Also known as TMD (or TM), this baffling and painful condition makes the hinges of your jaw ache, often when you wake up and when you chew or yawn. Surprisingly, it's sensible lifestyle changes that are your best bet for easing the discomfort.
Temporomandibular joint disorder (TMD) is a common, but often mysterious, affliction of the joints that connect your jaw to either side of your head just in front of your ears. By touching these spots as you open your mouth, you can feel the joints move. If you suffer from TMD, however, you don't have to use your fingers to find the spots: pain will probably do it for you. You may also feel pain in your ears, neck or shoulders, especially when you chew or yawn. And because the joints are so close to your ears, you might also hear odd popping, crackling or grating noises when your jaw moves. In more severe cases, you may even feel as if your jaw is unhinged, your upper and lower teeth are out of ailgnment or your mouth won't open.
No matter how severe your symptoms are, don't panic. TMD is frequently a temporary problem that resolves itself over time. Unless your jaw pain is a rare case caused by arthritis or an anatomical problem, derangement of the bones due to disease or injury, or by a birth abnormally, your symptoms are simply telling you that the muscles around your joints are tight and inflamed.
No-one has yet discovered the underlying causes of temporomandibular joint inflammation, but its triggers are well known. These include emotional stress, a recent injury to the jaw and bad postural habits, such as holding the handset between the side of your head and your shoulder when you talk on the phone or thrusting your chin forwards when you work at a computer. You're also more likely to develop TMD if you grind your teeth when you sleep (see on shortly) or if your teeth don't come together properly when you bite down, which dentists call a malocclusion. Even chewing tough foods such as dried apricots can contribute. And if you're female, you're also at greater risk. Three times as many women as men complain about TMD symptoms to their doctors or dentists, so hormones may also play some role in the disorder.
LIKELY FIRST STEPS
Treatment Options
LIFESTYLE CHANGES
---------------------------------------------------------------------------------------------------------------------------------------------
Soft foods Less taxing for your law to chew.
----------------------------------------------------------------------------------------------------------------------------------------------
Heat or cold Application reduce pain.
---------------------------------------------------------------------------------------------------------------------------------------------
Stress reduction Helps relax muscles in the jaw.
---------------------------------------------------------------------------------------------------------------------------------------------- Correct posture Alignment of head and neck relieves TMD.
MEDICATIONS
------------------------------------------------------------------------------------------------------------------------------------------
Nonprescription painkillers NSAIDs ease pain and inflammation.
------------------------------------------------------------------------------------------------------------------------------------------
Prescription drugs For severe and persistent TMD.
PROCEDURES
---------------------------------------------------------------------------------------------------------------------------------------------
Mouthguard Prevents tooth grinding at night.
The first and best approach for easing the discomfort of TMD is to make simple changes in your day-to-day life. You may be surprised at how quickly your jaw responds. Here are few things to try:
Bruxism--grinding your teeth while you sleep--can contribute to TMD, but mainly it causes a host of other problems, including premature loss of your teeth, disrupted sleep, snoring and potentially dangerous breathing pauses (sleep apnoea). Tooth grinding occurs most often in the 19- to 44-year-old group, and improves with age. Its cause is a mystery, but using alcohol, tobacco or caffeine can be trigger in some people, as can aggravation, stress and anxiety. If you have this probably, psychotherapy and stress-reduction techniques like yoga, meditation and moderate exercise may help.
Medications
Drugs don't cure TMD, but they can sometimes help relieve its symptoms. If you're in pain, try nonprescription medications such as paracetamol (Panadol), or better yet, NSAIDs (nonsteroidal anti-inflammatory drugs), such as aspirin or ibuprofen, which reduce pain and inflammation. If these
EXERCISE YOUR JAW--GENTLY
While certain doctors feel that rest, not exercise, is some evidence to show that mild stretching can help alleviate pain. If any of these movements makes your condition worse, stop immediately. Try 10 repetitions of each exercise:
>Will my TMD go away if my bite is corrected?
Some health-care professionals commonly recommend treating TMD with braces, crowns and bridges to change and balance your bite. Or they may suggest grinding down your teeth to adjust your bite (called occlusal adjustment). For most people, these have little or no value, and they can have irreversible effects that you may not want. If your doctor or dentist recommends one of these procedures, get a second opinion before you make a decision.
Procedures
If you grind or clench your teeth as you sleep, you may get relief with a mouthguard, a plastic oral appliance, also called a splint or bite plate, which fits over either the upper or lower teeth to keep you from grinding. These mouth splints need to be fitted by a dentist. They are expensive, but you may be able to receive reimbursement from your health fund. Unless you need to set a broken jawbone, remove diseased tissue or correct a dislocation in the joint, you should avoid surgery Artificial jaw joint implants have proven especially dangerous, and some have been recalled because they break down and damage surrounding bone.
