An Accurate Diagnosis is Critical for Successful Treatment
The source of facial aches and pains may be related to one or both of the temporomandibular joints (TMJ). Located on each side of the head, these joints work together, with a complex system of muscles, ligaments, discs and bones, to make different movements for chewing and speaking.
What is TMJ/TMD?
Temporomandibular Disorder (TMD) refers to a variety of conditions that affect TM joints, jaw muscles and facial nerves. TMD may occur when the jaw twists during opening, closing or side-motion movements. People with TMD may experience these symptoms:
pain in or around the ear
headaches and neck aches
tenderness of the jaw or jaw muscles
jaw pain or soreness that is more prevalent in the morning or late afternoon
jaw pain when chewing, biting or yawning
difficulty opening and closing the mouth
clicking or popping noises when opening the mouth
sensitive teeth when no other dental problems can be found
TMD affects more than twice as many women (particularly those of childbearing age) as men and is the most common non-dental related chronic facial pain.
What Causes TMD?
improper bite (how teeth fit together)
jaw dislocation or injury
Stress and TMD
Stress 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 (also known as bruxism).
How Is TMD Diagnosed?
Many other conditions cause similar symptoms like tooth decay, sinus problems, arthritis, or gum disease. To figure out what’s causing yours, the dentist will ask about your health history and conduct a physical exam.
He’ll check your jaw joints for pain or tenderness and listen for clicks, pops, or grating sounds when you move them. He’ll also make sure your jaw works like it should and doesn’t lock when you open or close your mouth. Plus, he’ll test your bite and check for problems with your facial muscles.
Your dentist may take full face X-rays so he can view your jaws, temporomandibular joints, and teeth to rule out other problems. He may also recommend other tests, like magnetic resonance imaging (MRI) or computer tomography (CT). The MRI can show if the TMJ disc is in the proper position as your jaw moves. A CT scan shows the bony detail of the joint.
You may get referred to an oral surgeon (also called an oral and maxillofacial surgeon) for further care and treatment. This doctor specializes in surgery in and around the entire face, mouth, and jaw area. \
Talk to Your Dentist About These Tried-and-True Treatments for TMD
Medications. Your dentist can prescribe higher doses of NSAIDs if you need them for pain and swelling. He might suggest a muscle relaxer to relax your jaw if you grind or clench your teeth. Or an anti-anxiety medication to relieve stress, which may bring on TMD. In low doses they can also help reduce or control pain. Muscle relaxants, anti-anxiety drugs, and antidepressants are available by prescription only.
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.
Sources: DeltaDentalIns.com, WebMD