Parafunctional habits are uses of a body part outside of its intention.
The term is mostly used regarding the mouth and oral habits. Examples of these habits include clenching, grinding, nail biting, cheek chewing, tongue thrusting, etc. These habits may be developmental in nature and occur in early life (tongue thrusting), or they are patterns we develop over time from external factors. One of the primary external factors that drives these, often subconscious habits, is stress.
Stress contributes to holding increased muscle tension and performing mindless activities with the mouth. These activities channel our internal feelings into a physical action. Not all parafunctional habits are driven by stress, but mindfulness and awareness are key components to addressing any oral habit.
The problem with parafunctional habits is, whenever you use something repetitively outside of its intended use, it is likely that tissue breakdown will occur. Let’s bring awareness to some of the top habits and what we can do about them!
Deep dive into a top parafunctional habit: clenching & grinding.
Bruxism is the technical term used for grinding your teeth, something which commonly occurs at night. Clenching also causes increased pressure on the teeth but it doesn’t necessarily involve the lateral movement of the jaw that wears down the teeth. Keep in mind though, clenching is dangerous to the health of your teeth as well. It can even cause cracking of teeth! Clenching and grinding are typically subconscious habits and we do not realize we are doing them. But, they are not limited to sleep only. Some people report clenching during the day, especially during times of increased stress or focus.
Why do these habits develop?
There’s no one exact answer. But, the most common reason is stress. The clenching and grinding becomes a physical presentation of pent-up emotion. This prevents us from being able to fully relax, even during sleep. And sleep is the one designated time of day we have for restoration. For some, the structure or our mouth/alignment makes us more susceptible to increased contact. For those in this category, the issue may never be fully resolved without a custom orthotic or orthodontic intervention.
Whatever the case, the mechanical factors contributing to the clenching must be addressed for full resolution. Here, I am referring to the muscles involved with the feeling of increased tension and occlusion in the jaw. These are primarily the masseter, temporalis and pterygoids.
In many cases, clenchers become much less susceptible to their habit once tension is released from these muscles with manual therapy techniques in physical therapy. Therefore, we improve the muscle health while at the same time reduce the tendency to perform the habit that contributes to the overactivity of the muscle. It’s almost as if the body feels less stress just by an improved state of muscle tension in the face. Therefore stress becomes less of a trigger for the clenching. Yay!
How to change parafunctional habits?
What we really want to know is how to get a handle on these oral habits to make lasting change. The first step to changing any habit is awareness. Start by paying attention to your daily oral habits and notice if you have any abnormal activities of the mouth. Because stress is the biggest contributor, stress management is key to making change. Whether that’s meditation, exercise, journaling, talking to a therapist, doing a hobby, or making sleep a priority, getting serious about stress management is so valuable for your overall health. It is especially helpful in reducing unnecessary muscle tension or the face/shoulders/neck/jaw.
Another important aspect is addressing involved structures with PT intervention as mentioned above. Dry needling of the muscles of mastication can be life changing for chronic clenchers. The most important thing is to get to the root cause so that you and your clinician can find ways to effectively treat the source for lasting change.
About the author:
Dr. Samantha Dove is originally from San Antonio, Texas and has recently moved to Cincinnati from Atlanta, GA with her husband Sam and their dog Koda.
She was a springboard and platform diver for the University of Texas at Austin and has been a Doctor of Physical Therapy for over 5 years. Dr. Dove treats all orthopedic conditions with special interest in the spine, chronic pain, vestibular, and TMJ/TMD populations. She has her Manual Therapy Certification through the University of St. Augustine (USA) and has extensive dry needling training with KinetaCore.
Dr. Dove highly values continuing education in a variety of physical therapy topics but has taken special interest in the CranioFacial courses through USA to advance her TMD treatment skills. Health and wellness are a natural interest of hers in her personal life including participating in activities such as yoga, running, gardening, reading, cooking, family walks at Eden Park and all things self care! She is very excited to explore Cincinnati and to be joining the team at Anchor Wellness Center!