Natural methods
Chiropractic treatment can be very helpful if spinal misalignment is contributing to your TMD. Acupuncture shows promise also, and biofeedback--educating your muscles to relax with the help of a machine that tells you if you're unconsciously clenching--is now a standard therapy. Studies show that up to 70 percent of patients who are trained in biofeedback as part of their therapy will get rid of their TMD for good. A Canadian study also showed that seven of ten patients who used glucosamine sulphate (500 mg twice a day) had about a 40 percent reduction in pain; the results were slightly better than the control group, which used ibuprofen instead.
What is happening
Temporomandibular joint disorder (TMD) is a common, but often mysterious, affliction of the joints that connect your jaw to either side of your head just in front of your ears. By touching these spots as you open your mouth, you can feel the joints move. If you suffer from TMD, however, you don't have to use your fingers to find the spots: pain will probably do it for you. You may also feel pain in your ears, neck or shoulders, especially when you chew or yawn. And because the joints are so close to your ears, you might also hear odd popping, crackling or grating noises when your jaw moves. In more severe cases, you may even feel as if your jaw is unhinged, your upper and lower teeth are out of ailgnment or your mouth won't open.
No matter how severe your symptoms are, don't panic. TMD is frequently a temporary problem that resolves itself over time. Unless your jaw pain is a rare case caused by arthritis or an anatomical problem, derangement of the bones due to disease or injury, or by a birth abnormally, your symptoms are simply telling you that the muscles around your joints are tight and inflamed.
No-one has yet discovered the underlying causes of temporomandibular joint inflammation, but its triggers are well known. These include emotional stress, a recent injury to the jaw and bad postural habits, such as holding the handset between the side of your head and your shoulder when you talk on the phone or thrusting your chin forwards when you work at a computer. You're also more likely to develop TMD if you grind your teeth when you sleep (see on shortly) or if your teeth don't come together properly when you bite down, which dentists call a malocclusion. Even chewing tough foods such as dried apricots can contribute. And if you're female, you're also at greater risk. Three times as many women as men complain about TMD symptoms to their doctors or dentists, so hormones may also play some role in the disorder.
- Resting the jaw (soft foods, no gum chewing).
- Heat or cold to ease stress and discomfort.
- Aspirin, ibuprofen or naproxen to reduce pain and muscle inflammation.
- Visit a dentist or doctor for an evaluation it self-help measures don't work.
QUESTIONS TO ASK
- How long does an episode of TMD usually last?
- Does having one episode mean that I'll be more susceptible to TMD in the future?
- If my condition is due to stress, does that mean the pain is all in my mind?
- Could my TMD be due to arthritis or some other disease?
Treatments
When treating TMD, it's important to be conservative. That means starting with lifestyle changes that give your jaw a rest and, if needed, adding nonprescription painkillers to reduce pain and inflammation. If your symptoms persist, prescription painkillers or muscle relaxants or a mouthguard that keeps you from grinding your teeth, can be useful. Only in severe cases should surgery be considered. If you're seeing a doctor who wants to operate, get a second opinion.
When treating TMD, it's important to be conservative. That means starting with lifestyle changes that give your jaw a rest and, if needed, adding nonprescription painkillers to reduce pain and inflammation. If your symptoms persist, prescription painkillers or muscle relaxants or a mouthguard that keeps you from grinding your teeth, can be useful. Only in severe cases should surgery be considered. If you're seeing a doctor who wants to operate, get a second opinion.
Treatment Options
LIFESTYLE CHANGES
---------------------------------------------------------------------------------------------------------------------------------------------
Soft foods Less taxing for your law to chew.
----------------------------------------------------------------------------------------------------------------------------------------------
Heat or cold Application reduce pain.
---------------------------------------------------------------------------------------------------------------------------------------------
Stress reduction Helps relax muscles in the jaw.
---------------------------------------------------------------------------------------------------------------------------------------------- Correct posture Alignment of head and neck relieves TMD.
MEDICATIONS
------------------------------------------------------------------------------------------------------------------------------------------
Nonprescription painkillers NSAIDs ease pain and inflammation.
------------------------------------------------------------------------------------------------------------------------------------------
Prescription drugs For severe and persistent TMD.
PROCEDURES
---------------------------------------------------------------------------------------------------------------------------------------------
Mouthguard Prevents tooth grinding at night.
NATURAL METHODS-----------------------------------------------------------------------------------------------------------------------------------------------
Complementary therapies For body and mind; glucosamine for pain.
TAKING CONTROL
Lifestyle changesComplementary therapies For body and mind; glucosamine for pain.
TAKING CONTROL
- Stop gnawing. If you routinely bite your fingernails or chew on pencils, here's a good reason to drop a bad habit: giving your mouth a rest is the best way to give TMD the boot.
