Dentist on Main Cape Town Rondebosch Observatory. Preventative Dentistry Man with Toothache

Jaw Pain

What are TMJ Disorders? And why do the cause Jaw Pain?

TMJ disorders are a group of conditions that cause pain in and around the jaw joint (called the Temporomandibular Joint or TMJ) and nearby muscles. Jaw problems affect a person’s ability to speak, eat, chew, swallow, make facial expressions, and even breathe. Approximately 10% of the population suffers from TMJ disorders, 90 percent of those most severely affected with chronic TMJ pain and dysfunction are women ranging from the teens years into their 50s.

What are the symptoms of TMJ Disorders?

Pain is the most common symptom of TMJ Disorders. TMJ pain is often described as a dull ache in the jaw joint and nearby areas, including the ear. Some people report no pain but have jaw dysfunction. Other symptoms can include:
• pain in the neck and shoulders
• migraine and/or chronic headache
• jaw muscle stiffness
• limited movement or locking of the jaw
• painful clicking, popping or grating in the jaw joint when opening or closing the mouth
• a bite that feels “off”
• ear pain, pressure and/or ringing in the ears
• diminished hearing
• dizziness and vision problems
Keep in mind that occasional discomfort in the jaw joint or chewing muscles is common and is not a cause for concern. Many people with TMJ problems get better without treatment. Often the problem goes away on its own in several weeks to months.
Recent research suggests that some patients with jaw problems also experience other painful conditions such as fibromyalgia, chronic fatigue syndrome, cardiovascular disorders, hearing problems, such as tinnitus, digestive and gastrointestinal disorders, vulvodynia, endometriosis, and sleep disorders.

What causes TMJ Disorders?

Not all causes are known. Some possible causes are injuries to the jaw area, various forms of arthritis, some dental treatments, your genes and/or hormones, an infection, and auto-immune diseases. Research has shown that TMJ patients can also be hypersentive to pain, which may explain why they may also have other chronic pain conditions.

How are TMJ Disorders treated?

Since most common jaw joint and muscle problems are temporary, lasting only weeks or months, simple care, such as hot or cold compresses and over-the-counter medications, is all that is usually needed to relieve the discomfort. Avoid treatments that can cause permanent changes in the bite or jaw. According to the National Institute of Dental and Craniofacial Research of the National Institutes of Health, TMJ treatments should be reversible whenever possible. That means that the treatment should not cause permanent changes to the jaw or teeth. Examples of reversible treatments are:
• Over-the-counter pain medications
• Prescription medications
• Gentle jaw stretching and relaxation exercises
• Stabilization splints (biteplate, nightguard) are the most widely used treatments for TMJ disorders. Studies of their effectiveness in providing pain relief, however, have been inconclusive. The National Institute of Dental and Craniofacial Research also states that irreversible treatments have not been proven to work and may make the problem worse. Examples of irreversible treatments are:
• Adjustment of the bite by grinding the teeth
• Extensive dental work
• Mandibular repositioning splint (changes the bite and jaw positioning)
• Orthodontics
• Surgical procedures including replacement of all or parts of the jaw joint
Complex cases involve chronic and severe pain and jaw dysfunction. Such patients are best treated by a team of specialists in such fields as neurology, rheumatology, pain management – all working together to develop an integrated care program.

Future Research

In recent years, The TMJ Association, Ltd. a national 501(c)(3) nonprofit patient advocacy organisation, has co-sponsored five international scientific meetings with the National Institutes of Health to address TMJ disorders. Details about these meetings and extensive information on TMJ disorders can be found on The TMJ Association’s website, www.tmj.org.
Long-term clinical studies are collecting data to identify genetic risk factors for TMJ disorders. The extent to which patients with TMJ disorders experience other chronic pain conditions is also an area of intense interest. For patients with severely damaged jaw tissues, advances in bioengineering may offer future benefits as new approaches have been developed to create jaw soft tissue and bone.

 

References:
1. Dworkin SF, Huggins KH, LeResche L, et al. Epidemiology of signs and symptoms of temporomandibular disorders: clinical signs in cases and controls. JADA. 1990; 120: 273-281.

2. Randal, J. (2007). A Systems Approach to the Understanding of TMJ as a Complex Disease. TMJ Science, 4(2), ii.

3. Aaron LA, Burke MM, Buchwald D. Overlapping conditions among patients with chronic fatigue syndrome, fibromyalgia and temporomandibular disorders. Arch Intern Med. 2000;160:221-227.

4. U.S. Department of Health and Human Services: National Institutes of Health. (Revised March 2010). TMJ Disorders. (NIH No. 10-3487). Washington, D.C.:Government Printing Office, 14.