When people experience jaw pain, they tend to assume they have a joint issue. They may even erroneously describe it as “TMJ” when really the pain could be in the jaw muscles or a result of a misaligned bite.
Issues with the jaw and facial muscles fall under a classification of temporomandibular disorders (TMD) and require patients to find a dentist who will take the time to get to the root cause of the problem. Some patients may indeed have a true joint disorder or joint damage – just as they can have joint problems in the knee or other parts of the body.
Dr. Rob Powell of Pelham Links Family and Cosmetic Dentistry said it’s best to note symptoms early and keep them from developing into more severe problems. Breaking or worn teeth, terrible headaches or jaw popping and clicking are some of the red flags.
Many people think they simply have to live with joint or jaw muscle pain, but that’s not the case, Dr. Powell said. It’s hard to diagnose because jaw pain is not a “one size fits all,” but having a conversation with your dentist, asking the right questions and figuring out what’s causing the pain – anything from bite disease to stress to clenching and grinding the teeth or even something as simple as chewing gum all the time – can lead to treatment for relief.
Clenching and grinding
What used to be called “bruxism” – excessive clenching and grinding of the teeth – is a common cause of jaw muscle pain. Everyone clenches and grinds their teeth to some degree, often the result of stress, Dr. Powell said. Clenching and grinding also can be caused by fatigue, poor nutrition or a side effect of certain medications, including antidepressants.
Some people, Dr. Powell said, are hard-wired to clench and grind their teeth. They often don’t seek out treatment, but leaving clenching and grinding untreated can lead to other issues, including joint disorders.
Determining what’s causing a person to clench and grind their teeth helps the dentist plan the best course of treatment – possibly an appliance fitted to the teeth to protect them from the wear and tear of excessive grinding.
Treating clenching and grinding is important because these patients end up spending a lot more money on dentistry, Dr. Powell said. They may have three to four times more dental work. But, with proper treatment, these patients can end up with dental health that is equivalent to someone who doesn’t clench or grind their teeth.
The bite, joint position and the jaw muscle have to coordinate. When they don’t, that’s when the pain comes in – especially if a patient is clenching and grinding their teeth, too.
Another common cause of jaw muscle pain is something called occlusal disease or bite disease. Having an uneven bite, missing teeth or improperly aligned teeth means those jaw muscles are working harder to bring the upper and lower teeth together when chewing.
A cracked or loose tooth could be the culprit. A dentist trained to look for the signs of occlusal disease can spot issues early, employ the right treatment and help the patient avoid long-term problems. If the bite disease is caused by misaligned teeth, the patient may need orthodontic work to straighten the teeth.
Some symptoms of bite disease from The Pankey Institute, an organization that provides advanced dental education programs, include:
- You clench your jaw muscles for a long period of time.
- When you wake up in the morning, your jaw muscles feel tired and sore to the touch.
- You experience pain behind the eyes.
- You grind your teeth while sleeping.
- Your jaw clicks and pops upon opening.
- Your head or scalp feels painful to the touch.
- Your ears ache or you hear ringing.
- You have neck, shoulder or back pain.
- You feel dizzy.
Though not all TMD-related issues can be cured, there are ways to treat most issues. Treatments vary as much as the issues themselves: appliances, braces, physical therapy, balancing the bite, muscle relaxers and more. Even Botox injections can be used to provide relief from jaw pain, tension and headaches.
Finding the underlying cause
Determining the best course of treatment comes down to figuring out whether the patient is suffering from muscle pain, joint pain or maybe even both.
It’s similar to back pain, Dr. Powell said. Is the spine out of alignment and causing pain, or is the muscle pain pulling the spine out of alignment? Jaw pain works in much the same way.
“Migraines, fibromyalgia, chronic fatigue – they can all stem from an issue with the jaw. It always amazes patients that their jaw pain can be the culprit of other problems,” Dr. Powell said.
While treatment options can vary, TMD is a complex issue. Patients with chronic jaw pain should take time to find a dentist with experience in the subject who is willing to get to the root of the problem and employ the best treatment.
By Holly Fisher