Banner. Girl flossing

simplesteps

IS IT YOUR JAW? A SYMPTOMS CHECKLIST FOR TEMPOROMANDIBULAR DISORDERS

Temporomandibular disorders can cause symptoms that are similar to other diseases.

Do you notice clicking or popping when you open your mouth? Is it difficult or painful to open your mouth? Does your jaw occasionally lock, so it is stuck open or closed? If so, see your dentist. You may have a temporomandibular disorder (TMD). These disorders include problems of the chewing muscles, the jaw joint (temporomandibular joint or TMJ) or both.

Here are some key symptoms linked to TMD.

Unusual sounds — Clicking, grinding or popping sounds when you open your mouth are common in people with TMD. Pain may occur at the same time. According to the National Institute of Dental and Craniofacial Research, researchers believe that most people with popping or clicking in the jaw joint have a displaced disk. But as long as there is no pain or problem with jaw movement, treatment may not be required. Grinding noises may be a sign of arthritis in the joint.

Locking or limited movement — The jaw joint is similar to a ball-and-socket joint. The jaw joint sometimes may lock in an open or closed position. A pad of tissue called the disk separates the jawbone from the skull. Locking occurs because the disk gets displaced. This may make it difficult for the jaw to glide out of the socket during opening. It may be hard to open your mouth because of pain. People with a lot of scar tissue in the joint from longstanding disease may also have limited opening.

"Ear" pain — You may think you have an ear infection, but ear pain may have another cause. It may be related to jaw joint inflammation or muscle tenderness. Pain from TMD is usually felt in front of or below the ear. Sometimes the pain resembles an earache.

Headaches — People with TMD often report headaches. Your dentist can help to determine if your headache symptoms are a result of TMD. A physician may need to diagnose and treat certain headaches not related to TMD.

Morning stiffness or soreness — If your jaw muscles are stiff and sore when you wake up, you may be clenching or grinding your teeth in your sleep. This can exhaust jaw muscles and lead to pain.

Difficulty chewing — A change in your bite —the way your upper and lower teeth fit together — can cause problems with chewing. This shift in your bite may be related to TMD.

Previous injuries and related conditions — A recent or old injury to the jaw joint can lead to TMD symptoms. Arthritis in the joint also may arise from injury. Arthritis in other joints may be a sign of rheumatoid arthritis which can also affect the jaw joint.

Others — Though the research is controversial, a feeling of fullness or ringing in the ears may sometimes be related to TMD. In these cases, you may need to consult an "ear, nose and throat" (ENT) doctor for a final diagnosis.

If these symptoms sound familiar, talk to your dentist. He or she will:

  • Examine your mouth and jaw
  • Test how well you can open and close your jaw
  • Examine other jaw movements
  • Feel the jaw joint and muscles for clicking, joint noises and pain or tenderness
  • Feel the jaw joint while you open and close it

X-rays are often taken to look at the jaw joint and surrounding structures to rule out other diseases. In some cases, a computed tomography (CT) scan may be needed to evaluate the area. It can show the bony detail of the joint. Magnetic resonance imaging (MRI) is often done to assess the health and position of the disk and bone.

It's a good idea to discuss any TMD symptoms with your dentist. However, occasional discomfort in the jaw joint and chewing muscles is quite common. Usually, it's not a cause for concern. It tends to get better on its own.

If you are diagnosed with TMD, the good news is that simple practices can relieve discomfort. These include eating soft foods, applying heat or ice packs and avoiding extreme jaw movements. Effective, conservative treatments include:

  • Soft diet
  • Nonsteroidal anti-inflammatory drugs (NSAIDS)
  • Muscle relaxants if you have muscle spasms
  • Biofeedback
  • Acupuncture
  • Physical therapy
  • Behavioral therapy including antidepressants
  • Oral appliances, such as an occlusal mouth guard designed to reduce tooth grinding and clenching

You should be aware that TMD problems can be caused by problems in the joint or related to problems in the muscles of the face that surround the joint. There are also many dental problems that can make it difficult to accurately diagnose TMD pain. These include dental cavities and cracked teeth. Medical problems that can be confused with TMD include migraine headaches, neuralgias (nerve pain) and sinus inflammation (sinusitis).

Occasionally dentists recommend adjustments of teeth (grinding of the enamel). This should be avoided as a management or prevention for TMD. If your general dentist is not successful in reducing or eliminating your TMD symptoms with conservative therapy, then referral to an oral surgeon should be done to further evaluate the jaw to determine if a there is a functional reason for your symptoms such as a disk derangement or a degenerative joint disorder.



Last updated November 20, 2020

 

References:

 

  • Zotelli VL, Grillo CM, Gil ML, Wada RS, Sato JE, da Luz Rosário de Sousa M. Acupuncture Effect on Pain, Mouth Opening Limitation and on the Energy Meridians in Patients with Temporomandibular Dysfunction: A Randomized Controlled Trial. J Acupunct Meridian Stud. 2017 Oct;10(5):351-359. doi: 10.1016/j.jams.2017.08.005. Epub 2017 Sep 22. PMID: 29078971.
  • Gauer RL, Semidey MJ. Diagnosis and treatment of temporomandibular disorders. Am Fam Physician. 2015 Mar 15;91(6):378-86. PMID: 25822556.
  • Ouanounou A, Goldberg M, Haas DA. Pharmacotherapy in Temporomandibular Disorders: A Review. J Can Dent Assoc. 2017 Jul;83:h7. PMID: 29513209.
  • De Rossi SS, Greenberg MS, Liu F, Steinkeler A. Temporomandibular disorders: evaluation and management. Med Clin North Am. 2014 Nov;98(6):1353-84. doi: 10.1016/j.mcna.2014.08.009. Epub 2014 Sep 22. PMID: 25443680.