This article originally appeared on VICE Denmark.
A lot can happen to your body and mind after you've done a bunch of cocaine or MDMA. Some stuff is good – deep conversations with a friend, a new appreciation of ice lollies, the tsunami of serotonin that floods your brain with joy – while other stuff can be wildly embarrassing in hindsight.
But one common and not particularly charming side effect of both these drugs is that, in the midst of your high, you might start uncontrollably clenching your jaw and grinding your teeth. If it's been a very big night, you might still feel the effects of all that gurning the next day.
But what if that pain doesn't go away? Could it do irreparable damage to your jaw?
"My jaw started making this clicking sound for a while, not too long after I did MDMA for the first time," says Jonas, 27, who asked not to have his full name published. "I woke up with a sore face after a night out last summer, and then the clicking started. I've had hangovers, but I'd never previously experienced this before. I thought to myself, 'This is bad.'"
He thought it would go away eventually, but the state of his jaw continued to worsen – unsurprisingly, after another particularly heavy weekend. "I was eating a sandwich the next day, and all of a sudden my jaw made a loud cracking noise," he tells me. "I think it’s a consequence of doing drugs. I can currently only really chew with the right side of my mouth."
It's not exactly clear why people start gurning when they're on drugs – though it is known that MDMA causes a huge release of the neurotransmitter serotonin in the body, and studies on rats have shown that an MDMA-provoked serotonin release has a negative impact on the natural reflexes in the jaw.
"It's kind of like chewing on a wine gum for a while and then taking it out of your mouth. That's the shape it has now – you can't reverse it."
Lene Sandal, a Danish physical therapist who specialises in jaw conditions, explains how this clenching and grinding could do more damage than a sore face the next day. "The human jaw has two joints with discs inside, which ensure you can move your jaw without experiencing pain," Sandal says. "But when your jaw is strained, the discs can get stuck and you lose the ability to open and close your mouth. If this happens and it goes untreated, you risk permanently damaging your jaw, leading to osteoarthritis."
Sandal suggests imagining the jaw as two smooth pieces of wood with a rubbery eraser between them. When you chew, swallow or use your mouth in general, the two pieces of wood happily slide along the eraser, never touching each other. But if the eraser disappears, they only have each other to rub up against.
For a second opinion, I speak with dentist Per Styltvig, who is a leading expert in the field of occlusal function – or, put more simply, how teeth line up to bite things. Styltvig says he's treated many patients with jaw issues that seemed drug-related, and though he couldn’t confirm to me just how many drug users may suffer from it, he did agree that gurning can lead to more permanent damage and osteoarthritis.
"If the discs become crooked due to a clenched jaw, they will start to crack and, over time, this will add more pressure than your jaw can take," Styltvig explains. "That’s when osteoarthritis kicks in. In the long run, you might experience constant lockjaw, but it won’t kill you."
Sandal concurs: "The clicking sound is a sign that the discs are breaking down. And once they do, there's no going back. It's kind of like chewing on a wine gum for a while and then taking it out of your mouth. That's the shape it has now – you can't reverse it."
So what can drug users do to protect their jaw – aside from, you know, not doing drugs?
"You can't really do anything to protect your jaw while you're under the influence of drugs," Sandal tells me. "If you used a standard mouthguard or retainer bought over the counter at the chemist, you'll only make the problem worse. You can buy a custom-made retainer – but if you’re high and you experience violent jaw cramps, you run the risk of disjointing your jaw entirely. Also, you can’t really speak, drink or breathe properly through your mouth while wearing one of those. There are very few specialised dentists and therapists who can treat the pain, and your jaw will never fully recover."
But there's no need to panic just yet – it would take a lot of drugs consumed over a considerable amount of time to trigger that kind of irreparable damage. And if you experience some of the symptoms after one heavy night, it doesn’t automatically mean that you’re in trouble.
"Isolated incidences are not a big deal," Styltvig says. "And by isolated incidences, I mean when your jaw clicks but you don’t really feel any pain. If you start experiencing pain or constant lockjaw, that’s a sign that you should start worrying. Still, if you’re doing that many drugs, I don’t think the state of your jaw is your biggest problem."
This article originally appeared on VICE Denmark.