Within the joint itself, there are moving parts that allow the lower jaw ( mandible ) to close on the upper jaw.
The joint is designed as a ball & socket with a disc sandwiched between it.
The TMJ is one of the most frequently used joints in the body every day; especially in chewing, biting, yawning & talking.
The joint is very complex which also makes it very delicate, sensitive & prone to injury.
The muscles,tendons & bones which make up the joint contribute to the operation of the joint.
When the muscles are relaxed & balanced & both jaw joints can open & close comfortably (properly aligned), talking, chewing, biting & yawning are typically pain-free.
The TM joint can be located by putting a finger on the flap of skin that protects the opening of the ear & then moving the finger slightly forward.
Pressing inwards firmly & opening & closing the jaw will allow you to feel the action of the TM joint.
The motion can also be detected by gently inserting a finger partially into the ear canal & again opening & closing the jaw.
If these movements cause a considerable amount of pain, it is pretty certain that TMJ syndrome is present & treatment should commence immediately.
TMJ disorders are a group of complex problems involving the jaw joint.
TMJ disorders may also be referred to as myofascial pain dysfunction or Costen’s syndrome.
Because all components of the joint work together, a problem with any one component can lead to stiffness, headaches, ear problems, bite problems ( malocclusion ), clicking sounds, popping sounds, tooth & gum pain ( in the absence of tooth decay or gum disease ), locking of the jaw, poorly aligned teeth, inability to fully open the jaw, difficulty chewing, ringing in the ears, dizziness, neck, shoulder & arm pain, a tendency to clench the jaw, & even visual disturbances in some cases.
Bruxism ( teeth grinding & teeth clenching ) will increase the wear & tear on the cartilage lining of the TMJ. Those who clench their jaw or grind their teeth may be unaware of this behaviour unless they are told by someone else while sleeping or by a health professional such as a dentist or chiropractor who will pick up on the telltale signs of wear & tear on the teeth &/or the joint itself.
Many patients wake up in the morning with jaw or ear pain.
Habitual gum chewing, habitual rock candy chewing or fingernail biting can also cause TMJ disorder.
Malocclusion — dental problems & misaligned teeth will make it difficult for patients to find a comfortable bite.
They may also notice that their teeth do not fit together the way they used to. Chewing only on one side of the jaw can lead to or be a result of TMJ problems.
Often times children will adopt the same chewing patterns as their parents.
If the parents chew habitually on one side, their children will unconsciously learn this behaviour from them.
Jaw problems are soon to result.
Trauma – previous fractures of the jaw or facial bones can lead to TMJ syndrome.
Birth trauma especially if forceps or the vacuum assist were used, direct blows to the jaw from contact sports, whiplash injuries whether from sports injuries or motor vehicle accidents, kids falling directly on their chin & extensive periods of dental work where the mouth is held open for extended periods will also lead to TMJ syndrome.
All of these will cause a structural misalignment of the TM joint.
Posture – forward head carriage seen predominantly in those who sit frequently at a computer frequently or play video games will alter the alignment of the cervical spine (neck). This will irritate the nerves in the neck which supply the TM joint. The pinched neck nerves will then refer pain to the TMJ area.
This includes holding the phone between the neck & the shoulder and the use of the tiny ear phones that fit directly into the ear canal ( ipods ).
Stress – not knowing what the effects of stress are or how to manage stress will lead to unreleased nervous energy. It is very common for people under stress to release their nervous energy by either consciously or unconsciously clenching or grinding their teeth.
This will certainly over time cause a misalignment of the TM joint, resultant inflammation & then the pain will follow.
TMJ disorders usually occur due to physical misalignment of the joint itself &/or unbalanced activity, spasm or over use of the jaw muscles. One rarely happens without the other.
Approximately 80% of patients with a TMJ disorder will complain of headaches & 40% will report facial pain.
This pain is often made worse by opening & closing the jaw.
Sometimes exposure to cold weather or air-conditioning will cause an increase in the pain.
About 50% of patients will notice ear pain with a TMJ disorder.
This will be in the absence of an ear infection but it is not uncommon for ear infections to cause a TMJ problem.
I have also seen patients with TMJ disorder suffer from recurrent ear infections as a result of their jaw problem due to the proximity of the ear & the TM joint.
Hearing loss & drainage of pus from the ear will usually distinguish an ear infection, but it is not uncommon for patients not to hear as well on the same side as the TMJ dysfunction. Grinding, popping or crunching sounds ( termed crepitus ) are very common in patients with TMJ syndrome.
These may or may not be accompanied by an increase in pain.
Dizziness is reported by about 40% of patients with TMJ disorder. It is usually not the spinning type ( vertigo ) but usually a vague sense of dizziness or imbalance.
Hearing loss will affect about 33% of patients with TMJ problems. It is usually described as muffled, clogged or full ears.
They may notice ear fullness & pain during airplane take-offs & landings.
These symptoms are usually caused by problems associated with the Eustachian tube, the structure responsible for pressure in the middle ear. The muscles responsible for opening & closing of the Eustachian tube are thought to be affected by TMJ disorder.
Ringing in the ears ( tinnitus ) will affect 33% of patients with TMJ syndrome. Again, this is thought to be due to the proximity of the ear & the jaw. Of those patients, half will report resolution of the ringing after the TMJ problem has been treated successfully.
Most patients are prescribed drugs & medications such as pain-killers & anti-inflammatories. Understand that these may offer symptomatic relief only but will not & do not address the cause of the problem.
Rest, heat therapy, ice therapy, a soft diet, physical therapy & stress management have also been prescribed for TMJ patients with some success. Of course, dental intervention may be required to correct bite & poorly aligned teeth in TMJ patients.
Orthodontics ( braces), dental restorations ( crowning , bridging, grinding down ) & night guards ( to prevent clenching & grinding ) have also been used with varying degrees of success.
And in extreme cases, or those cases where the less invasive modes of treatment have failed, surgery is then recommended.
I would suggest this to be the absolute last resort as I have rarely witnessed a successful jaw surgery.
Chiropractic care: what many patients do not realize ( either because they are unaware or their family doc or dentist is unaware ) is that chiropractic care has proven to be highly effective in helping people with TMJ syndrome.
Because we are experts at treating disorders & conditions related to the joints of the spine & extremities, we have the knowledge & the techniques to address structural misalignments of the TM joint.
Our treatments are non-invasive ( no drugs, no surgery ), address the cause not just the effect ( symptoms ), & work hand in hand with any dental correction that may be required in some instances.
In our clinic, we have had great success treating patients suffering from TMJ syndrome.
So if you are struggling with jaw pain & do not know what to do next, or if you are considering surgery for your TMJ problem PLEASE give us a call.
Remember that there is never any charge to come in & discuss your concerns with us. We are always here to help in any way that we can so please call today.