Temporomandibular Joint Disorder (TMD)

The National Institutes of Health estimates that 5 to 10 percent of Americans have TMD, or problems affecting the jaw joint and/or muscles. Your temporomandibular joints are located where the skull connects to your lower jaw. To feel these joints, place your fingers in front of both ears and open your mouth. The muscles on the sides of your head and face control the movements of the joints. Researchers believe women between 20 and 40 may be more likely to suffer from TMD due to hormone levels.

Approximately one in eight Americans suffer from headaches. Experts estimate that 75 percent of all headaches are caused by muscle tension, which may be related to the bite. Headaches also can be caused by clenching jaw muscles for long periods of time. Signs that may indicate a headache of dental origin include:

• Pain behind the eyes
• Sore jaw muscles or "tired" muscles upon awaking
• Teeth grinding
• Clicking or popping jaw joints
• Head and/or scalp is painful to the touch
• Earaches or ringing in the ears
• Neck, shoulder or back pain
• Dizziness

If you have gone through treatment and still experience orofacial pain, you may have a sleep disorder, such as bruxism, or a sleep-related breathing disorder, such as snoring or sleep apnea. Bruxism is the technical term for grinding and clenching. Snoring that goes undiagnosed may lead to an increased tendency for the airway to collapse, leading to sleep apnea. Sleep apnea is a condition when the tissues and muscles in the back of the throat collapse the airway. People with untreated sleep apnea stop breathing repeatedly during their sleep, sometimes hundreds of times during the night and often for a minute or longer.

Your dentist has a variety of treatments that can help alleviate your orofacial pain. One device is called an orthotic, or splint, that is worn over the teeth until the bite can be stabilized. Permanent correction may require reshaping teeth, building crowns, orthodontics or a permanent appliance for the mouth. Your dentist might also recommend physical therapy, counseling, relaxation training or massage therapy.

Other ways to alleviate the pain include:

• Place an ice pack on the painful area for 10 minutes, three or four times per day.
• Eat softer foods and avoid chewing gum or ice.
• Cut food into smaller pieces.
• Keep upper and lower teeth slightly apart, except when chewing or swallowing. Keeping your tongue between your teeth may help  with this.
• Sleep on your back.
• Don't rest your hand on your chin. When talking on the phone, don't rest the receiver on your shoulder.

Your dentist will take a medical and dental history to determine if any trauma has occurred in the facial area, perform a physical examination to examine your temporomandibular joint and head and neck. Maintaining or correcting your bite ensures optimal health, and proper care will help reduce or eliminate orofacial pain or discomfort.

Orofacial pain includes a number of clinical problems involving the chewing (masticatory) muscles or temporomandibular joint. Problems can include temporomandibular joint discomfort; muscle spasms in the head, neck and jaw; migraines, cluster or frequent headaches; or pain with the teeth, face or jaw.

You swallow approximately 2,000 times per day, which causes the upper and lower teeth to come together and push against the skull. People who have an unstable bite, missing teeth or poorly aligned teeth can have trouble because the muscles work harder to bring the teeth together, causing strain. Pain also can be caused by clenching or grinding teeth, trauma to the head and neck or poor ergonomics.

Some people may experience pain in the ears, eyes, sinuses, cheeks or side of the head, while others experience clicking when moving the jaw or even locking if the jaw is opened or closed.