The pain of TMJ dysfunction can be sharp, searing and catching, or dull and constant. It can be extremely debilitating if left untreated. Our jaw joint is a very unstable connection, held in place by muscles and ligaments. There is a disk in this support network that prevents the lower jaw bone rubbing against the bone of the skull. This disk needs to be maintained in the correct position to function correctly. When the lower jaw is forced back, most commonly by a narrow upper jaw, front teeth leaning back or a deep bite, the disk dislocates. This will lead to clicking joints when opening and closing, resulting in spasm and pain in the ligaments and muscles associated with the disk. It also leads to tooth grinding and headaches. The lower jaw needs to be in a comfortable “down and forward” position to allow the disk to function correctly. Correcting the factors that forces the lower jaw back is the best way of ensuring healthy jaw joints. Unfortunately many clinicians think that tooth grinding is due to stress and personality disorders, which is way off the mark. Treating jaw problems with anti-depressants and muscle relaxants, a common proposed treatment modality amongst clinicians, is not what we would recommend at QRDC.
Other symptoms include:
- Ear pain, or fullness of the ears
- Facial pain
- Sore, tight, tender jaw muscles
- Temple, cheek, tooth or jaw pain while swallowing, yawning, talking or chewing
- Jaw popping, clicking or locking upon opening or closing, or while chewing
- Reduced ability to fully open or close the mouth
- Frequent headaches or neck aches
- Muscle pain and spasms in the face, head and neck
- Ringing in the ears
A thorough consultation and clinical assessment process is very important in making the correct diagnoses of TMJ. Mandibular function is assessed, together with a full history of medical factors and issues experienced to date. Clinical HD photographs are taken and followed up by study models analysed by means of the Schwartz-Korkhaus process. These models are pivotal in determining the size, shape and developmental issues causing the underlying pain and discomfort.
This is followed up with OPG (Panoramic) & Lateral Cephalometric X-rays. These radiographs are analysed by means of a Bimler Elite Cephalometric Analysis. This analysis is necessary to determine the relationship between the jaws, the anterior cranial base and the facial profile. This information provides us with the necessary scientific data to complete the treatment plan formulation.
If TMJ is diagnosed, Dr Stefan will present all the options available and formulate a treatment plan that best suits your condition. This may be in the form of bespoke appliances, usually discreet and removable, to develop your jaw in a method that will ultimately eliminate the pain over time with necessary adjustments along the way.
When treating TMJ, we offer a choice to our patients where we can fit a removable splint that holds the lower jaw in a comfortable position at night when most of the grinding occurs. Unfortunately, when the splint is not worn, the jaw drops back into an undesirable position and does not correct the problem permanently, but will treat the symptoms. The alternative is to correct the jaw position by using orthodontic appliances to leave the patient with the most stable, pain-free result.
Between Treatment Relief
- Rest your muscles and joints by eating soft foods when in pain
- Do not chew gum, pencils, or fingernails
- Avoid clenching or tensing the muscles of the jaw, face and neck
- When in pain try relaxing your jaw muscles with moist heat or with ice
- Try to practice stress management techniques, relaxation or deep breathing exercises
- Make sure to get plenty of good sleep
- Avoid caffeine and alcohol
- Always follow the advice of your dentist or oral specialist, and use your appliance as prescribed
The size of our lower jaw is genetically determined. However, the upper jaw grows and develops under the direct influence of muscle and air pressure. Every time we swallow or breathe, pressure is placed on the bone of the upper jaw. The jaw then grows in the direction in which these pressures are exerted. When we swallow correctly, our tongue presses against the palate, flattening it out to help develop our jaw width – the wider our upper jaw, the fuller our lips and cheekbones appear in adulthood. When we breathe through our nose, the difference in air pressure between the nose and mouth also helps to shape the upper jaw. These factors have a significant impact as we develop, particularly during the growth spurt years. For our jaws to develop correctly, we need to swallow properly and breathe through our noses.
Incorrect feeding techniques, bottle-feeding, dummies/pacifiers, thumb sucking and incorrect breathing habits all disturb the natural balanced development and growth of our jaws. The result of these factors in all instances is a narrowed and underdeveloped upper jaw, leaving little room for our teeth to erupt. We then find that the teeth become crowded, misaligned and sometimes impacted. It also impedes the position of the lower jaw, forcing it backwards, sideways or both, causing the teeth to settle into an unnatural and irregular bite – very often an overbite or underbite develops. This is completely preventable if treatment starts at an early age.
The narrow upper jaw, as well as the lower jaw trapped in a backwards position, may have a dramatic effect on the appearance of our face, as well as the health of the joint of our lower jaw. Headaches, clicking jaws, tooth grinding and breathing issues like snoring often arise from this unfortunate development. Do book a consult with Dr Stefan, to determine whether your headaches or jaw pain are resulting from TMJ associated issues.