TMJ & Headaches
Have you ever suffered from a headache, earache, face, neck and back pain, or dizziness without ever really knowing the true cause of the pain? What you could be suffering from is Temporomandibular Joint Dysfunction (TMD).
Patients oftentimes try seeking a medical cure for their discomfort. Unfortunately, after years of unsuccessful treatment they learn to live with pain, often with the aid of medications. A known condition that accounts for a large percentage of these patients is Temporomandibular Joint Dysfunction (TMD). Many patients suspect they have a joint disorder because they hear clicks or pops in their joint when they open and close their mouth. Their jaws may have even locked when opening. However, symptoms, such as the pain mentioned above, can be associated with TMJ dysfunction, but they are not the disorder itself. Treating the source of the pain, not the pain itself is the goal of the treatment TMJ dysfunction.
The Temporomandibular joint (TMJ) is your jaw joint, which holds your lower jaw in place and slides and rotates when your jaw is moving. Muscles that connect your jaw to the skull which allow you to move your jaw forward, side-to-side, and open and close, surround your TMJ.
Additionally, the jaw joint and muscles are innervated by the Trigeminal nerve. This nerve is one of the most complex and powerful nerves in the human body. It is intimately associated with the TMJ and completely responsible for your jaw and tooth functions. It feeds sensation and function to your jaws, face, tongue, sinus, palate, eyes, teeth, and lips. The trigeminal accounts for over 40% of the brain’s processing. In other words, your brain spends over 40% of its energy trying to figure out what the trigeminal nerve is sending to and from it. Thus, it is not surprising that this nerve could be the one of the sources of your the jaw and headache pain.
The way your teeth fit together is called occlusion (a.k.a bite). Your TMJ, jaw muscles, and occlusion closely interact during everyday function. When they do not function together properly, or there is a problem with just one part of the system, a Temporomandibular disorder (TMD) can result. This term describes a variety of conditions associated with chronic pain that affect the TMJ and jaw muscles.
Sources of TMJ Dysfunction
There are several sources for TMJ dysfunction. When your teeth do not fit together in proper relation to each other and to your joints, your jaw will try to compensate and automatically shift to a new position. This is termed a malocclusion. Signs of malocclusion that we look for include clenching and grinding of the teeth, tooth wear, and muscle soreness. Pain can then be referred through nerve pathways to areas such as the head, neck, shoulders, and back. Certain conditions can aggravate TMD, particularly stressful situations in which many people tend clench and grind their teeth. This leads to overuse of the muscles and subsequent discomfort. Other conditions that can affect the health of the TMJ include trauma, disease, nutritional deficiencies and infections.
TMD Symptoms to Look For:
- Frequent headaches or chronic neck pain
- Jaw pain and tired jaw muscles more prevalent in the morning or late afternoon
- Clicking noise when you open or close your mouth
- Difficultly opening and closing
- Jaw pain when chewing or yawning; jaws have locked up
- Earaches or ringing in the ears without infection or other cause
- Clenching and grinding (increases with stress)
- Sensitive, broken, or worn teeth when no dental problems exist
- Teeth do not fit together
Diagnosis for TMJ Dysfunction
Diagnosing and treating TMJ dysfunction includes a complete examination of the TMJ, muscles and teeth. We ask each patient to complete a pain questionnaire. Models are made of your teeth and an x-ray may be taken of your jaw joint called a tomograph. We often use a technique called bimanual manipulation and a leaf gauge to determine the correct position of your jaw as your teeth come together. There are various treatment modalities based upon your diagnosis. The first line of treatment is to identify the source of pain: joint, muscles or your teeth. First, we may recommend that you wear an occlusal splint to help diagnose and treat your TMJ disorder. Our splints are custom fabricated to relate the upper and lower jaws and teeth to the correct positions. Once you have worn your splint for a specified period of time, treatment to permanently correct the problem is planned.
Treatment for TMJ Disorders:
- Occlusal splint – a custom fitted acrylic appliance that fits over your top or bottom teeth that allows your joint to move into its proper position relieving pressure and relaxing your muscles.
- Occlusal equilibration – conservative procedure in which the teeth are reshaped to correct a mild malocclusion. By eliminating certain interferences, a more ideal fit of the teeth can be achieved.
- Orthodontics – braces may be an option to permanently reposition teeth for a more stable bite.
- Restorative procedures – crowns or bridges may be necessary to restore teeth that are worn and replace missing teeth for improved occlusion.
- Joint surgery – last result in severe TMD cases, surgical correction may be required.
Please contact PDG for more information or to schedule a consultation!