Tackling Temporomandibular Joint Disorder
After a long night’s rest, you wake up in the morning and your jaw hurts. You have problems chewing and your lips don’t touch. You could have temporomandibular joint disorder.
Temporomandibular joint (TMJ) is a hinge point located on each side of the head where the mandible (lower jawbone) connects with the temporal bone of the skull. The bony surfaces are covered with cartilage and are separated by a small disc, which prevents them from rubbing against one another. The muscles that enable the opening and closing of the mouth serve to stabilize this joint.
When pain originates in this area the condition is called TMJ disorder. The TMJ is susceptible to diseases that affect other joints such as rheumatoid arthritis and osteoarthritis, or tumors.
When the mouth is opened and closed, the mandible moves forward and down. For normal jaw function, the left and right TMJ work together. If this movement is not coordinated a disc could slip out of position, resulting in dislocation of the TMJ.
Grinding of the teeth (bruxism), extreme jaw clenching and trauma to the face can lead to TMJ pain. In most cases, pain on the side of the face is not related to TMJ disorder. The dentist or doctor can examine you for certain symptoms that are characteristic of TMJ disorder. These include tenderness over the joint; a clicking sound or grating sensation when you open or close your mouth; the locking of the joint or joints, making it difficult to open or close your mouth.
In women ages 25 to 55, TMJ is often associated with depression, anxiety, sleep disturbances, gastrointestinal symptoms or frequent infection. An estimated 11.2 to 12.4 million U.S. adults in 2018 had pain in the region of the temporomandibular joint.
The TM joints are among the most complex joints in the body. When a person opens his or her mouth, the rounded ends of the lower jaw, called condyles, glide along the joint socket of the temporal bone at the side of the head. When the mouth is closed, the condyles slide back to their original position. To keep this motion smooth, a soft disc that lies between the condyles and the temporal bone absorbs shocks from chewing and other movements. Any problem that prevents the complex system from working properly may result in TMJ.
There are three common TMJ diagnoses: a muscular problem such as discomfort or pain in the muscles controlling the jaw; a functional problem such as a dislocated jaw or disc; or a degenerative joint disease such as arthritis in the jaw. The good news is all three respond well to treatment.
Keep in mind that TMJ is a cyclical condition and can flare up as a result of anything from a psychosocial event such as the death of a family member to a major change in diet.
In most cases, TMJ discomfort will go away on its own. But you can practice these prevention and management tips:
§ Apply warm compresses to the jaw to calm muscle spasms.
§ Take an over-the-counter anti-inflammatory medication to manage jaw pain.
§ Avoid chewing gum and eating hard foods.
§ Stop bad habits, such as clenching your teeth. Teeth should never touch unless you’re chewing food.
§ Avoid treatments that cause permanent changes to the bite or jaw. If an irreversible procedure is recommended, get a second opinion.
For stress management with TMJ:
§ Learn relaxation techniques.
§ Practice assertive communication.
§ Pay attention to daily mood swings, and learn to regulate anxiety.
§ Employ time-management strategies to avoid stress.
In the past, TMJ was more frequently treated by surgery to adjust the bite, but now conservative approaches are the standard. These include application of moist heat, jaw exercises, over-the-counter pain relievers and relaxation techniques.
