Clicking Eyelids and Teeth: What Signals Are the "Sinews" of the Face Sending?

When it comes to clicking eyelids and teeth, there is a popular folk saying that "a twitching left eye foretells wealth, a twitching right eye foretells disaster," which always seems to carry a hint of jest and mystery. However, from a clinical observation standpoint, eyelid twitching and the sounds produced by chattering teeth or jaw clenching are far more than simply "wealth" or "disaster." There is a widely circulated saying that "nine out of ten people have hemorrhoids," but if we consider abnormal sounds from the eyelids and masticatory muscles, perhaps two or three out of ten people will encounter this at some stage. In modern medicine, this is often classified as "orbicularis oculi spasm" or "temporomandibular joint disorder," but from the perspective of traditional Chinese medicine, it is more like a duet performed jointly by "loss of nourishment of the sinews and vessels" and "disturbance of wind-pathogens" within the body.

Why is it specifically the eyelids and teeth? On a single face, the eyes are governed by the liver, the teeth are the surplus of the bones and governed by the kidneys, and the muscles at the junction of the upper and lower jaws belong to the Yangming meridians. When these two seemingly unrelated areas produce sounds simultaneously, it suggests that the problem may not be local, but rather a shared imbalance in the body's "sinews" and "essence-blood." The logic behind this deserves careful examination.

I. "The Origin of a Hundred Diseases" in the Classics: Starting from Two Passages

"All wind-induced tremors and dizziness belong to the liver." — Huangdi Neijing · Suwen · Chapter 74: Discussion on the Most Important and Profound Theories

How should the character "tremor" be interpreted? What the ancients called "tremor" referred to involuntary shaking or quivering of a certain part of the body. Eyelid twitching is "movement," and teeth grinding and creaking is also "movement." Whenever there is this kind of involuntary movement, the first thing in Chinese medicine to consider is "wind," and the root of wind diseases mostly traces back to the liver. The liver stores blood and governs the sinews. The muscles of the eyelids, gums, and joints all require the nourishment of liver blood. If liver blood is insufficient, the sinews and vessels become like branches deprived of dew—stiff and dry—and at the slightest disturbance, they produce a "clicking" sound.

"Yang qi, when one is overworked, becomes hyperactive, and essence is exhausted... accumulated through the summer, it causes fainting." — Huangdi Neijing · Suwen · Chapter 3: Discussion on the Connection of Life with Heaven

This passage says that when a person is in a state of excessive worry and fatigue, yang qi enters a hyperactive, diffusing state, which in turn consumes yin essence. Applied to the context of clicking eyelids and teeth, it can be understood as: prolonged late nights, excessive mental strain, or physical exhaustion will deplete the yin of the liver and kidneys, leading to yin failing to restrain yang. When yang qi cannot be contained, it generates "deficient wind." This deficient wind stirs internally and manifests externally as involuntary eyelid twitching or friction sounds from the jaw joint during chewing.

In plain terms, this is like an old machine: if the lubricating oil (liver blood and kidney essence) is insufficient, the gears (joints and muscles) will grind against each other and produce abnormal sounds, along with idle spinning and jumping. Chinese medicine looks at this problem not at the surface of the machine, but at how much oil remains in the "fuel tank."

II. The "Cross-Departmental Cooperation" of the Yangming Stomach Meridian and the Jueyin Liver Meridian

From the perspective of meridian pathways, the eyelids and masticatory muscles belong to different meridians, yet they happen to form a yin-yang pair. The eyelids belong to the "flesh wheel," which in the five-wheel theory is attributed to the spleen and stomach; while the teeth and jaw joint are fortresses through which the "Yangming meridian" passes. The Foot Yangming Stomach Meridian begins at both sides of the nose, ascends to encircle the lips, has meridian pathways distributed near the jawbone, and enters the upper teeth. On the other hand, the Foot Jueyin Liver Meridian has a branch that separates from the ocular system, descends through the cheeks, and encircles the inner lips. The twitching of the eyelids and the clicking of the jaw happen to be caught at the junction zone between the liver meridian and the stomach meridian.

