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TM What?
You may have heard of it on TV. It was probably called TMJ Syndrome and there is a lot of confusion about this subject. We dentists can't even agree on what to call it. However, one thing any practicing dentist will agree to is this: Chronic cramping of the powerful jaw closing muscles can cause a world of pain and some very tender jaw joints, called TMJ's. The muscular pain can feel like anything from a toothache to a bad tension headache. The pain can be so severe it can be mistaken for a migraine. Inflamed jaw joints feel like an ear ache.
Following are a few possible precipitating factors:
- An uneven bite which causes the jaw joints to slide out of place on closing.
- Trauma, e.g., an auto accident or sports accident.
- Stress, simply holding your teeth together hour after hour, day or night. Even if you don't actually grind them, can cause more pain than you can believe!
- Combinations of the above.
Treatment depends on the cause, severity and duration of the pain. Restorative dentists must be able to identify patients at risk but not yet having symptoms prior to performing dental procedures. I have personally seen the placement of just a simple filling trigger an episode. As restorative dentists, we must always be aware of the potential for muscular or joint pain when planning reconstructive dentistry.
There is relief!
Conservative Treatment:
- Soft diet
- Muscle relaxants
- "Motrin" class of drugs (non steroidal anti-inflammatory drugs). An interesting note is that since narcotics tend to increase swelling and inflammation they can actually make your pain worse, not better.
- Stress reduction therapy
- Physical therapy
Active Treatment:
- Construction of removable appliances by your dentist which will create an unstrained, comfortable position for your jaw joints. This can be likened to a back brace or arch supports in your shoes to treat pain of the back.
- Correction of your bite so that when you close your mouth your jaw joints are in an unstrained, comfortable position.
- MRI or CT scans of the joints to check for damaged cartilage or ligaments, much the same as an injured knee might be scanned for damage.
- As a last resort, orthoscopic surgery. Again, the same way a knee might be treated.
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