If your jaw joint clicks or pops regularly, you need to consult your dentist right away. Though many people get used to living with their jaw making noise when they chew, these symptoms may indicate a more serious and permanent condition—TMJ dysfunction. Your TMJ may not be causing you any pain, but serious implications of the disorder were recently discussed in a current issue of Dental Health Magazine.
Temporomandibular joint disorder, also known simply as TMJ, can cause a number of problems for individuals with this condition. Early symptoms of TMJ include pain that is localized in the neck and head, headaches and clicking or popping sounds. Many times these noises are a result of the joint disc or cartilage having been displaced or dislodged to the front of the joint. As a result, when you open your mouth the condyle (the “ball” of the ball and socket joint) pops forward onto the disc, and then when you close the ball pops back off the disc, leaving “bone against bone” in the joint itself.
Sufferers of TMJ may find it painful to move their jaws, due to intense and persisting pain, and many times the problems are compounded by muscle spasms and cramps causing headaches and facial pain. If left untreated, these symptoms may get worse and lead to more problems, such as inflammation, perforation of the disc and degeneration of the bony joints themselves. Few people realize the seriousness of this illness when it first develops. With time, the conditions caused by TMJ can develop into osteoarthritis, a painful and serious condition characterized by irreversible damage to the joint bone.
TMJ Disorder Causes
Some people may have a genetic predisposition to TMJ, but more often than not, TMJ is caused by a behavior. People with perfectly normal jaw functioning have the ability to develop TMJ at any point in time. Symptoms that persist over time cause damage to the jaw, thus intensifying the effects of TMJ.
There are many causes of TMJ disorder, which include:
- Teeth Grinding—Patients often don’t realize that they’re grinding their teeth, due to the fact that it usually takes place at night during sleep. Nighttime teeth grinding is often noticed by one’s sleeping partner. Stress and anxiety may also cause one to grind their teeth at night. This is called “bruxing” or “bruxism”, and when it occurs at night it is referred to as “nocturnal bruxism”. Recently, there has been some research that indicates that nocturnal bruxism may be associated with Sleep Apnea , and that the teeth grinding and jaw movements are a subconscious attempt by our central nervous system to open the airway.
- Jaw Clenching— Much like grinding, many people clench their jaw during the day or when sleeping may develop TMJ as a result. Jaw clenching can also be the result of stress. This habitual clenching is unintentional for the most part, and most clenchers are unaware that they are doing it. You may have observed people whose cheek and chewing muscles will rhythmically bulge in and out during the day, and they are oblivious to their habitual clenching.
- Excess Chewing—Chewing too much and too often can increase your chances of developing TMJ. For many people, over chewing is a habit, such as habitual gum chewers. (My wife, for instance!)
- Over-opening your mouth—Opening your mouth too wide while you are yawning, sneezing or eating can cause a trauma to the joint capsule and ligaments that can cause you to develop TMJ.
- Holding your phone between your cheek and shoulder, habitually resting your chin on your hand or fist while sitting at a desk, or even habitually holding a pipe or cigar between your teeth– Sometimes just holding your head in a stressful posture, such as sitting in front of a computer for hours without getting up can overstress TMJ muscles.
- Sometimes your “bite” is “off”— either because of genetics, or missing or crowded teeth, or dental restorations (fillings or crowns) that don’t allow your teeth to fit together comfortably or your jaw to return to a comfortable place when you chew.
Treating TMJ Disorder
Treating your TMJ symptoms requires us to first understand what factors contribute to your developing the disorder. Sometimes it takes a little detective work and trial and error to determine your exact cause. There are several treatment options available for those with TMJ. These include the following:
- Most important, first consult with your Dentist—The first and most critical step you should take in figuring out whether or not you have TMJ is seeing your dentist. He can help you figure out what is causing your TMJ and put into place a plan of action for treating your TMJ. Your dentist may recommend a Bite Splint or an Occlusal Guard or similar removable oral appliance aid in treatment. Alternatively, if your bite is off, he may adjust or “equilibrate” your bite so your teeth fit together more comfortably. Many times a combination of these two procedures are performed. I am always available for consultation at my Southfield dental office at 248-356-8790.
- Stop the habit that is causing the problem—such as stop chewing gum, habitually eating chewy and hard food, holding your phone with your neck, holding a pipe between your teeth, resting your chin on your hand or fist — or whatever behavior is causing the problem
- Moist Heat—Use a hot water bottle or a wet washcloth in unsealed plastic bag placed in a microwave (Careful! Not too hot or you can burn yourself!!) placed over sore muscles 4-6 times per day are very helpful to relieve muscle spasms.
- Anti-inflammatories—800 mg Ibuprofen (Motrin, Advil, Nuprin) taken 3 times per day (with food if you have a sensitive stomach) is very helpful. Absolute maximum dosage is 3200 mg per day or 800 mg 4 times per day. Aleve (Naproxen Sodium) is an alternative to Ibuprofen. Check with your doctor or dentist before starting a regimen of these over the counter NSAIDS (non-steroidal anti-inflammatory medicines).
- Muscle relaxers—prescription muscle relaxers such as Flexeril or Robaxin are sometimes helpful for the short term.
Hope this has been informative and helpful!
That’s all for today, so until next time,
Mark W Langberg, DDS, MAGD