Why do I have jaw pain and how do I fix it?

Temporomandibular Joint Disorders -commonly referred to as “TMJ” but clinically termed as “TMD” can be related to problems with jaw muscles, the jaw joints and often may involve a postural component. Patients presenting with TMD may have symptoms that range from sore or tight muscles in the face, scalp and neck, pain in the TMJoints at rest and/or to function, headaches, inability to open wide and/or move the jaw laterally,ear stuffiness and tinnitus (ear ringing). Usually the disorder is a result of microtrauma (history of clenching or grinding the teeth) or macrotrauma (accident or event that caused trauma to the jaw).

Recent literature indicates that the source of 50% of TMDisorders  is a sleep-related breathing problem. As a reflex to open the airway when it is blocked during sleep the lower jaw moves forward moving the tongue with it and the lower teeth clench against the upper teeth to hold it there as a protective mechanism. In addition it is thought that the arousals during sleep that occur with an airway obstruction also cause an episode of teeth grinding .

As these events happen repeatedly night after night the cumulative effect over time can cause signs and symptoms of TMD.  A complete and thorough assessment of the patient is imperative in attempt to identify the source of the patient’s complaints and contributing factors. Oral orthotic appliances, various surgeries, exercises, physical therapy and other related modalities ie ultrasound, phonphoresis,etc, lifestyle and habit modifications can all play a part in resolving the patient’s symptoms once the primary source is determined.

When an oral orthotic appliance is the treatment of choice the dentist must decide why it is being used, when the patient should wear it, what is to be accomplished in using it and how should it be designed.  The orthotic appliance can be used to relax fatigued jaw muscles or those in spasm,  realign the upper and lower jaws, reposition  TMJoint discs that are dislocated or more favorably posture the head with the neck and shoulders.

The important take home point is:  

“ALL DENTAL MOUTHGUARDS ARE ABSOLUTELY NOT THE SAME”

One last myth to dispel:

“DENTAL MOUTHGUARDS CANNOT STOP A PATIENT FROM GRINDING THEIR TEETH”.

Author
Michael F. Hnat, DMD, DABDSM Headshot Michael F. Hnat, DMD, DABDSM, DABCDSM Dr. Michael Hnat brings exemplary knowledge and experience in both dental sleep medicine and TMJ-related issues. He is a graduate of the University of Pittsburgh School of Dental Medicine and the prestigious mini-residency in Temporomandibular Joint (TMJ) Disorders from Tufts University School of Dental Medicine. He is Clinical Assistant Professor in dental sleep medicine at the West Virginia University School of Dentistry. The focus of his clinical practice is oral appliance therapy for the treatment of sleep-related breathing problems, TMJ disorders, and head and neck muscle pain. Dr. Hnat is credentialed thru the American Board of Dental Sleep Medicine and the American Board of Craniofacial Dental Sleep Medicine.

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