Temporomandibular Joint Dysfunction
by The Dentist Brisbane
Jaw joint arthritis check done each time at Bite Dental examinations.
TMJ Dysfunction - It's a Pain in the Jaw …
… and the neck, ear, temple or cheek! And what about those headaches?
Say hello to the temporomandibular joint (TMJ). It's a seldom thought-of but hard-working part of the body that allows us to talk, chew, eat, swallow and yawn. Let's discuss what's right with the temporomandibular joint, what happens when things go wrong with it and what we can do about it.
The Physics of the Temporomandibular Joint
The temporomandibular joint is located where the jawbone, or mandible, connects to the temporal bone that forms the side of your skull. You can easily locate it by placing your fingertips lightly on the sides of your face, in front of your ears. When you open your mouth, you can feel the rounded ends, or condyles, or the jawbone as they slide out the joint socket. The condyles will 'disappear' from your touch as they go back into the joint socket when you close your mouth. The smooth (we hope) , sliding action that you feel is made possible by a small disc of cartilage that lies between the jawbone and the temporal bone.
That little disc of cartilage absorbs a tremendous amount of force. The average bite force in humans is estimated to be 73 kgs, which is about the total weight of a typical adult human being. But that's just the force on whatever lies between your teeth as you bite down. Because the jawbone acts like a lever, and the joint serves as a fulcrum (remember your high-school physics?), the joint itself receives even more force. Fortunately, the cartilage disc lubricates and cushions this action, spreading the force out over the joint space and allowing us to keep on chewing. Without this cartilage, our poor TMJ's would quickly 'grind' to a halt!
When Good TMJ's Go Bad
Unfortunately, sometimes things go wrong with this complex structure located in front our ears. Trauma, for example from being in a car accident or getting 'socked' in the jaw, is one source of TMJ pain. If the cartilage becomes displaced - like a 'slipped' disc - it can put pressure on the nerves in the jaw while at the same time becoming less effective for absorbing the friction and pressures that come from using the jaw joint. In addition, the muscles that move the jawbone when it's being used can spasm and become sore, causing pain and tenderness. More causes of TMJ dysfunction include:
- Teeth grinding (bruxism), which often results from stress and commonly takes place at night, during sleep.
- Excessive gum chewing or fingernail biting, or simply 'biting off more than you chew' by taking large bites of food when eating.
- Poorly-aligned bite, which may result from ill-fitting bridges, crowns or other dental appliances.
- Arthritis of the temporomandibular joint.
Obviously, if your jaw hurts - especially in front of the ear - that's an indication of TMJ dysfunction
. The pain may be sharp and sudden whenever you bite or chew, or it may become a dull and constant ache. Sometimes the pain is so strong and so associated with the ear that patients seek out an ear specialist, convinced they have an ear infection. When this is thoroughly checked out and no infection is found, then the patient is referred to a dental specialist for diagnosis of TMJ dysfunction.
TMJ dysfunction can also produce a range of symptoms, such as:
- Popping and clicking of the jaw when opening and closing the mouth, as for talking, chewing, etc.
- Locking of the jaw, making it difficult to close - or,
- Difficulty in fully opening the mouth.
- Changes in the way the teeth align which each other, which can cause problems with the bite and even the gums.
- Frequent headaches or neck pain and stiffness.
Bringing Your TMJ Back into Balance
A number of treatments have developed for this all-too-common ailment, some of which have not been thoroughly approved or tested. Fortunately, with early detection, simple and safe treatments for TMJ dysfunction can be quite effective. Lifestyle changes such as moderate exercise, like 30 minutes of running several times a week, can reduce the stress that leads to night-time teeth grinding, jaw clenching or other psychologically-induced factors that put stress on the temporomandibular joint.
Other remedies suggested for treatment at the early stages include:
- Eating soft foods that don't require much chewing, to rest the muscles involved.
- Avoid chewing gum and excessive jaw clenching. Relaxation techniques may be helpful here.
- Use of prescribed or over the counter pain relievers and anti-inflammatory medications.
- Physiotherapy with a specalist jaw joint physiotherapist
- Moist heat can be applied several times daily to further relax the jaw.
- In the case of an injury to the jaw, ice packs can be applied soon after to prevent or reduce swelling.
Severe or chronic TMJ dysfunction requires a more intensive approach. A 'nightguard' may be made to prevent nighttime tooth grinding and thereby protect your TMJ from further stress or damage. Sometimes adjustments can made in the bite alignment by filing or polishing the tooth surfaces themselves. This leaves you feeling like you've got more 'space' in your mouth, and reduces the unconscious tendency to 'clench' or grind your teeth during the night.Finally, in extreme cases, surgery may be required to relieve the joint dysfunction.
As we've seen with so many other dental problems and issues, catching a problem early makes correction and treatment so much easier. The same thing goes with keeping our miraculously-constructed temporomandibular join working smoothly. At Bite Dental Studio, we do a thorough check for any dysfunction in the jaw joint at each examination visit. That's because we believe 'a stitch in time saves nine.'