by Alvin Ho, myofunctional therapist, Leeming clinic
“Brain fog” is one common complaint I hear when managing patients with jaw pain (also known as temporomandibular joint dysfunction, TMJ dysfunction or TMD). “Brain fog” is also something which often bothers patients with a history of anxiety, panic attacks, and symptoms of extreme or chronic fatigue.
Some common symptoms associated with “brain fog” include:
- Challenges with concentrating or focusing on tasks
- Memory issues, especially with short-term memory tasks
- Word-finding difficulty
- Slow/ sluggish though processing and reaction times
- Mental fatigue or feeling of being overwhelmed by daily tasks (usually out-of-proportion to the task difficulty)
Here I want to discuss some key mechanisms which could link “brain fog” with TMD, and what you should do if you are experiencing “brain fog”.
Why jaw pain (TMD or TMJ) can feel like brain fog
Jaw pain especially when persistent can keep activating the body’s sympathetic nervous system (also commonly known as the fight-or-flight response). This then inhibits the parasympathetic nervous system which is associated with the rest-and-digest functions.
When the body keeps on getting signals of pain incessantly, especially in the face and neck regions, anxiety and depression pathways in the brain are more readily accessed. This can worsen cognitive ability as well as negatively affect sleep function. With this combination, people often feel as if they were drunk or having a hangover and everyday simple tasks can feel completely overwhelming.
This manifests in research in three ways:
- TMD patients have worse sleep – this then leads to next-day fatigue and poorer cognition even in the absence of pain
- TMD associated bruxism (jaw clenching or grinding) is linked to altered sleep architecture – sleep studies often show increased instances of micro-arousals especially in the deep sleep and REM sleep stages which are key for restorative function in sleep
- Neurochemical changes in patients with TMD – some studies show altered white matter and pathway differences in TMD sufferers vs healthy controls. This may not show true “damage” but highlights how the brain can adapt to chronic signals of pain (also known as nociceptive load in the literature)
Does jaw pain directly cause brain fog?
TMD may not cause “brain fog” directly, but it can function like a switch. Essentially, persistent jaw pain can lead the body into an environment where sleep is negatively affected, which then leads to reduced recovery capacity and poorer immune function, which also can contribute to mood alteration. In this analogy, TMD may not be the mains power supply directly causing the “brain fog” but it is definitely a switch which facilitates the supply of power through.
While I do not fully understand the neurophysiological mechanisms behind the association, I do notice that many of my patients have their complaints of “brain fog” resolved as we are fixing the jaw pain issue.
What to do if you have symptoms
Foremost, there are many other conditions apart from jaw pain or TMD which could cause “brain fog”. It is paramount that you check in with your regular General Practitioner to establish that it is not caused by something more sinister.
If you are experiencing “brain fog”, here are some signs that it could be associated with jaw pain or TMD:
- Fatigue and “fogginess” most prominent in the morning especially when you first wake up
- Clenching or grinding your teeth when you sleep and often wake up with tight jaw muscles
- Waking up feeling unrefreshed even though you have been sleeping a good seven to eight hours with no apparent disruptions
- Jaw or ear clicking and popping
- Recurrent tension-type headaches behind the eyes or at the temples
- Ear fullness, ringing (tinnitus), and/or occasional light-headedness or dizziness when moving your head
- Short-term memory lapses or recent inability to focus on familiar tasks
If you have checked at least two or three of those items, I encourage you to get assessed for TMD and potentially seek treatment by clicking “book now” on your top right hand corner.
If you need further help or discussion around this matter, pop in to see me in Leeming. I am a trained myofunctional therapist and am qualified to help. Please book online or phone (08) 9313 7433.
