. I hope to stop taking it after I start using the new appliance and the new round of botox and steroids. Ask me in a couple months.


@Snapple2020 Thanks for the reply. A TMJ flare after surgery! I hadn’t thought about that. That right there is enough to make me think twice about having surgery. Good to hear that, once it’s all said and done, you are doing better. I do think that there is something to the calcification causing muscle tightness. So complicated!

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