Jaw Pain
I
've seen a lot of folks over the years with jaw pain. First, it's good to make sure it is not a pure dental problem. If your teeth are all good and you still have jaw pain, you may have a Temporal Mandibular Joint ( TMJ) issue. The very same muscles that allow us to chew, bite down, the Masseter and Temporalis Muscles are usually sore with this condition. Take your fingers and see if the muscles just in front of your ears and jaw line are tender or have a dentist or other doctor check for you. The TMJ joint is located just in front of your ear lobe. You can open and close your mouth and feel the joint there. It can be painful as well with TMJ and in fact, usually is very sore indeed. You may also have popping or cracking sounds as you open and close your jaw. The range of motion from full wide open to closed mouth may be limited and painful. Headaches and head soreness can be associated with this issue of TMJ as well. Pain usually runs from the TMJ area up the side of the head in front of the ear to the crown of the head.
The Cause
The TMJ is lined with cartilage and has a pad called a meniscus for the joint to pivot on, just like the knees do. It can be damaged by blunt force like a direct blow or car accident or over time with repetitive motion/stress like always chewing gum or tobacco, hard candy, nuts, etc. Injuries 96
to the neck, such as whiplash can cause TMJ problems as well and it need not be from a common car accident. Near crashes, hard landings, a wicked bounce in your buggy, truck, ATV, quad or bike can all cause this problem. Simple and plain stress can be and is a common cause of TMJ seen at my clinic. Hours at the desk, money and or relationship issues, job worries, stress of all types can cause folks to clinch and or grind their teeth. This is called Bruxism and is often seen by dentists and TMJ specialists and can also affect a person's sleep. It can be extremely painful and affect a person's ability to eat and chew their food properly. Dentists will often take x-rays of the TMJ and then take a mold of your mouth and teeth. They will then send the molds out to a lab that will make an appliance you are supposed to wear like a sports mouth/teeth guard to keep the person from grinding their own teeth at night while sleeping and even in the daytime. I've personally seen prices for these sort of treatments go from about $500 for the appliances to quotes of $6,000 for all treatments and x-rays.
The problem with guards
Here is my beef with these bite/ night guards. They still allow the person to clinch down. This clenching in turn causes the jaw muscles to engage, flex and work. They get very sore and fatigued with no rest. That causes the pain of TMJ most of the time unless an MRI of the TMJ joint and meniscus reveals a tear or degeneration in the joint itself. A plain X-Ray will generally not reveal the cartilage and/ or meniscus of the TMJ. Only the MR (Magnetic Resonance) image will show
S&S OFF ROAD MAGAZINE - DECEMBER 2020 - www.ssorm.com
those structures unless they are calcified and then they may indeed show up on a plain film X-Ray. As I related, these night guards can be expensive and still do not prevent a person with TMJ from clenching and grinding but they do protect the teeth from the pressure of the other teeth. There is a device called a "Discluder" and only some dentists are aware of it. It is more like a retainer you wear in either the upper or lower mouth. It snaps into place like a retainer you would get from an Orthodontist. You generally cannot see it when you are wearing it. It prevents occlusion. That is it prevents the teeth, mainly the molars, from being able to come together. This in turn prevents the clenching muscles of the jaw, that allow us to bite down and chew our food, from engaging. This and ONLY this, can really prevent Bruxism, grinding of teeth, day and night for the folks who are chronic clinchers.
Alternative Treatment
In my opinion, a dentist that can make you a Discluder is your best bet if you grind your teeth and that is the cause of your TMJ problem. The Discluder device is a small plastic/acrylic piece that prevents your front and or back teeth from coming together completely and this prevents occlusion/clenching and lets the jaw muscles relax! At my clinic I also use a combination of therapies to help out. They include therapeutic ultrasound, electrical muscle stimulation, stretching and often a referral to a DDS that can make you a proper Discluder. I had to go through this myself with all this TMJ pain. I had it on one side and was grinding my teeth at night during my sleep and even in the daytime. It was just before I got married back in the mid 1990's and I guess I was nervous, for darn good reason! Ha! But, we are better now! If the TMJ issue came on after an accident, the bones of the upper neck can also be slightly misaligned, not moving properly and putting slight pressure on the nerves, called a subluxation, to the TMJ area and associated muscles as indicated
