“What can I do for my painful TMJ? ”

“ I have TMJ.”  Do you, or someone you know, suffer from jaw pain?  Temporomandibular joint disorders (TMD) include a number of clinical problems that involve the temporomandibular joint (TMJ), the muscles we use to chew,  or both.  

TMD can feel like a generalized pain across the face, sometimes referring to the neck and upper back.  Most people can sense a  jaw ache, although it can also feel like an earache, a toothache, and/or  a headache.  Most patients notice their “TMJ” when trying to eat.  Dr. Aliisha has noticed in her patients that stress is often a culprit in causing facial pain.

Problems associated with the TMJ have to due with the structures that allow our jaw to function.  There is a cushioning disc that slides between the jaw bone (mandible) and the skull (temporal bone) 

Sometimes the disc gets out of place  and can be painful  due to inflammation of the disc tissues or capsule.  If the disc is able to go back into place a click is heard.  When the disc is unable to click back into place most people feel it as not being able to open all the way, and trying to open their mouth hurts.  Arthritis can also damage the TMJ resulting in pain and diminished function. 

Pain in the muscles we use to move our jaw can be debilitating, and most commonly I, Dr. Aliisha, find the masseter to be the most common source of pain.  To find the masseter muscles, press your teeth firmly together and feel for a “bulge” just in front of and below your ears. If pressing here replicates the pain you have been experiencing, there are several things you can do at home to help.  (Of course I recommend that you also consult with your dentist.)  Self care for TMJ pain includes:  rest, trying to de-stress, a soft diet,  avoiding opening wide,  and becoming aware of day time or night time habits that are contributing to the pain.  

Daytime habits associated with TMJ pain include:

-clenching the teeth (making the masseter muscles enlarged and shortening the muscle fibers,) 

-chewing on gum, ice, straws/toothpicks, fingernails, etc., 

-other habits that cause injury: such as using our teeth to open things, tear tags, etc.     

Once a patient is more self-aware of daytime habits, we work on helping diminish the damaging habit.   Examples include- making the “N” sound to help relax the jaw. At rest, our lips should be closed, and our teeth NOT pressed together.  We should be breathing through our nose and not sucking or chewing on our cheeks or sides of tongue.  

Nightime habits involve griding teeth-- what dentists refer to as “bruxism.”  Treating bruxism will be the topic of a separate post.

Once your doctor examines you, sometimes muscle relaxants or an oral appliance will be prescribed (depending on the source of issue.)  In appropriate cases, Dr. Aliisha has advanced training in using neurotoxins (also known as Botox or Xeomin) to help alleviate pain and dysfunction caused by overactive muscles. In addition, (again depending on the source of the TMJ issue,) there are several therapies such as orthodontics, sleep medicine, massage, and physical therapy to help bring the patient relief and improved functioning.  As a last resort, surgery will be discussed. 

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