Temporomandibular Joint Syndrome (TMJ)

Description

Your temporomandibular joints-located in front of each earconnect your mandible (lower jaw) to each side of your skull. When working correctly, the two joints move at the same time. Temporomandibular joint syndrome (TMJ)-also known as temporomandibular disorder (TMD)-occurs when these joints are out of sync. As a result, the discs that sit between these joints and the skull slip out of position, resulting in irritation and inflammation of the joints and malfunction of the jaw.

Though stress does not cause TMJ, it contributes to the problem. Generally there is an underlying physical reason for the syndrome. In fact, it is commonly triggered by some kind of trauma to the head, neck, or jaw-including whiplash, a Physical blow to the head, jaw, or face, regular and extreme clenching of the teeth, and regular grinding of the teeth while sleeping.

Signs and Symptoms

• Headaches (in some cases)
• Jaw pain and tenderness
• Clicking sound or grating sensation when eating or opening the mouth
• Dull pain in front of the ear
• Difficulty opening or closing the mouth due to locking of the joint
• Pain in the neck, back, shoulders, face, ear, and/or throat (in some cases)

Conventional Medical Treatment

To diagnose TMJ, your physician or dentist examines your bite (the way your teeth close) for alignment abnormalities, and may perform X-rays.

Treatment may include anti-inflammatory medications. In more serious cases, a corticosteroid is injected into the jaw. You may be given a plastic bite plate to wear over your teeth to encourage proper alignment of the mandible and simultaneous functioning of the joints. Also called a splint, the device may relieve jaw-locking, pain, and noise. Such conservative therapy should be continued for at least six months before resorting to other measures. At this point, your physician or dentist may order a CAT scan or MRI to understand why you are not responding to treatments. Additional measures may include arthrocentesis, in which a fluid is injected into the joint, often releasing a locked jaw with no or few complications. Additional measures can include physical therapy, ultrasound (a method of delivering deep heat), biofeedback, or transcutaneous electrical nerve stimulation. With another, more expensive procedure, arthroscopy, the doctor uses optics to look into the jaw and remove any tissue or debris that may keep the jaw from working properly. Your doctor may prescribe anti-inflammatory relaxants to ease muscle tightness and pain.

Complementary and Alternative Treatments

Nutrition and Supplementation

Your diet should consist of lightly steamed vegetables, fresh fruits, whole grains. white fish. skinJess chicken and turkey, brown rice, and homemade soups and breads. Foods that increase stress include all forms of sugar, white flour products, junk foods, candy, colas, potato chips, and fast foods. Caffeine also increases tension, which aggravates the problem. Avoid alcohol, as it is a contributing factor in tooth-grinding, which can cause or aggravate TMJ.

To rest your body and jaws, do not chew gum, and cut back on foods that require heavy chewing, such as red meat and bagels.

These daily supplements should help treat TMJ:

• calcium (2000 mg)-has a calming effect
• magnesium (1500 mg in divided doses)-relieves stress
• vitamin B complex (100 mg 3 times daily)-the antistress vitamins
• coenzyme (60 mg)-improves oxygenation of tissues
• vitamin C (4000 to 8000 mg in divided doses)-combats stress; heals and repairs connective tissue
• glucosamine sulfate (1500 mg)

(For an acute condition, take supplements until your symptoms subside. If symptoms persist, seek the advice of your healthcare provider. For a chronic condition, consult your healthcare provider regarding the duration of treatment.)

Bodywork and Somatic Practices

CranioSacral Therapy is a leading therapy in this area.

Chiropradic

TMJ syndrome may be caused by a variety of factors, including stress, improper, alignment of the teeth, and direct trauma to the jaw as a result of a car accident or blow to the chin. After a complete dental workup, the patient may find that chiropractic care, including massage and muscle stimulation to the affected muscles, provides significant relief.

Traditional Chinese Medicine

Acupuncture By using what's known as "oral acupuncture" and focusing on points behind the last molar, an acupuncturist can mitigate the neck, face, and jaw pain caused by TMJ, along with related headaches or ringing in the ears. Distal points are also used.

Acupuncture also may be helpful in reducing stress, which can prevent recurrent episodes.

Acupressure The practitioner may focus on Large Intestine 4, Gallbladder 2, Stomach 7, Small Intestine 8 and 19, Stomach 44, and related auricular points to treat this condition.

Chinese Herbal Therapy Herbs may be prescribed to treat stress, headache, tinnitus, and other TMJ symptoms (see these individual entries for more information).