You wake up and your face hurts. Your jaw often locks at inconvenient times, sometimes just when you’re trying to brush your teeth in the morning! And then there’s the clicking. The clicking is seriously distracting when you eat!
Does this sound familiar?
Maybe the pain isn’t too bad in the morning, but it becomes more intense during the day. Work is stressful: you may find yourself clenching your jaw without being aware of it. And the way that you’re slumped in your office chair or slouching over your laptop can worsen your symptoms of jaw pain, headache, clicking, and locking.
One of my patients, seventeen-year old Emma, came to see me with these symptoms – but she also had trouble focusing and completing tasks, and felt irritable. Her concerned mom described her as uncharacteristically tightly wound.
These are all signs of temporomandibular joint disorders with an Airway/ Sleep component, which if left untreated can result in complications down the line.
Symptoms of TMJ Disorder
Temporomandibular joint disorders (TMD) may start with a simple click when you yawn or chew your food – but this symptom can progress into something more uncomfortable. It usually begins in girls after puberty and spikes again in women in their late 40’s and early ’50s, around perimenopause. Clicking may progress to jaw locking and often occurs in women with systemic joint laxity and clenching.
With TMJ syndrome you may experience:
- Clicking, popping, or grinding noise as you move your jaw
- Jaw pain
- A tight feeling across your face
- Headache around the temple
- Ear pain
- A feeling of fullness or ringing in the ear (tinnitus)
- Difficulty opening your jaw
- Jaw lock when you open your mouth
- Pain when chewing
- Pain in the mornings, or when stressed
Your temporomandibular joints have a very important job. They connect your lower jaw to the temporal bone in front of the ear, and act as a pair of hinges. The joints allows you to raise and lower your bottom jaw, and to protrude and retract it, working with your facial bones and five sets of facial muscles.
The temporomandibular joint is unique in that it incorporates the articular disc, which is made out of elastic fibrocartilage, and acts as a cushion between the two bone surfaces. When your temporomandibular joint is working normally, this cushion stops your bones from rubbing together.
A jaw click tells you something may be wrong with one or more articular discs, and therefore your jaw.
How Do You Test for TMJ?
To test for a temporomandibular joint disorder, your functional dentist can perform a physical exam by checking the full movement of your jaw, and assessing whether you are achieving your full range. They listen to the pop or scraping noises made as you open and close your mouth, and can feel the way that your mouth moves. Your dentist may also press on areas to help them identify painful or uncomfortable trigger points related to TMJ.
A Cone Beam CT (CBCT) is the gold standard imaging machine used to diagnose TMJ. The CBCT gives your a dentist a 3D view of the temporomandibular joint and skull. The image is the best way for your dentist to check for erosion of the bone, as well as narrowing of the airway
Armed with the results of the test, your integrative dentist can come up with a precision personalized plan of treatment.
What Will Happen if TMJ is Not Treated?
Your symptoms of TMJ may worsen over time if you do not seek treatment. However TMJ symptoms are self-limiting , and you may experience the following:
- Joint damage and inflammation
- Wearing down of your teeth
- Increasing muscle contraction causing pain in your head neck and face
- Development of an airway sleep disorder
- Ear ringing and fullness
Life with TMJ can be unpleasant as it affects not just your sleep, mood, and eating habits, but even the way you sit and walk, and the amount of oxygen you breathe in at night.
Airway sleep disorders (ASDs) and temporomandibular joint disorders are intimately linked. Often as TMJ progresses, a pushed back lower jaw can be the cause of your pain, and also the cause of sleep disordered breathing. The ASD provoking a lack of oxygen at night can lead to chronic headaches and neck pain, which are usually worse in the morning, and often combined with brain fog. But both conditions are easily treatable.
A Guide to TMJ Treatments
You don’t have to struggle on with a temporomandibular joint disorder, avoiding certain foods and losing sleep, feeling like you’ve barely rested when your alarm goes off. There are a number of treatments suitable for relieving the symptoms of TMJ – so you can get back your quality of sleep and enjoyment of food. I recommend finding a functional dentist to treat you, as they can look at your body as a whole, not just focus on your jaw.
- TMJ oral appliances. In my practice, I use several types of appliance, including the ACG DAY and NIGHT appliances from Prosomnus. A TMJ appliance realigns your jaw to reduce clicking and takes the pressure off the nerves by the joint. I also use other appliances to relieve facial pain and avoid grinding where applicable.
- Sleep appliances. I prescribe sleep appliances such as ProSomnus IA and Select for patients with airway sleep disorders linked with TMJ. A sleep appliance allows you to receive more oxygen at night, as it opens up your airway. An AirwayCentric® dentist is able to treat you in a systemic manner, ensuring you can breath optimally.
- Botox or trigger point injections. These injections into tender points can help relax muscles and reduce pain. Trigger point injections involve anaesthetic, and “reset” nerve endings registering pain, while botox is more of a long-term solution, as it can last up to 8 months depending on your diagnosis.
- Physical therapy. PT of the jaw should include functional manual therapy not simply exercise and massage. It should can also include correction of posture, the Alexander technique, and heat or cold therapy.
- Chiropractic treatments. Your chiropractic treatment would be tailored to you, but may involve cranial therapy, applied kinesiology, and spinal correction.
- Medication. Prescribed medication such as muscle relaxants, NSAIDS, or neuropathic medicines may come in useful as you are undergoing other treatment to help relieve sleep or simply reduce pain.
Using a mixture of these treatments is an excellent way to treat TMJ without resorting to surgery, and my patients report improved sleep and relief within weeks. A click in the jaw might seem like a minor inconvenience – but it may result in a lot of pain and discomfort down the line. Get it checked by a functional dentist, and improve your health inside and out.
If you’d like to learn more about our AirwayCentric® approach, pick up a copy of GASP!: Airway Health – The Hidden Path To Wellness by Dr. Michael Gelb and Dr. Howard Hindin. If you’re struggling with headaches and jaw trouble in the New York area and suspect TMJ is to blame, fill out our contact form, or call to make an appointment with Dr. Gelb on (212) 752-1662.