- Dispense with your pillow. Until you jaw feels better, try sleeping on your back or on your side without a pillow. This will distribute your body weight more evenly.
- Go to a pain clinic if don't get relief with self-help measures or medical treatments your doctor or dentist recommend. Pain clinics, which are usually associated with hospitals or univerisites, are also a good source for second opinions for TMD treatments.
The first and best approach for easing the discomfort of TMD is to make simple changes in your day-to-day life. You may be surprised at how quickly your jaw responds. Here are few things to try:
- Eat soft foods until the pain goes away. Stick with a 'chew-less' diet--mashed potatoes, scrambled eggs, yoghurt. If you must eat meat or produce, run them through a blender. And don't eat anything that's bigger than bite-sized. Apples are out; apple puree is in.
- Apply heat or cold. Both are equally helpful for reducing TMD pain and can be used interchangeably. A warm, moist compress is very effective. Or try rubbing your jaw joint with a rough towel to bring blood flow to the area. An ice bag can do the trick, too.
- Try not to yawn or chew gum. Your jaw needs to rest. That means keeping your mouth closed and still. You might not even want to talk much until your symptoms start to go away.
- Reduce stress. Practise yoga, mediate, see a therapist or do aerobics--anything that helps lessen the tooth grinding and jaw clenching you unconsciously do at night when you're sleeping.
- Align your spine. Although your jaw joint may hurt, your problem may actually start in your shoulders or neck. Correcting your posture can make a dramatic difference to the way you feel. Don't crane your neck forwards when you read; and don't carry shoulder bags that feel unusally heavy.
Bruxism--grinding your teeth while you sleep--can contribute to TMD, but mainly it causes a host of other problems, including premature loss of your teeth, disrupted sleep, snoring and potentially dangerous breathing pauses (sleep apnoea). Tooth grinding occurs most often in the 19- to 44-year-old group, and improves with age. Its cause is a mystery, but using alcohol, tobacco or caffeine can be trigger in some people, as can aggravation, stress and anxiety. If you have this probably, psychotherapy and stress-reduction techniques like yoga, meditation and moderate exercise may help.
Medications
Drugs don't cure TMD, but they can sometimes help relieve its symptoms. If you're in pain, try nonprescription medications such as paracetamol (Panadol), or better yet, NSAIDs (nonsteroidal anti-inflammatory drugs), such as aspirin or ibuprofen, which reduce pain and inflammation. If these
EXERCISE YOUR JAW--GENTLY
While certain doctors feel that rest, not exercise, is some evidence to show that mild stretching can help alleviate pain. If any of these movements makes your condition worse, stop immediately. Try 10 repetitions of each exercise:
- Place one or two fingers on your lower front teeth and gently press down until your mouth is opened as wide as it can be without pain.
- Place a palm or list under your chin for a little resistance as you try to open your mouth.
- Open your jaw slightly. Move it as far to the right as you comfortably can, then move it the same way to the left.
- Open your jaw in front of mirror, as wide as you comfortably can, watching to make sure your descending chin remains centered relative to your face.
- Turn your head as far as you can to the left, then the right.
- Roll your head gently in a circle, right to left, left to right.
- Tilt your head sideways, as if trying to touch your shoulder with your ear. Do this on both sides, and be careful not to inadvertently raise your shoulder instead of lowering your head.
>Will my TMD go away if my bite is corrected?
Some health-care professionals commonly recommend treating TMD with braces, crowns and bridges to change and balance your bite. Or they may suggest grinding down your teeth to adjust your bite (called occlusal adjustment). For most people, these have little or no value, and they can have irreversible effects that you may not want. If your doctor or dentist recommends one of these procedures, get a second opinion before you make a decision.
Procedures
If you grind or clench your teeth as you sleep, you may get relief with a mouthguard, a plastic oral appliance, also called a splint or bite plate, which fits over either the upper or lower teeth to keep you from grinding. These mouth splints need to be fitted by a dentist. They are expensive, but you may be able to receive reimbursement from your health fund. Unless you need to set a broken jawbone, remove diseased tissue or correct a dislocation in the joint, you should avoid surgery Artificial jaw joint implants have proven especially dangerous, and some have been recalled because they break down and damage surrounding bone.
Natural methods
Chiropractic treatment can be very helpful if spinal misalignment is contributing to your TMD. Acupuncture shows promise also, and biofeedback--educating your muscles to relax with the help of a machine that tells you if you're unconsciously clenching--is now a standard therapy. Studies show that up to 70 percent of patients who are trained in biofeedback as part of their therapy will get rid of their TMD for good. A Canadian study also showed that seven of ten patients who used glucosamine sulphate (500 mg twice a day) had about a 40 percent reduction in pain; the results were slightly better than the control group, which used ibuprofen instead.
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