More Than 15 Percent of American Adults Suffer from Chronic Facial Pain
If you have pain or tenderness in your jaw, or persistent headaches or neck aches, you may be suffering from a temporomandibular (tem-puh-roe-mun-DIB-u-lur) joint (TMJ) disorder. For many sufferers of TMJ disorders (TMD), the dentist is a logical first stop in trying to diagnose and treat this problem.
The temporomandibular joint acts like a sliding hinge, connecting your jawbone to your skull. It lets you move your jaw up and down and side to side, so you can talk, chew, and yawn.
Signs and symptoms of TMD may include:
Pain or tenderness of your jaw;
Aching pain in and around your ear;
Difficulty chewing or discomfort while chewing;
Aching facial pain;
Locking of the joint, making it difficult to open or close your mouth;
Headaches and neck aches.
TMD can also cause a clicking sound or grating sensation when you open your mouth or chew. But if there’s no pain or limitation of movement associated with your jaw clicking, you probably don’t need treatment for a TMJ disorder.
The parts of the bones that interact in the joint are covered with cartilage and are separated by a small shock-absorbing disk, which normally keeps the movement smooth. We don’t know what causes TMD. Dentists believe symptoms arise from problems with the muscles of your jaw or with the parts of the joint itself. Jaw pain may occur on one side or on both sides, depending upon the cause.
Painful TMD can occur if:
The disk erodes or moves out of its proper alignment.
The joint’s cartilage is damaged by arthritis.
The joint is damaged by a blow or other impact.
Grinding or clenching your teeth (also known as bruxism), puts a lot of pressure on the joint.
Stress, which can cause you to tighten facial and jaw muscles or clench the teeth, is thought to be a factor in TMD. Even strenuous physical tasks, such as lifting a heavy object or stressful situations, can aggravate TMD by causing overuse of jaw muscles, specifically clenching or grinding teeth.
When to see a Dentist or Doctor
Seek medical attention if you have persistent pain or tenderness in your jaw, or if you can’t open or close your jaw completely. In about 90 percent of the cases, says the Delta Dental Plans Association, your description of symptoms, combined with a simple physical examination of face and jaw by your dentist, provides useful information for diagnosing these disorders.
What to Expect
You may be asked some of the following questions:
Is your pain constant or do your symptoms come and go?
Does any activity seem to trigger the pain?
Does your jaw click or pop when you move it? Is that clicking painful?
Is it difficult to open your mouth normally?
Tests and Diagnosis
During the physical exam, your doctor or dentist will probably:
Listen to and feel your jaw when you open and close your mouth;
Observe the range of motion in your jaw;
Press on areas around your jaw to identify sites of pain or discomfort.
If your doctor or dentist suspects a problem with your teeth, you may need X-rays. A CT scan can provide detailed images of the bones involved in the joint, and MRIs can reveal problems with the joint’s disk.
Treatments and Drugs
In some cases, the symptoms of TMJ disorders may go away without treatment. If your symptoms persist, your doctor or dentist may recommend a variety of treatment options. Many practitioners, especially dentists, are familiar with tried-and-true conservative treatment of TMD.
Your dentist might suggest a muscle relaxer to relax your jaw if you grind or clench your teeth. Taking over-the-counter or Nonsteroidal anti-inflammatory drugs (NSAIDs), like naproxen or ibuprofen, can relieve muscle pain and swelling.
A splint or night guard. These plastic mouthpieces fit over your upper and lower teeth so they don’t touch. They lessen the effects of clenching or grinding and correct your bite by putting your teeth in a more correct position. What’s the difference between them? You wear night guards while you sleep. You use a splint all the time. Your dentist will tell you which type you need.
Dental work. Your dentist can replace missing teeth and use crowns, bridges, or braces to balance the biting surfaces of your teeth or to correct a bite problem.
Relaxation techniques. Consciously slowing your breathing and taking deep, regular breaths can help relax tense muscles, which can reduce pain. Ask your dentist if you need physical therapy or massage. Also consider stress reduction therapy.
Lifestyle and Home Remedies
Becoming more aware of tension-related habits — clenching your jaw, grinding your teeth or chewing pencils — will help you reduce their frequency.
Avoid overuse of jaw muscles. Eat soft foods. Cut food into small pieces. Steer clear of sticky or chewy food. Avoid chewing gum.
Stretching and massage. Your doctor, dentist or physical therapist may show you how to do exercises that stretch and strengthen your jaw muscles and how to massage the muscles yourself.
Heat or cold. Applying warm, moist heat or ice to the side of your face may help alleviate pain.
If more treatment is needed, it should be conservative and reversible. Avoid, if at all possible, treatments that cause permanent changes in the bite or jaw. If irreversible treatments are recommended, be sure to get a reliable second opinion.
Sources: The Mayo Clinic, Web MD, Delta Dental
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