TMJ SYNDROME - FACIAL PAIN ETC FROM YOUR TEMPOROMANDIBULAR JOINT

The tmj syndrome includes headaches, earache, facial pain and neck pain, discomfort when chewing etc, due to problems with our jaw joint.

One may become aware that one's teeth don't fit together the same as before.

The cause of temporomandibular disorders is malocclusion plus tension, but it is after whiplash injury that temporomandibular joint symptoms often first appear.

We “grit our teeth” in lots of circumstances. This seems to be a natural thing to do, for some reason, possibly getting us ready for a fast takeoff in an emergency.

Some people do it a lot, and get sore jaw muscles and jaw joint as a result. This is usually put down to a reaction to stress.

The muscles which close the jaw in chewing, pass from the skull down to the lower jaw bone.

A muscle can only shorten when it contracts. It cannot pull one end in more than the other.

When we chew, our jaw muscles acting alone would therefore pull the skull down as well as the lower jaw up.

This doesn’t happen, as the neck muscles tighten at the same time to stop the head bobbing as we chew.

If one habitually clenches one’s jaw, this same mechanism operates, tightening up the neck muscles and producing symptoms of the tmj syndrome.


Examining your jaw movement for any restriction.

See how many finger tips you can fit between your lower and upper teeth. This should normally be 4 (held together vertically.)

Press gently between the head of the Mandible and the ear, as you open and close your mouth. Try to estimate whether the gap between them is the same on both sides, and whether the head of the mandible moves equally on the two sides.

Feel for tenderness of your jaw joint.

Press on your cheek bones with a finger from each hand. Move your fingertips back, repeatedly pressing up and down on the bone, until they are touching the front of the ear.

Now open and close your mouth, and you should be able to feel the lower jaw bone moving.

As you open and close your mouth, press firmly over the faint cleft between the cheek bone extension and the rounded upper end of the jaw bone (“head of Mandible.”)

Is this tender on one or both sides, compared to pressing on the cheek bone with the same pressure?


Place the tips of your index fingers in your ears and press firmly forwards (against the head of the mandible) to detect any tenderness on either side.


Now press repeatedly as you move along the depression immediately above the cheek bone, and observe any tender spots here (in Temporalis muscle.).


Observe your centric occlusion

You do this by going to a mirror and baring your teeth. Clench your jaw and look at the front two teeth of each jaw. Is the gap between them on the upper and lower jaw, lined up exactly?

The way your upper and lower teeth fit together when you touch them during swallowing, or clench your jaw, is called your “occlusion.”

The head of the mandible on each side should then be in the same part of its range of movement. It normally slides forward as we open, backwards as we close our mouth.

If you’ve lost back teeth especially, but quite often anyway, it may be in a different position on the two sides. The temporomandibular joint becomes strained and sore, producing the tmj syndrome.

Mandibular overclosure and tmj syndrome

Here, both mandibular heads are too far back, as the jaw bones have lost vertical dimension. This can strain the joints and even dislocate the mandible from under the intra-articular discˢᵉᵉ ᵇᵉˡᵒʷ.

Some treatments to consider

If any of the abnormal findings are present, and you have headache or facial pain, a check up for temporomandibular disorder by a specialist dentist is worth considering.

People like Harold Gelb and Joseph Da Cruz, are experts in this field of tmj syndrome.

The first thing to do, is to start working on the habit of clenching your jaw, if this is what your do.

Put the tip of your tongue between your teeth, just touching the inside of your lips. Do this every time you find yourself touching your teeth together.

Wearing a special splint (like a denture) can help, and sometimes specialized orthodontic work is used, considering carefully the TMJ funcion.

Rather than the usual diazepam, acupuncture is often very useful for relief of symptoms of tmj syndrome.



tmj syndrome may be an expression of emotional tension.

From temporomandibular syndrome to sinus pain



Dislocated jaw - easy to replace if you know how

Some people, including my father, get their jaw stuck open - wide open. Yawning is the culprit.

Acute, dramatic "tmj syndrome."

Someone needs to get their thumbs on the victim's back lower teeth, and push down.

Hey presto, all is back to normal! (with a bit of a clunk)

Clicking or popping jaw.

"Anterior disc dislocation with reduction" (ADWR) is quite a mouthful, and refers to the cartilaginous disc in the jaw joint(s.)

The plural was deliberate, as the temporomandibular joint is essentially two joints, one on top of the other, separated by the disc. Your cheek bone stays still and the disc moves back and forward on it, while the lower jaw bone rotates on that.

The disc can pop in and out from between the bones (mostly because the jaw bone is moving too far back - overclosure.) This can be the cause of the noise.

"Atypical facial pain" - what is left after checking all over

It's a bit like diagnosing irritable bowel syndrome, if it's not your teeth or sinuses, what is it?
It's probably the muscles and joints around here, which get ignored a lot of the time.

Some extra places you can check on yourself for soreness, are inside your mouth and at the front of your neck.

If you feel the inside of your cheek with the opposite index finger, and go further back here, you feel the lower jaw bone.
A tiny bit further if you can, and you are pressing on jaw muscles.

Compare your two sides, with the same pressure, for different tenderness.



Press directly backwards, very gently, right alongside your voice box. If you feel a strong pulse it is your carotid artery and you should desist.

More likely, you will feel the neck bones, the artery and jugular vein being further out to the side.

If you gently run your finger up and down alongside your voice box, you may feel the bumps which are the individual bones of your neck. If you can feel these, it is in the grooves between them particularly, to feel.

Compare your two sides for tenderness, with the same gentle pressure. Increased tenderness is often confined to one level on one side.



Next is sterno mastoid muscle, which is on the surface of your neck and runs on each side from behind your ear obliquely down to your breastbone.

You can pinch this muscle up between fingers and thumb, moving up and down both sides looking for a tender spot.

If you do find such a spot in sternomastoid, just hold on to it for a couple of minutes until it relaxes.



Treatment is the same as above, for tmj syndrome.



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