Mention “TMJ” to people, and almost to a person everyone either knows someone who has this disorder, or they have it themselves. Despite the millions of people who suffer from TMJD (Temporo Mandibular Jaw Disorder) there is mostly just educated speculation as to the possible causes of this disorder. Even less is certain about its cure.
The temporo mandibular joints are small ball-and-socket hinge like structures on each side of your head that essentially connect your lower jaw to your skull. The lower jaw has rounded ends (condyles) that smoothly move in and out of this socket when one eats, speaks, yawns, etc. The surfaces of these bones are covered with cartilage, so bone is not grinding on bone, and the surfaces are also separated by a small disk which acts as a shock absorber. Sixty-eight pairs of muscles in your face and jaw area work to help stabilize this joint so that it moves smoothly to ensure speaking, swallowing, chewing, breathing, and even keeping your head on your shoulders! For the person with TMJD, however, any or all of these movements can become extremely painful as the condyles become dislocated or the cartilage excessively worn or overly stretched.
Researches now divide the disorders of the temporomandibular joint into three categories: one is myofascial pain, and it is the most common. This pain is characterized by discomfort or pain in the muscles that control jaw function and the neck and shoulder muscles. Then there is of the internal derangement of the joint, which means 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. (See reference below.)
This much science knows, but the certainty seems to stop here. The causes of TMJD seem to be as variable as the people who have it. Actual numbers of people experiencing TMJ disorders fluctuate widely, ranging from five to fifteen percent of the population of the United States to more than thirty-five percent of people. Women are more likely to develop this condition than men…and no, excessive talking is not to blame, although talking can cause pain if one has this disorder!
Amazingly, many suffering from a TMJ ailment seem to know the exact cause of his/her disorder. Some develop this condition due to facial or head injuries because of blows to the head, jaw or face, or from whiplash A great many sufferers indicate that they developed TMJ pain after prolonged dental procedures. Could it be your bite? Maybe your spine is misaligned. Do you need orthotics in your shoes? Perhaps there is a genetic connection. NIDCR is conducting a study to identify biological or genetic factors that may contribute to this disorder. Another recent study suggests there is a link to serotonin levels. While it would seem very reasonable to blame grinding and clenching of teeth for TMJD, ironically many people who grind and clench never experience TMJ pain. Arthritis can certainly be a cause, as can simply having tight jaw muscles due to stress.
Overuse of the jaw is another possible cause. Excessive gum chewing, nail biting and gnawing on items like plastic straws can overtax the muscles of this joint.
You may be experiencing TMJ problems if your jaw clicks, pops, catches, or locks when you open your mouth, Frequent headaches, neck-aches and ear pain and ear infections are other indicators of TMJ joint disorder. When TMJ affects the ear, one may then experience dizziness, lightheadedness, ringing in the ears, and a fullness or pressure on the ear drum. (Perhaps you don’t need those antihistamines after all.)
Pain from the jaw can also radiate down your shoulders into your arms. Your teeth may not line up when you close your mouth, and you may not be able to open your mouth fully. In fact, the old song about the leg bone being connected to the hip bone, being connected to the back bone is an entirely appropriate analogy of TMJ pain. You may experience aches and pains throughout your body as your jaw struggles to align itself.
Fortunately, most people suffering from TMJ disorder will recover without medical intervention. Others will recover but will continue to have periodic bouts of the condition. Sadly, there are those for whom 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 joint may not experience total recovery either. Whether your case of TMJD is fleeting or permanent, experts agree that one of the most important things you can do is to ease the stress on the jaw joint, and this can be done through dietary changes. This does not mean one must subsist on oatmeal, soup, or pureed foods for six months to a year, and that is how long (or longer) it may take for your jaw to fully recover. It does mean, however, that a diet that is easy to chew will be most helpful for your condition.
Other possible courses of action for improvement involve physical therapy, chiropractic work, applying heat or ice packs, massage therapy, hypnotism, and avoiding extreme jaw movements (such as wide yawning, singing, gum chewing, screaming, etc.) Learning stress reduction techniques is another possible course of action, as well as short-term use of pain relievers. Mouth guards are widely prescribed by many dentists, but one must remember that mouth guards are not a cure for TMJ disorder. Mouth guards will help prevent damage to one’s teeth if one is grinding and clenching excessively, especially at night. Mouth guards, however, do not address the fundamental issue of WHY one is clenching and grinding. For some people, wearing a foreign object in one’s mouth can cause an increase in clenching and grinding and resulting 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 have orthodontics to change the bite, or crowns, bridge work or grinding the teeth down to balance the bite. “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 that can affect every moment of your life, not just when you’re eating. Sleep can be disturbed, work can be compromised, activities are affected (whether they be sports, exercise, singing, or playing wind instruments) participation in group outings can be affected, and your dental health as well as your overall health and well being can suffer.
Remember the old expression, “patience is a virtue, possess it if you can…” Most of us are sadly lacking in this virtue and want a quick fix, but patience, time, a softer diet, and stress management will go a long way in easing the pain of this disorder for the majority of people who suffer from it.