Tooth pain can be caused by a dental problem, such as a cavity or gum disease, or by a non-dental problem like a sinus infection. Some dental pain is caused by stress – if you’re stressed to the point of clenching your jaw and grinding your teeth, you can develop pain associated with the temporomandibular joint (TMJ). The TMJ is the joint that hinges the lower jaw to the skull, enabling you to open and close your mouth.
TMJ disorders are a group of conditions that cause pain in and around the TMJ and nearby muscles. Clenching your jaw and grinding your teeth puts an additional strain on the muscles of the jaw causing inflammation. TMJ problems can affect a person’s ability to speak, eat, chew, swallow, make facial expressions, and even breathe.
In many cases, the symptoms can be resolved by a removable appliance (or splint) that your dentist can provide.
What are the Causes for TMJ dysfunction?
There is not a single explanation for the cause of TMJ dysfunction. Multiple things may contribute to muscle tightness and problems with the jaw and joints. Some possible influencing factors are:
- Misalignment (malocclusion) of teeth
- Injury to the jaw, temporomandibular joint, surrounding nerves or muscles
- Grinding or clenching the teeth (bruxism)
- Stress and anxiety
- Sleep disorders and breathing difficulties
- Dislocation of the soft cushion or disc between the ball and socket joint of the TMJ
- Presence of arthritis or other inflammatory musculoskeletal disorders in TMJ
What are the symptoms of TMJ disorders?
Pain is one of the most common symptoms of TMJ Disorders. TMJ pain is often described as a dull ache in the jaw joint and nearby areas, including the ear. Some people report no pain but have jaw dysfunction. Other symptoms can include:
- clicking, popping or grating sounds when you move your jaw
- difficulty opening and closing your mouth or a ‘locking’ jaw
- pain or discomfort in your jaw muscles, especially when you eat or yawn
- pain in front of your ears, which may spread to your face, head, neck or upper back
- headache or earache
- pressure behind your eyes or inside your ears
- a change in your bite.
- jaw muscle stiffness
- dizziness and vision problems
- tooth sensitivity
Diagnosis of jaw joint problems
If you have discomfort or problems with your jaw, see your dentist. They will ask about your symptoms, examine you and ask about your medical history. They will then examine your head, neck, face and jaw to see if you have any tenderness.
They may ask you to move your jaw in all directions too. This can help them to see how well you can move your jaw, and whether it’s painful or makes clicking noises when you move it. They will also want to look inside your mouth to see if you have any problems with your teeth or gums.
Your dentist will also ask you whether anything triggers your jaw problems, such as chewing or yawning. They will also check whether you grind your teeth or bite your nails, as both of these can cause jaw problems.
Because the jaw joint is so complicated, there are lots of possible causes of jaw problems. Therefore, it can be difficult to work out what’s causing your symptoms. The diagnosis is usually made after examining you.
Your dentist might refer you to see a specialist doctor, such as an oral and maxillofacial surgeon.
You may have one or more of the following tests:
- An X-ray
- A computed tomography (CT) scan
- A magnetic resonance imaging (MRI) scan
- An ultrasound scan
How Your Dentist Can Help
There are a few different methods dentists can use to treat TMJ once it has been diagnosed. This could be as simple as identifying and managing the cause (e.g. stress and tooth clenching), doing some simple jaw exercises or wearing a splint. It is made of clear plastic and fits over the biting surfaces of the teeth of one jaw so that you bite against the splint rather than your teeth. This often helps your jaw joints and muscles to relax.
If your pain continues, your dentist may also refer you to a dental specialist with extra training in TMDs. This could be a specialist in oral medicine or orofacial pain, an oral surgeon, an orthodontist, a periodontist or a prosthodontist. If your dentist refers you to a dental specialist, he or she will explain what that specialist does.
Surgery is rarely used to treat TMDs. However, if none of the other treatments have worked, or if it is very hard to open your jaw, you may need surgery. If you need surgery, your dentist will refer you to an oral and maxillofacial surgeon with expertise in temporomandibular joint surgery.
Can TMJ disorder go away on its own?
Many cases of TMJ pain, it won’t be resolved without treatment. If you are experiencing constant jaw pain, it is recommended visiting a dentist as soon as possible. Your dentist will recommend a treatment option best suited to you, which may require a specialist to help.
You can sometimes prevent or ease strain on your joints and ease your symptoms by:
- avoiding hard and chewy foods, including chewing gum
- cutting food into smaller portions
- avoiding opening your jaw wide or clenching
- applying a warm or cold compress to your jaw several times a day
- massaging or gently stretching your jaw muscles.
If your TMJD is related to stress, your dentist may recommend relaxation techniques or refer you to your doctor.