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The temporomandibular joint is located just in front of your ears. If you place your fingers in this spot and open your mouth, you can feel its movement. When you open your mouth, the rounded ends of the lower jaw (condyles) first open like a hinge. As you open wider, they glide forward. To keep this motion smooth, a soft disc lies between the condyle and the temporal bone. This disc absorbs shock to the temporomandibular joint from chewing and other movements. Chewing creates a strong force. This disc distributes the forces of chewing throughout the joint space.
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When you have TMJ pain, often it comes from the muscles that operate your jaw. They can be stressed and can be in spasm. Pain can also come from damage to the disc, dislocation of the disc, or arthritic changes to the joint. It requires a great deal of expertise to diagnose the source of pain and then to treat it in these cases.
On the right is a photograph of a patient in TMJ pain. You can see the deep stress lines that come from the constant muscle tension that she is suffering. |
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Causes of TMJ Pain
Trauma is a frequent cause of these disorders. And there are two types of trauma that can occur, acute or chronic.
Acute trauma, also called macrotrauma, is from a single event. An automobile accident, a punch in the jaw, or a traumatic wisdom tooth extraction can all damage either the joint or the disc.
Chronic trauma, or microtrauma, comes from habits. Bruxism is the habit of grinding and clenching the teeth. This continual hammering on the temporomandibular joint can change the alignment of the teeth. Muscle involvement causes inflammation of the membranes surrounding the joint. Pain can thus come from the joint itself or from the muscles. Often, people who are bruxers aren't even aware of the habit, because they do it in their sleep. Causes of bruxism include ordinary stress or misalignment of the teeth.
Symptoms
Pain in the facial muscles and jaw joints may radiate to the neck or shoulders. Joints may be overstretched. You may experience muscle spasms. You may feel pain every time you talk, chew, or yawn. Pain usually seems to come from the joint itself, in front of the ear, but it may move elsewhere in the skull, face, or jaw.
TMJ problems may cause ear pain, ringing in the ears (tinnitus), and hearing loss. Sometimes people mistake TMJ pain for an ear problem, such as an ear infection, because the ear is so close to the joint.
When the joints move, you may hear sounds, such as clicking, grating, or popping. They may be loud enough for others to hear. Clicking and popping are common when the disc is displaced. If there is no pain associated with the sounds, no treatment may be needed.
Your face and mouth may swell on the affected side.
The jaw may become dislocated and lock wide open, or it may not open fully at all. Also, upon opening, the lower jaw may deviate to one side. You may find yourself favoring one painful side or the other by opening your jaw awkwardly. These changes could be sudden. Your teeth may not fit properly together, and your bite may feel odd.
You may have trouble swallowing because of the muscle spasms.
If severe, headache and dizziness may be caused by TMJ problems, enough so that you may feel nauseous or vomit. Click here to read about TMJ headaches.
Treatment of TMJ Pain
The first primary objective of treatment is to find the proper rest position of the jaw and then correct the teeth so that they fit together comfortably in that position. Treatment can be as simple as adjusting a single tooth or providing an orthotic applicance that helps the jaw rest in this position. Or it can be as complex as a complete mouth reconstruction. Dentists need a high level of expertise to do this well. Dr. Chal is a recognized expert in this field who teaches other dentists, and has had much success with patients.
The patient photographed above in pain is shown here at the right after Dr. Chal completed her treatment. She is now pain-free. Notice how much more relaxed her face appears. This is typical of his results.
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Explore the menu at the top of the page, under the TMJ section, for more information on this subject.
Click here to read testimonials of TMJ relief from Dr. Chal's patients.
Click here to visit Dr. Chal's main Phoenix dentist website where you can read detailed, illustrated descriptions of treatment options, read more information about his credentials, and see many photographs of his work.
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