Temporomandibular Joint (TMJ) Syndrome - Arthritis & Dental Problem Symptoms

Temporomandibular Joint (TMJ) Syndrome

Created on: 06/10/07
Arthritis Today, July-August 2007

Chew on This: Your jaw joint can be a source of painful arthritis

A deep yawn causes a loud pop near your cheekbone. Chewing just plain hurts. Opening your mouth wide makes you wince as your jaw forgets it’s a hinge and locks in place. These are just some of the painful range-of-motion problems experienced by the nearly 11 million Americans who have temporomandibular joint (TMJ) syndrome affecting the joint connecting the lower jaw to the skull.

“People with TMJ syndrome classically have only mild discomfort, such as a dull ache on both sides of the jaw in front of the ears,” said the late Oscar Gluck, MD, past director of the Arizona Rheumatology Center in Phoenix. “In these cases, the TMJ syndrome is entirely due to osteoarthritis (OA) in the jaw.” When TMJ syndrome occurs in younger patients (mostly women, typically between the ages of 20 and 40), the pain can be much more severe and often is accompanied by headaches or ear pain.

Medical evaluation is vital to determine the root of jaw pain, Dr. Gluck stressed, because if TMJ persists without treatment, the joint could deteriorate and progress to OA. “When people clench their jaw muscles, the pressure within the joint increases, which decreases the amount of nourishing and lubricating synovial fluid that can flow through the joint. With too-few nutrients and too-little lubrication, the tissues experience friction and become sticky, which can lead to a pulling or tearing of the ligaments,” explains Keith Yount, MD, an orofacial pain specialist with Raleigh Facial Pain Services in Raleigh, N.C.

According to the Milwaukee-based TMJ Association, treatments range from conservative, reversible therapies that usually work well to more aggressive and irreversible approaches, such as surgery.

Some irreversible therapies, such as root canals or extraction of wisdom teeth, often are performed because the pain is thought to stem from a dental problem, says Dr. Yount. He stresses that the cornerstones of conservative treatment – biofeedback to reduce tension, physical therapy to strengthen the joint, devices worn at night to prevent grinding and improve the mechanical action of the jaw joint, as well as medications such as nonsteroidal anti-inflammatory drugs and muscle relaxants – usually are effective within two to three months and most effective when used all at the same time.

Great Idea!
If you have jaw pain and suspect you might have TMJ, try this: Carry a small kitchen timer with you and set it to go off at random times throughout the day. When it rings, immediately observe how you are holding your teeth, neck and shoulders. Are you clenching your jaw muscles tightly? The subconscious nervous habits of grinding teeth, clenching muscles tightly or slouching into bad posture – all of which can increase pain-causing tension in the jaw and neck – can be overcome with patience and persistence. Making your subconscious actions conscious helps you to change them.

Arthritis Today, July-August 2007

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