It seems like all my friends have jaw pain.
As we got deeper into our thirties, I was ready to hear about bad backs and troublesome knees. But the mouth thing was unexpected. Some were at night they would grind their teeth and need mouth guards. Others had doctors inject botulinum toxin, commonly called Botox, into sore jaws. And we’re all now very familiar with a new body part: the TMJ, or temporomandibular joint, which connects the jawbone to the skull.
TMJ is a common, convenient abbreviation for jaw pain, but the correct term for the condition is temporomandibular disorder, or TMD. There are several types of TMD, all of which involve jaw bones and muscles.
About 10% to 15% of adults have some form of jaw disorder, estimates Dr. Thomas P. Sollecito, professor and chairman of oral medicine at the University of Pennsylvania School of Dental Medicine. “The vast majority do not require treatment,” he says. TMD may resolve on its own, or may be painless and require no intervention.
So how do you know if the clicking sound your jaw makes is a problem? Do you have TMD or have you just been sleeping strangely? We asked experts.
What are Temporomandibular Disorders (TMDs)?
TMDs are “conditions or symptoms related to the structure and function of the jaw system,” explains Dr. Karyn A Kahn, a dentist at the Cleveland Clinic.
According to the National Institute for Dental and Craniofacial ResearchTMDs fall into three main categories: disorders of the temporomandibular joint, disorders of the muscles used for chewing, and headaches associated with jaw tension.
Because TMD covers a range of conditions, symptoms can vary. “There are many different signs and symptoms that may indicate a patient is experiencing a jaw disorder,” says Kahn. These include a clicking or popping sound in the jaw, facial pain, tooth fractures from grinding, limited jaw movement, and even seemingly unrelated problems such as headaches and earaches.
Women suffer from TMDs more often than men, although no one knows exactly why. Some studies have found a link between estrogen and jaw pain, Kahn says. Sollecito says others have also suggested that women experience stress differently and engage in jaw clenching more often. “And some people think that women simply seek more (medical) care than men,” he says, meaning more cases have been recorded in women.
What Causes TMDs?
TMDs have several causes. They can result from physical trauma (for example, a blow to the jaw), genetics, anatomical factors such as how your jaw is aligned, and lifestyle habits such as chewing gum or eating a lot of chewy foods such as bagels.
Temporomandibular disorders have also been found to overlap with some chronic pain conditions such as migraines, fibromyalgia, chronic back pain and chronic pelvic pain in women, says Dr. Clark Stanford, professor of prosthetics and dean of restorative dentistry at the University of Iowa.
TMDs can also result from emotional distress. Stress can lead to jaw tension and teeth grinding, both of which strain the jaw muscles and cause pain. Stanford’s diagnostic process includes both a comprehensive clinical examination and a psychological assessment. A recent patient had been suffering from acute jaw pain for several months. As they spoke, he learned that she had recently lost a close friend and as a result had been combining work stress and personal grief.
“It sounds weird when a dentist asks what’s going on in your life,” says Stanford. “But once patients understand why they grab their teeth all the time, they often understand the need for an intervention to reduce that habit.”
after newsletter promotion
How are TMDs treated?
In general, experts recommend starting small when it comes to TMD treatment. For those who grind their teeth at night, doctors often prescribe a night guard – a plastic, retainer-like device – to help protect their teeth.
So-called self-help therapies are also useful tools. Stanford says this may include daily exercises to loosen the jaw, awareness of sleep habits, and education about which foods can make pain worse. In some cases, cognitive behavioral therapy and other stress reduction techniques may also be helpful.
In cases where TMD is primarily the result of jaw clenching, doctors may do so recommend botulinum toxin, commonly called Botox. When injected into the masseter muscles on the sides of the jaw, it reduces the amount of muscle contraction in the area and reduces clenching and pain, Kahn explains.
In some advanced cases, open joint surgery for TMJ may be necessary, Kahn says. But that is only possible if “all conservative therapies have been tried and failed” and the jaw pain “is inhibiting their quality of life,” she says.
If you experience jaw pain, consult a doctor or dentist. But if your jaw makes an occasional clicking sound and you have no pain, you’re probably fine. Sollecito estimates that a third of people have a jaw click.
“Pops and clicks don’t excite me,” says Stanford.