Chinese medicine theory points out that liver qi governs ascending and dispersing, while stomach qi governs descending and free flow. If the qi movement of these two meridians becomes "congested" or "locked in a stalemate" at this location, the manifestation is dysfunction of the small muscle groups of the head and face. Clinically, some people who grind their teeth or clench their jaws often present with dry mouth, bitter taste, distension and fullness in the hypochondriac regions, burning sensation in the stomach, or constipation—which in Chinese medicine is precisely evidence of disharmony between wood (liver) and earth (spleen) and abnormal ascending and descending of qi movement.

If at this point one focuses only on the teeth—grinding them down or wearing a dental guard—it is likely treating the branch rather than the root. The root of the problem lies in "wind" and "qi," not in the "bones." Of course, modern dental interventions have their own necessity and value, but from the perspective of Chinese medicine pattern differentiation, regulating the liver-stomach relationship and allowing the sinews and vessels to be re-nourished is the fundamental approach. Clinically, one must first distinguish whether liver blood deficiency predominates or Yangming stomach heat predominates, as the directions of regulation differ between the two.

III. Cold Wind Entering the Collaterals and Phlegm-Dampness Causing Trouble: How Many People "Fall Prey"

There is a type of clicking eyelids and teeth that quietly appears after exposure to cold wind or getting caught in rain. This situation is relatively common among people who spend long periods in air-conditioned environments or who do not keep their head and face warm during autumn and winter, and it is often accompanied by shoulder and neck stiffness and sensitivity to wind and cold. Chinese medicine holds that this occurs when "wind-cold pathogens" take advantage of weakness to enter, lodging in the meridians and collaterals, causing local qi and blood stagnation. Blood congeals upon encountering cold; congealing leads to obstruction; obstruction leads to spasm and tension of the sinews and vessels, and the eyelids and masticatory muscles emit sounds of protest.

There is another situation related to "phlegm-dampness." This type of person is usually somewhat overweight, or has metabolic problems such as high blood lipids or fatty liver. Chinese medicine says "a hundred diseases often involve phlegm." In people with a phlegm-dampness constitution, their meridians are like river channels clogged with silt—qi and blood do not flow smoothly. When wind pathogens carry phlegm-dampness upward to disturb the head and face, abnormal twitching of facial muscles results. These individuals often simultaneously experience heaviness of the head as if wrapped in something, expectoration of phlegm upon waking, a sticky sensation in the mouth, and unformed stools. At this point, the "clicking" sound is actually a signal of turbid phlegm causing mischief in the meridians and collaterals.

The key points for pattern differentiation between these two situations are: sounds caused by wind-cold lessen with warmth and worsen with cold; sounds caused by phlegm-dampness are often most pronounced upon waking in the morning, and the person generally feels foggy-headed. Clinically, if some individuals simultaneously present with eyelid puffiness or a heavy, achy sensation in the joints, they may belong to a state of combined wind-dampness, and simply dispelling wind is not appropriate—transforming dampness and unblocking the collaterals is also needed.

IV. Blood Deficiency Generating Wind: The "Clicking" Sound in the Dead of Night

Many people have this experience: during the day things are fine, but once nighttime comes and they sleep, their teeth begin grinding and creaking, and their eyelids also twitch, even affecting sleep quality. This phenomenon of no sounds during the day but sounds at night is often attributed in Chinese medicine to "blood deficiency generating wind."

Why is blood deficiency related to nighttime? Night belongs to yin, day belongs to yang. During the day, yang qi is on the exterior and can suppress the deficient wind within the body, so symptoms are not obvious. At night, yang qi enters the yin aspect, the body's defensive exterior force weakens, and the deficient wind within takes the opportunity to cause trouble. The liver stores blood; when a person lies down, blood returns to the liver. In people with blood deficiency, the liver's blood storage at night is insufficient, the fascia loses nourishment, and twitching and trembling movements easily occur.

Furthermore, blood deficiency is often accompanied by spleen deficiency. The spleen is the source of qi and blood production. If meals are irregular, or one excessively diets, or excessive worry damages the spleen, all can lead to insufficient generation of qi and blood. The "clicking" sound caused by blood deficiency is usually accompanied by sallow complexion, pale lip color, pale and brittle nails, scanty menstruation in women, and susceptibility to dizziness and palpitations. The core of this type lies in "nourishing"—nourishing liver blood and nourishing spleen-stomach qi—rather than simply calming the liver and extinguishing wind.

