Temporomandibular joint (TMJ) disorder

If your jaws hurt or you’ve noticed a clicking or popping sound when you open your mouth, you may be suffering from a temporomandibular joint (TMJ) disorder. TMJ problems are especially common in young women and may lead to a number of seemingly unrelated symptoms. Getting dentist care for TMJ problems can help you manage the symptoms and improve your ability to chew normally.


The following signs indicate that you may need to seek dentist care for a TMJ disorder

Facial, jaw, or ear pain
Pain in the neck and shoulders
Popping, clicking, or grating sounds when you open or close your mouth
Jaw getting locked while opening or closing
Pain when talking, chewing, or yawning
Headaches
Hearing loss or tinnitus
Muscle spasms
Dizziness
Difficulty chewing or biting
Difficulty opening your mouth all the way


Sometimes labelled as TMD, occurs when there is a disharmony between the way the muscles move the jaw and joint jaw joint effortlessly and the way the teeth meet during those movements. There are 68 pairs of muscle that directly or indirectly affect the positions of the jaw. Apart from opening and closing the jaw, the role of these muscles are to position the lower jaw where it needs to be to get maximum interdigitation or meeting of the teeth. So if the upper jaw is tilted, sloped too steeply, positioned too far or back, the muscles and tendons of the lower jaw will have to move it into an odd and strained position for the teeth of the two jaws to work together optimally. This places pressure on the jaw joint.

Since there are many blood vessels and nerves that exit the skull in the area of the jaw joint (temporomandibular joint), this eccentric position of the jaw or pressure on the jaw joint can impinge on them setting up conditions leading to myriad of symptoms such as:

TMJ Dysfunction Symptoms: Depression, hearing loss, ringing of the ears, worrying, insomnia, nervousness, anxiety, forgetfulness, sinusitis, fatigue, indigestion, allergies, ulcers, cold hands and feet, body pains and numbness.
Postural Symptoms: Neck pain, scoliosis, excessive lumbar lordosis (sway back), thoracic hyperkyphosis (hump back), rotation of the pelvis resulting in uneven leg length, uneven shoulder height and quite possibly head tilt.
Degeneration of the jaw joint: Jaw joint clicking, jaw joint locking, jaw joint pain, neck pain, shoulder pain, dizziness and referred pain to the sinuses.
Chronic symptoms: Muscle aches and pains, anxiety, cold hands and feet, muscle spasm, allergies or sensitivities, forgetfulness, fatigue


The cause of TMJ problems may not always be clear, but many factors can contribute. These are some potential causes for TMJ symptoms:

    Trauma to the face or jaw
    Stress-related jaw-clenching or teeth-grinding
    Muscle disease
    Other dental problems such as malocclusion
    Arthritis
    Some dental surgeries and procedures like ill-fitting bridge / cap etc


Treating TMJ disorders not only helps to alleviate the persistent pain a patient suffers on a daily basis, but actually aids in the prevention of further damage to the jaw and related muscles. In order to determine the best TMJ solution for your unique case, DR. Vora will perform a thorough assessment of your mouth and jaw, as well as your dental and medical history. Most treatment options focus on restoration of the joint by eliminating muscle spasms and restoring correct co-ordination.

Mouth guard: It is an oral appliance which is also known as an oral splint. This is one of the most common and effective methods of treating TMJ and bruxism, or nighttime teeth grinding (often associated with TMJ dysfunction).It should be specifically designed for you and customized to fit your dentition.
Moist Heat: Moist heat from a heat pack or a hot water bottle wrapped in a warm, moist towel can improve function and reduce pain. Be careful to avoid burning yourself when using heat.
Ice pack:Ice packs can decrease inflammation and also numb pain and promote healing. Do not place an ice pack directly on your skin. Keep the pack wrapped in a clean cloth while you are using it. Do not use an ice pack for more than 10 - 15 minutes.
Soft diet: Soft or blended foods allow the jaw to rest temporarily. Remember to avoid hard, crunchy, and chewy foods. Do not stretch your mouth to accommodate such foods as corn on the cob, apples, or whole fruits.
Over the-counter analgesics:For many people with TMJ Disorders, short-term use of over-the-counter pain medicines or no steroidal anti-inflammatory drugs (NSAIDS), such as ibuprofen, may provide temporary relief from jaw discomfort. When necessary, we can prescribe stronger pain or anti-inflammatory medications, muscle relaxants, or antidepressants to help ease symptoms.
Relaxation Techniques:Relaxation and guided imagery can be helpful in dealing with the pain that accompanies TMJ dysfunction. Deep, slow breathing enhances relaxation and modulates pain sensations. Some have found yoga, massage, and meditation helpful in reducing stress and aiding relaxation.
Treatment of underlying dental disorder:Severe pain caused by damaged joints may require more invasive treatments, such as orthodontic treatment, crown and bridges, Surgery may be considered as a last resort. Surgical interventions for TMJ disorders can be safe and effective.

TMJ pain may also be managed with simple lifestyle changes. You may wish to:
Avoid chewing gum
Avoid biting your nails
Avoid biting your lower lip
Practice good posture
Limit large jaw movements, such as yawning and singing
Relax facial muscles and concerted efforts to relax your lips and teeth apart.
Cradling the telephone, which may irritate jaw and neck muscles.