An aching jaw may sometimes be mistaken for a simple toothache or something as serious as a heart attack. If you experience pain or notice unusual sound (or “click”) in your jaw, consult a dentist or general physician for an examination. It could be a sign of a temporomandibular joint disorder (TMD). This condition affects the jaw muscles, nerves, and the joint itself. Pain may be experienced in the head, jaw, face, or neck.
The Temporomandibular Joint
The temporomandibular joints are located in front of the ears on both sides of the head. Unique in their mechanics, they connect the lower jaw to the skull and serve as a sliding hinge to move the lower jaw when talking or chewing. The articular disc separates the surface of the bones and prevents contact.
Symptoms of a TMJ Disorder
Symptoms associated with a TMJ disorder include pain on one or both sides of the face that lasts for days, months, or even years. Other TMD symptoms are:
- Unusual Sounds – The jaw might make a clicking, popping, or grating sound, but may or may not hurt. Unusual sounds in the jaw are a result of a displaced articular disc.
- Ear Pain – When ear pain occurs, you may suspect you have an ear infection. It could be related to inflammation of the joint or tenderness of the surrounding muscles. Pain caused by TMD is usually felt below or in front of the ear.
- Headache/Migraine – People with TMD often experience constant headaches or migraines. Your dentist can determine if these are a result of TMD and will provide an effective treatment plan to minimize symptoms.
- Locking or Limited Movement – The structure of the jaw joint is similar to a ball-and-socket joint, except the socket itself is movable. Sometimes the joint becomes locked or limited. If you have a TMJ disorder, the pain from a locked joint may cause difficulty when opening or closing your mouth.
- Morning Jaw Stiffness or Soreness – Clenching or grinding the teeth in your sleep can result in jaw muscle stiffness or soreness in the morning. This nightly habit can exhaust the jaw muscles and lead to discomfort.
- Difficulty Chewing – Any changes in your bite can make chewing difficult. You may even feel that your upper and lower teeth do not fit together properly. The shift in your bite could also be a symptom of TMD.
Your healthcare provider may recommend over-the-counter drugs like ibuprofen or acetaminophen for pain relief. Wearing a bite guard at night and doing exercises to strengthen jaw muscles may also help. For severe cases of TMD, surgery may be necessary.
What Causes TMD
Although trauma and wear and tear can lead to TMD, more studies are necessary to determine the exact causes. Current theories are that it’s due to hormonal, genetic, or environmental factors. The disorder is more common in adults 20 to 40 years old. Those with a rheumatologic disease, migraines, osteoporosis, or other health conditions that weaken bone or cartilage are most at risk.
Statistics show a higher prevalence of TMD among women, but those figures may be inaccurate. Dr. Nojan Bakhtiari, DDS (a board-certified TMJ and orofacial pain specialist in New York City) says that women may simply be more likely than men to seek medical treatment. However, studies show that menopausal women are more likely to experience a resurgence in TMD symptoms. Researchers are still looking into a possible link between female hormones and this particular jaw joint.
Possible causes of TMD include:
- Physical injury
- Autoimmune disease
- Dental surgery
- Infection
- Erosion or improper alignment of the articular disc
Diagnosing TMJ Disorders
A physical examination can determine if symptoms are due to TMD. To diagnose your symptoms, a dentist may do the following:
- Listen for any unusual sounds when opening and closing your mouth
- Observe range of motion in the jaw
- Press different areas around the jaw to locate the source of pain
- X-rays (if the dentist suspects a problem with the teeth), a CT scan (for images of the bones), or an MRI (for images of the articular disc)
- Arthroscopy (a minimally invasive procedure that involves inserting an arthroscope into the joint)
Treatment Options
In some cases, TMD symptoms may subside without treatment. If they persist, several options are available.
- Medication – Your healthcare provider may recommend a combination of medication with nonsurgical treatment options to alleviate pain caused by TMD.
- Pain Killers and Anti-Inflammatory Drugs – If over-the-counter medications do not work, you may need a prescription for stronger pain relievers.
- Tricyclic Antidepressants – While these medications are typically prescribed to treat depression, they can also be used to relieve pain.
- Muscle Relaxants – These drugs may be prescribed for a few days or weeks to relax the muscles affected by TMD.
- Therapies – The following non-drug therapies may also be recommended for patients with TMD:
- Oral Splints or Mouth Guards – People suffering from TMD may benefit from wearing occlusal dental appliances that are inserted over the teeth.
- Physical Therapy – Physical therapy treatments include moist heat, ice, ultrasound, and stretching exercises to help strengthen jaw muscles.
- Counselling – Educating patients helps to understand the different factors and behaviours that can trigger symptoms and how to avoid them.
- Self-Care – Proper self-care can successfully treat mild to moderate symptoms at home. Rest is highly recommended, along with the following:
- Avoid chewing gum
- Eat soft foods
- Avoid clenching the jaw or grinding the teeth
- Do gentle stretching exercises for the jaw
- Massage the affected jaw muscles
- Apply moist heat and ice alternately
- Surgical Treatments – When other treatment options fail to alleviate symptoms, your dentist may recommend surgical treatment, including:
- Arthrocentesis – This minimally invasive procedure involves the insertion of small needles into the joints to allow fluid to irrigate through the joint and eliminate inflammatory by-products.
- Injections – Injecting corticosteroid into the joint reduces painful symptoms of TMD. Also, injecting botulinum toxin type A (Botox) into the jaw muscles can ease swelling and pain when chewing.
- TMJ Arthroscopy – This open-joint surgery can effectively treat different types of the disorder. Compared to other open-joint surgical options, TMJ arthroscopy comes with fewer risks and complications.
- Modified Condylotomy – This surgical treatment option addresses the TMJ indirectly via the lower jaw (mandible). The goal is to increase space in the joint so it can move more freely.
- Open-Joint Surgery – If a structural problem is the root of discomfort and hasn’t been resolved with conservative treatments, an open-joint surgery may be recommended. This procedure repairs or replaces the damaged joint. However, it has more risks than other invasive options.
Severe and lasting TMD may affect quality of life. There are ways to manage pain and find relief by seeing a trusted dentist specializing in temporomandibular disorder.
For a trusted dentist in Oshawa, call Clearbrook Dental at (905) 434-4244 to book an appointment. Our team uses state-of-the-art dental care approaches and the latest technology to treat patients. Contact us to discuss how you can achieve the best dental health.