- Symptoms of TMD
- Causes of TMD
- What can be done for TMD
Neck pain, headaches and migraines are a common cause of concern amongst many patients. These symptoms can be disabling as well as acutely painful and present to us often undiagnosed.
Whilst there are many causes of these symptoms the diagnosis that most often gets missed is a problem with the jaw known as the temperomandibular joint (TMJ). It's been estimated that up to 30% of adults will experience Temperomandibular joint disorders (TMD) at some point in their lives.
Symptoms of TMD
The most common symptoms of TMD are(1):
- Clicking, popping or grating noises when moving your mouth
- Muscle pain around the jaw
- Pain in front of the ear that may spread to the cheek, ear and temple
- Difficulty opening the mouth – the jaw may feel tight, as if it is stuck, making eating difficult
- Headache or migraine(2)
- Earache or a "buzzing" or blocked sensation in the ear
- Pain in other areas of the body – such as neckache or backache
- Changes in neck posture(3)
One paper even showed a link between TMD and aspects of vision. This is because the nerve that goes to the jaw (TMJ) and muscles that move the jaw are intimately linked with the muscles that sense movement in the eyes(4).
This nerve also has a potential link with many other nerves that can affect organs all over the body(4).
Causes of TMD
Possible causes of TMD include(1):
- Clenching your jaw or grinding your teeth when asleep (bruxism). This is commonly caused by stress and overworks the jaw muscles and puts pressure on the joint.
- Wear and tear of the inside of the jaw joint – usually caused by osteoarthritis
- Injury to the jaw joint – for example, after a blow to the face or surgery
- Stress – some people may inherit increased sensitivity to pain or stress
- Uneven bite – for example, when new fillings, dental crowns or dentures are fitted
- Specific diseases – TMD may be associated with specific diseases such as rheumatoid arthritis, gout or fibromyalgia
What can be done for TMD
Osteopathy aims to release tightness and tension around the TMJ to alleviate pain and help increase the range of movement in the jaw. Specific techniques that involve inserting the finger in the mouth to relieve the deep tension in the jaw muscles have been shown to be highly effective(5).
Problems that develop secondary to jaw problems including neck and shoulder pain can also be treat by your osteopath. You can also contact your dentist to be assessed for a mouth guard (plastic devices that fit over your teeth) which may be helpful if you grind your teeth.
There are a number of self-help measures that can help improve TMD, including(1):
- Resting the joint by eating soft food and avoiding chewing gum
- Holding a warm or cold flannel to the jaw for 10-20 minutes, several times a day
- Doing a few gentle jaw-stretching exercises – your healthcare professional can recommend appropriate exercises
- Avoiding opening the joint too wide until the pain settles
- Avoiding clenching the teeth for long periods of time
- Massaging the muscles around the joint
- Relaxation techniques to relieve stress
- Not resting your chin on your hand
(1) http://www.nhs.uk/conditions/temporomandibular-joint-disorder/Pages/Introduction.aspx. Accessed 4.2.2017
(2) Temporomandibular dysfunction and headache disorder (2015). Speciali JG, Dach F.
(3) Static body postural misalignment in individuals with temporomandibular disorders: a systematic review (2014). Thaís C. Chaves, Aline M. Turci, Carina F. Pinheiro, Letícia M. Sousa, Débora B. Grossi
(4) Dental Occlusion and Ophthalmology: A Literature Review (2016). Nicola Marchili, Eleonora Ortu, Davide Pietropaoli, Ruggero Cattaneo, Annalisa Monaco
(5) Intra-oral myofascial therapy versus education and self-care in the treatment of chronic, myogenous temporomandibular disorder: a randomised, clinical trial (2013). Allan Kalamir, Petra L Graham, Andrew L Vitiello, Rodney Bonello, and Henry Pollard