Jaw pain: it's not just stress
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Five years ago, Stephen, a 40-year-old business manager, began to experience occasional pain in the jaw and muscles of the face and neck. Occasionally, he had difficulty moving his jaw and heard clicks when he chewed. The doctor and the dentist recommended that you reduce stress in your life and make sure you do not clench your teeth. Despite trying, the symptoms worsened so much that his work performance was impaired. Another doctor recommended consulting with a dentist with experience in the treatment of orofacial pain. This dentist diagnosed Steve's problem as temporomandibular disorder (TMD) and recommended a combination of treatments that ultimately alleviated pain and difficulty in chewing.
There is great controversy among doctors and researchers about the name, definition, symptoms, causes and treatment of temporomandibular disorders. As a result, many people with TMD should consult several doctors and dentists before obtaining a correct diagnosis and treatment.
The temporomandibular joint (TMJ) is the joint of the jaw. Temporomandibular disorders (TMD) refer to a group of conditions that affect the temporomandibular joint, as well as the muscles that control mastication. Although the terms ATM and "ATM disorder" are often used to describe disorders related to this joint, the term that is becoming accepted is TTM.
Because we can not reach an agreement regarding these disorders, we do not know with certainty how many people suffer from TMD. For most people, the discomfort is temporary and varies over time. Only a small percentage suffers from serious long-term problems. TTM seems to affect women more than men.
The temporomandibular joint connects the lower jaw (mandible) to the temporal bone on the side of the head. You can feel it on either side of your head if you place your fingers in front of your ears and open your mouth or move your jaw from side to side.
The ATM is composed of two sections separated by a disc, which cushions the movements coming from chewing and other movements in the jaw. This system, along with the muscles connected to the joint and those around it, allow the jaw to move up and down, forward and backward, and to the sides. This movement allows you to talk, chew, and swallow. Any factor that prevents joints and muscles from working together correctly can contribute to TMD.
Experts believe that TMD arises because of several interacting factors. However, there is no consensus regarding the specific factors involved and the roles each one plays. These factors can contribute to the appearance of the TTM:
Trauma to the jaw or neck
Arthritis of the joint
Oral habits, such as grinding teeth, squeezing or biting the lips
Bite problems that affect the way teeth are closed
Muscle tension
Psychological conditions, such as depression and anxiety, are also related to TTM.
The symptoms of TMD include the following:Pain or discomfort in the jaw joints and around these, in the ears or muscles of the jaw, face, temples or neck
Headaches
Limited movement or snagging of the jaw
Problems chewing
Painful sounds like clicking, breaking or squeaking when moving the jaw
Problems in the ear, such as pain or sensitivity to noise or wind
Decrease in quality of life
Fortunately, the TMD is usually temporary. It can disappear alone or with medical treatment. Chronic or debilitating TTM only affects a small group of people.
Diagnosing TMD can be difficult due to the lack of scientific evidence and controversies related to the disorder. Most cases are diagnosed based on their own description of the symptoms, their clinical and dental history, and a physical examination of the jaw, head and neck.
The treatment must be adapted to its symptoms and contributing factors. It can be difficult to solve, so the treatment focuses on the control of symptoms and the restoration of functions. In general, all that is needed is a simple treatment to relieve discomfort and restore proper functioning. Most doctors and researchers recommend medical treatment that does not cause permanent changes in the structure or position of the jaw or teeth.
The personal care practices that usually relieve TMD symptoms include applying heat or cold and avoiding movements that overload the jaw, such as chewing gum, laughing or yawning with your mouth open. Other medical treatments include stress management, physical therapy with exercises you can do at home, and medications to relieve pain and inflammation. Oral devices, commonly known as "splints" or "night protectors," are often used to help decrease the act of clenching or grinding the teeth, as well as to relieve overload in the joints and muscles.
For people who have a more chronic evolution, it is useful to add cognitive-behavioral therapy (CBT) to relieve pain and depression related to TMD. CBT is a problem-solving strategy that helps you modify what you think about the symptoms of TMD and how you control them.
If you think you have TMD, talk to your dentist or doctor. If necessary, you will be referred to a dentist who specializes in orofacial pain.
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