TMJ Problems

TMJ Problems: A Real Grind
Temporomandibular joint syndrome (TMJ), also known as temporomandibular disorder (TMD) or myofacial pain syndrome affects 60 million North Americans. It is twice as prevalent in women as men.

The temporomandibular joint is a joint in the skull, just in front of the ear, into which go the condyles (ends) of the lower jaw (mandible).

Symptoms
Sometimes this syndrome is mistaken for inner ear problems, neurological disorders and even tumor growths. Some of the common symptoms of TMJ are a "clicking" or "popping" sound when opening the mouth, the jaw shifting to one side when opening, headaches, earaches, stiff neck, dizziness, pain in the jaw muscles, limited jaw opening and facial pain.

Often these symptoms develop because of what we do to our teeth and jaws during periods of stress. The muscles that open and close our jaws become overworked and go into spasm. Much of the pain associated with TMJ comes from the muscle pulling on the bone to which it is attached. Contributing factors include bruxing (grinding) or clenching the teeth, as well as oral habits such as lip or cheek biting, protruding the chin, biting our nails and/or biting down on a pipe or pen resting in the mouth. Chewing gum or sucking on candy can be risk factors. Other habits can put abnormal pressure on facial muscles. These include holding the telephone between the chin and shoulder to free the hands, or resting the chin on the palm of the hand while sitting.

Treatment
First get a definitive TMJ diagnosis through a clinical examination, oral history of the problem, medical history, x-rays and study casts.

Treatment can vary depending on the risk factors, severity of the problem, condition of the bite and relationship of the jaws. Usually it is necessary to refrain from chewy foods such as bagels and pizza for a while. Of course, chewing gum is taboo. Sometimes the bite is adjusted (smoothed down). Certain mouth exercises and relaxation techniques may play a part. Often moist heat is applied to the back of the mandible or on the face, over the temporomandibular joint. Medication may be used to minimize the pain. If it is determined that you are grinding your teeth while you sleep, an appliance called a night guard can be custom fabricated to cover your teeth at night to absorb the force of grinding.

Most people get relief within a few days. If the problem has been longstanding, treatment will probably take more time. Just remember, it's not a life or death matter -- but it could mean some adjustments in your life style.