Temporomandibular Disorder and Jaw Pain
Temporomandibular Disorder and Jaw Pain
R and R for Your Aching Jaw
Often referred to as TMJ syndrome, a temporomandibular disorder (TMD) is among the most vexing of problems: You can't open your mouth. Or you can't get it closed. Your jaw hurts so much that you're grimacing in pain. And it's making strange popping noises, like when you would crack your knuckles as a kid. And you have a Godzilla-size headache.
Also known as TMJDS, or temporomandibular joint disorder syndrome, TMD affects the jaw joint and the muscles that control chewing. Part of the reason TMD hurts is that many people who have it clench or grind their teeth--most often at night, but sometimes during the day. All that clenching and grinding can tire the jaw muscles and make you wince with pain.
If you have TMD, you might also experience severe headaches; pain in your neck, face or shoulders or clicking or grating sounds in your jaw. And you may notice that, suddenly, your upper and lower teeth no longer line up the way they used to.
The temporomandibular joint connects the lower jaw, or mandible, to the temporal bone, which is part of the skull (hence the name). When the temporomandibular joint is overstrained or injured, you hurt and can't use it as easily as when you're healthy and limber.
BLAME ESTROGEN
Women doctors say that TMD falls into three main categories. The most common form is characterized by discomfort or pain in the jaw, neck or shoulder muscles. Less common forms include a dislocated jaw or injury to the jawbone or joint diseases such as osteoarthritis or rheumatoid arthritis. A woman affected by TMD may have one or more of these conditions at the same time.
"Women are treated for TMD twice as often as men," says Donna Massoth, D.D.S., Ph.D., a dentist and psychologist in the Department of Oral Medicine at the University of Washington in Seattle.
There may be a link with estrogen. A study of female baboons showed that they have receptors for the female hormone estrogen in the jaw--male baboon's don't. And, just as migraine headaches are linked to an increase in estrogen, the hormone also may be a factor in TMD.
BREATHE DEEP (AND LOSE THE CHEWING GUM)
For some individuals TMD pain tends to come and go. Not that TMD pain is easy to forget. Luckily, whatever the root of your TMD pain, women dentists offer these tips to help you ease the discomfort.
Try frozen corn and a hot washcloth. "Jaw pain can be relieved with ice," says Dr. Massoth. Apply an ice pack or a bag of frozen vegetables to your jaw for up to ten minutes an hour, repeating as necessary through the day.
In between icings, apply moist heat--that's a heating pad or washcloth--for 20 minutes at a time.
"Use ice for immediate, acute injury less than a day old. And use heat for older, chronic injuries. Heat will help increase circulation and relax your jaw muscles," says Barbara Rich, D.D.S., a dentist in Cherry Hill, New Jersey, and spokesperson for the Academy of General Dentistry.
Rest your jaw. As with any strained muscle or joint, the best remedy for an overtaxed jaw is rest, Dr. Rich says. "You can do that by avoiding chewy, crunchy foods like steak or French bread," she says. Also, don't cradle the phone between your neck and shoulder, and use good posture.
Stifle that yawn. Opening too wide can make your jaw hurt, says Dr. Rich. "So try not to open your mouth all the way. If you feel a yawn coming on, try to stifle it."
Go easy on that hoagie. Taking very large bites can also make your jaw hurt. To lessen the ache, take small bites. Hoagies, for example, are too big a target for an aching jaw.
Cut your food into smaller pieces and chew thoroughly and slowly to keep your jaw from aching, says Leanne Wilson, Ph.D., clinical psychologist in the Department of Oral Medicine at the University of Washington in Seattle.
Toss the chewing gum. Nervously chewing pencils, pens or chewing gum may aggravate TMD, says Dr. Wilson, so skip the chewing gum entirely and keep your writing utensils in your hand.
Massage your jaw. Gently massaging your jaw can increase the blood flow to the joint and help relieve pain.
When To See A Doctor
If you experience radiating pain in your face or mouth, painful clicking or popping in your jaw, or a sudden change in the way your teeth fit together, or if pain persists despite two weeks of self-help remedies, see a dentist. Your dentist may suggest a bite plate, a plastic guard that fits over the upper or lower teeth, to reduce clenching or grinding and ease mucle tension. She may also suggest physical therapy and short-term use of muscle relaxants and anti-inflammatory drugs to help relieve TMD pain.
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Breathe deep. "Stress and TMD are often intimately related," says Dr. Wilson. "Tension and stress can aggravate any physical ailment," she says. No surprise, then, that you're more likely to find yourself grinding your teeth before asking your boss for a raise than when you're relaxing in a sauna.
To calm yourself when you're tense and help your TMD pain subside faster, try taking a few deep breaths, says Dr. Wilson. Listening to a relaxation tape can help relax your muscles and mind even further.
Chip away at caffeine. Avoid caffeine, Dr. Massoth suggests. Caffeine wires up your nerves, which may increase muscle tension. And remember: Caffeine isn't found just in coffee, but in many teas and sodas as well as chocolate. Read labels for hidden sources of caffeine.
Stretch. "Once the severe pain of a TMD attack subsides, it's important to use your jaw muscles again," Dr. Wilson says. It's a natural tendency to baby a muscle that hurts, but if you stop opening your jaw, the muscles can tighten and end up hurting even more.
To keep your jaw limber, try this: Open as wide as you can without feeling pain, hold a few seconds, then slowly close halfway. Open again, hold a few seconds, then slowly close your mouth. Do this as often as 10 to 15 times a day, suggests Dr. Wilson. Any exercise program should be approved by your dentist, and if opening causes significantly more pain or locking or catching of the joint, it should be discontinued, she adds.
