The mysteries of TMJ and what to do about it

Despite the millions of people who suffer from TMJD (temporomandibular jaw disorder), there really is only educated speculation as to its causes.

by Becky Coffield — 

Mention TMJ and almost everyone either knows someone who has the disorder, or they have it themselves. Despite the millions of people who suffer from TMJD (temporomandibular jaw disorder), there really is only educated speculation as to its causes. Even less is known about its cure.

The temporomandibular joints are small, hinge-like ball-and-socket structures on each side of the head that essentially connect the lower jaw to the skull. The lower jaw has rounded ends (condyles) that smoothly move in and out of these sockets. The surfaces of these bones are covered with cartilage, which prevents bone from grinding on bone. The surfaces are separated by a small disk which acts as a shock absorber.

Sixty-eight pairs of muscles in the face and jaw work to help stabilize this joint so that it moves smoothly to ensure speaking, swallowing, chewing, breathing and even keeping one’s head on their shoulders. For a person with TMJD, however, any or all of these movements can be extremely painful as the condyles become dislocated or the cartilage is excessively worn or stretched.

Researchers now divide the disorders of the temporomandibular joint into three categories. The first is myofascial pain, which is the most common. This pain is characterized by discomfort or pain in the neck, shoulder and muscles that control jaw function. Internal derangement of the joint is the second, meaning the jaw is dislocated, the disc is displaced or the condyle is injured. The last category is degenerative joint disease, such as arthritis in the jaw joint. (www.medic8.com/dental/tmj-disorders.htm)

Researchers have learned a great deal, but the causes of TMJD seem to be as varied as the people who suffer from it. Estimates of the number of people experiencing TMJ disorders fluctuate widely, ranging from 5 to 15 percent of the U.S. population to more than 35 percent. Women are more likely than men to develop this condition — and while excessive talking is not to blame, talking can cause pain in certain cases.

Amazingly, many suffering from a TMJ ailment seem to know the exact cause of their disorder. Some develop this condition due to facial or head injuries or from whiplash, others indicate that they developed TMJ pain after prolonged dental procedures.

The National Institute of Dental and Craniofacial Research is conducting a study to identify biological or genetic factors that may contribute to the disorder. Another recent study suggests a link to serotonin levels. While it would seem reasonable to blame the grinding and clenching of teeth for TMJD, ironically many people who grind and clench never experience TMJ pain. Arthritis certainly can be a cause, as can simply having tight jaw muscles due to stress. Overuse of the jaw is another possible cause.

You may be experiencing TMJ problems if your jaw clicks, pops, catches or locks when you open your mouth. Frequent headaches, neck aches, ear pain and ear infections are other indicators of TMJD. When the ear is affected, one may experience dizziness, lightheadedness, ringing in the ears, and a fullness or pressure on the eardrum. Pain from the jaw also can radiate down the shoulders, into the arms. Aches and pains may be experienced throughout the body as the jaw struggles to align itself.

Fortunately, most people suffering from TMJ disorder will recover without medical intervention. Others will recover but will continue to experience periodic bouts of pain or discomfort. Sadly for a few, the pain of this disorder will become an indelible black mark on the fabric of their lives. Those with osteoarthritis or rheumatoid arthritis in the jaw may never experience total recovery.

Whether your case of TMJD is fleeting or permanent, experts agree that one of the most important things you can do is ease the stress on the jaw joint, which can be achieved through dietary changes. This does not mean you must subsist on oatmeal, soup or pureed foods for six months to a year, even though it may take that long or longer for the jaw to fully recover. It does mean, however, that an easy-to-chew diet will be most helpful.

Other courses of action for improvement may involve physical therapy, chiropractic work, applying heat or icepacks, massage therapy, hypnosis and avoiding extreme jaw movements. Learning stress-reducing techniques is another possible treatment method, as well as short-term use of pain relievers.

Mouth guards are widely prescribed by many dentists, but one must remember that they are not a cure. They will help prevent damage to the teeth if there is evidence of excessive grinding and clenching, especially at night. Mouth guards do not, however, address the fundamental issue of why one clenches and/or grinds. For some people, wearing a foreign object in the mouth can exacerbate this problem, resulting in pain.

Be cautious with this disorder. More medical treatment is not necessarily better. Some dental experts urge that TMJD treatment be conservative and reversible. “Conservative treatments do not invade the tissues of the face, jaw or joint. Reversible treatments do not cause permanent, or irreversible changes in the structure or position of the jaw or teeth.” (ibid)

Always seek a second opinion if you are advised to use orthodontics to change your bite, or if crowns, bridgework or grinding the teeth down to balance the bite are recommended. “Scientists have learned that certain irreversible treatments, such as surgical replacement of jaw joints with artificial implants, may cause severe pain and permanent jaw damage. Some of these devices may fail to function properly or may break apart in the jaw over time.” (ibid)

TMJ disorder can be an extremely painful condition, one that can affect every moment of your life. Sleep can be disturbed, work can be compromised, activities are affected, and your dental health and overall health and well-being can suffer. Most of us want a quick fix; however, patience, time, a softer diet and stress management will go a long way toward easing the pain of this disorder for the majority of people who suffer from it.

Becky Coffield is the author of several books, including You Can Conquer TMJ: Ideas and Recipes. www.youcanconquertmj.com.

Reprinted from AzNetNews, Volume 26, Number 3, June/July 2007.