For this type, from the perspective of Chinese medicine theory, appropriately consuming some foods that nourish liver blood—such as animal liver, black sesame, and mulberry—may help improve the loss of nourishment of the sinews and vessels. However, the specific combinations and cooking methods must be determined by a licensed Chinese medicine practitioner based on individual constitution, and one should not blindly supplement, lest rich and greasy foods impair the stomach.

V. Four Directions for Daoyin and Lifestyle Regulation

When facing clicking eyelids and teeth, in addition to seeking pattern differentiation and treatment from a licensed Chinese medicine practitioner, there are several directions in daily life that can serve as auxiliary maintenance approaches. They do not act directly on the symptoms themselves, but rather adjust the relationship between "wind," "blood," and "sinews" at the root, so that the body no longer creates trouble.

From the perspective of dietary recommendations and restrictions, spicy hotpot, barbecue, and strong liquor—these pungent, warm, dry, and heat-producing foods—easily fuel the wind. Cold and raw foods, such as ice cream and iced beverages, damage spleen-stomach yang qi and aggravate qi and blood stagnation. Neither category is friendly to people with involuntary facial muscle twitching. One may appropriately favor foods that are soft, moist, and rich in collagen, as these ingredients help provide the body with the "base material" of yin fluids.

Regarding sleep-wake rhythms, nighttime is the period when the liver meridian is on duty, and when a person lies down, blood returns to the liver. If one habitually stays awake during the hours that should be spent sleeping, liver blood will be continuously overdrawn, and the problem of fascia losing nourishment will become increasingly severe. Try going to bed a bit earlier than usual and banish electronic devices from the bedroom. In terms of emotional regulation, "when overworked, yang qi becomes hyperactive"—long-term tension, anxiety, and perfectionist tendencies are invisible forces that consume yin essence. Relaxing through meditation, listening to music, or conversing with others is like extinguishing the fire of the body's "wind."

Regarding exercise and daoyin, special note should be made that massage or daoyin methods involving facial muscles must be determined by a licensed Chinese medicine practitioner based on individual constitution, and one should not attempt vigorous or complex operations on one's own. From a macro perspective, gentle and soft exercises such as walking and Baduanjin help qi and blood circulate and allow the sinews and vessels to be nourished. However, any exercise should follow the principle of slight perspiration without fatigue; profuse sweating will instead further deplete qi and yin.

Have you ever considered that clicking eyelids and teeth may not just be a local muscle problem? It may be the body reminding you: wind pathogens are knocking at the door outside, yin blood is sending an urgent distress signal inside, and your sinews and vessels are caught in the middle, at a loss. Beneath the myriad appearances, what Chinese medicine sees are meridian pathways and the rise and fall, abundance and depletion of essence-blood. Bringing one's gaze back from the "sound" to the fundamentals of the body—that is the starting point for restoring all of this to quietness.

References:

1. The original text of Huangdi Neijing · Suwen can be accessed at the Traditional Chinese Medicine Ancient Texts Database: https://tcmdata.cintcm.com/

2. World Health Organization strategy documents on traditional medicine: https://www.who.int/health-topics/traditional-complementary-and-integrative-medicine

3. Official website of the National Administration of Traditional Chinese Medicine: https://www.satcm.gov.cn/

orbicularis oculi spasm, temporomandibular joint disorder, blood deficiency generating wind, Yangming Stomach Meridian and Jueyin Liver Meridian, loss of nourishment of sinews and vessels

Eyelid twitching and jaw creaking may seem unrelated, but they both belong to the distress signals of the "sinews." Starting from the theories in the Huangdi Neijing that the liver governs the sinews and that overwork causes yang qi to become hyperactive, this article analyzes three common constitutions—wind-cold entering the collaterals, phlegm-dampness causing trouble, and blood deficiency generating wind—clarifies the qi movement of the liver and stomach and meridian pathways, and provides four dimensions of daily maintenance: diet, sleep-wake rhythms, emotions, and daoyin.

Related Knowledge Q&A