What causes TMJ? When you have TMJ, what happens? TMJ is a medical ailment that can occur to anyone. This condition is specific to the head and neck area. Symptoms can include pain, limitations in movements (like opening your mouth), and headaches, to name a few.

Dr. Eslampour at TMJ & Sleep Apnea Center in San Marcos has years of training and experience treating patients with TMJ. While his main goal is to help prevent TMJ for his patients, he also treats patients with active and chronic TMJ. So let’s begin by looking at what it means when you hear someone say, “I have TMJ.”

TMJ – More than a Joint

TMJ is the abbreviation of the medical terminology for the jaw joints: Temporo-Mandibular Joint. But that is not what people mean when they say they have TMJ. They are referring to the fact that there is something wrong with the jaw joints causing some degree of pain and other symptoms such as limited range of motion (e.g., not being able to open wide.)
Over time the term “TMJ” has become more of a catch-all phrase for pain and problems not stemming from a tooth that affects the head and neck area. Sometimes people refer to TMJ issues as TMD. These terms can be considered the same.

TMJ causes can be any of the following: jaw pain of various degrees, tension headaches, limited range of motion, jaw joints popping and clicking, catching, locking, abnormal opening/closing motion, ear stuffiness or ringing, tired jaw muscles, neck stiffness, or pain on moving, change in bite, broken teeth, loose teeth, bone loss, a shift in jaw position, facial changes and more.

Our jaw joints are always in use. Any time we move our mouth, we are using the jaw joints. When we chew our food, yawn, swallow, laugh, and more, we use the jaw joints. And we don’t ever think about our jaw joints ‘til we have a problem.

Joints, in general, are designed to allow for a smooth interface between the two bones involved. Usually, this is achieved by a piece of cartilage or similar. They protect the bones from being rubbed against each other, which causes pain and bony changes similar to arthritis. And jaw joints are no different. Their purpose is to allow for smooth opening and closing of the jaw. And like other joints in the body, trauma can also damage jaw joints. And the damage can impact the jaw bone and the small disc of cartilage meant to protect the jawbones. TMJ can also be due to the over-activity of specific muscles. These patients also suffer damage to the jaw joints eventually, but the problem is not coming from the joint. Instead, the joint becomes the victim of overactivity of the muscles.

TMJ Causes

So what are some of the causes of TMJ? TMJ can be due to many reasons. And all of these reasons have one thing in common: they cause trauma to the jaw joints and muscles.

Trauma to the head and neck area can result in TMJ. And trauma is hard to prevent. In a car accident, even a small one, there is trauma to our body and joints. The impact of the accident can damage a weakened jaw joint compared to a healthier joint. If the person in the car accident has asymptomatic TMJ, the accident can make the TMJ symptomatic.

 

 

Car accidents are not the only type of trauma. Playing sports without protective gear increases the risk of getting injured and developing TMJ. Being hit with a ball to the face, an elbow, a fist, a foot, falling, or having someone fall on you, are only a few examples of sports trauma.

Trauma can also result from innocuous events like your dog bumping you in your face. Or your infant or small child accidentally banging into your head with their head or similar. The point being is that many forms of trauma can cause damage. Another source of trauma, albeit self-inflicted, which causes TMJ is excessive muscle activity.

Muscle overactivity leads to the buildup of massive amounts of pressure in the jaw joints leading to joint damage. Habits such as clenching of the teeth (e.g., squeezing them together) or grinding the teeth (e.g., squeezing and rubbing them against each other) even for a few seconds lead to TMJ over time. Not only that, clenching leads to buildup of lactic acid in the jaw muscles.

The accumulation of lactic acid causes the muscles to feel tired and worn out. These muscles will get fatigued easier. And to make things worse, the more we clench, the stronger these muscles become. And over time, the damage caused by clenching will become more pronounced.

As the clenching gets stronger, it will lead to tooth damage. Teeth may chip or crack and break. Sometimes the teeth start moving and shifting around, leading to changes in the bite. Also, facial changes become noticeable. People who clench develop a “square” appearance of the jaw.

The jaw bone itself may start becoming thicker in some parts. Big bony masses (called a “Taurus” or “Tauri” for multiple bony groups) start developing on the jawbones. Most patients don’t notice these as they develop slowly over time.  However, after a while, they start causing problems. They may cause the tongue to shift backward which can lead to sleep apnea. They can also cause trouble when eating certain foods like chips or tacos.  And when you need dental care, it makes it challenging for both you and your dentist.

Habits that can lead to TMJ include gum chewing. Chewing gum for hours on end is very traumatic to the jaw joints and the muscles involved. Clenching while doing mundane tasks like reading or driving or cooking or working or sleeping causes TMJ over time. Any activity which results in us squeezing our teeth together has the potential of causing TMJ over time.

TMJ – Treatment

TMJ treatment involves relieving the pressure built up in the joints and the muscles over the course of the disease. The initial goal is to alleviate the pain associated with this disease. The long term goal is to prevent the disease from returning and causing more damage.

Before treatment begins, the head, neck, and jaw joints are thoroughly evaluated and examined. The symptoms will dictate what therapy measures will be most effective. The treatments used most often are using splints for reducing the load on the jaw joints. Our doctor may also recommend physical therapy and electro-therapeutics (e.g., TENS). Using medications to relax the tight muscles (e.g., Botox) can also be considered. Surgery is not recommended very often as it doesn’t have a high success rate.

TMJ, like high blood pressure, needs continuous monitoring and prevention to keep it under control. While there are no pills to take for TMJ, minimizing clenching and grinding forces is key to long-term success.

TMJ – Preventative Measures

There are steps one can take to reduce the risk of developing TMJ. Listed below are some helpful tips aimed at reducing the risk of getting TMJ.
We’ll go over daytime routines that you can readily implement. We’ll also discuss nighttime treatment (for when you sleep).

Daytime Recommendations/Tips

First and foremost, be aware of your clenching/grinding. If you catch yourself doing this, you want to stop it as it is the fastest route to TMJ. Most people don’t even notice that they’re clenching, so you may have to pay attention to see if you do. People clench their teeth for a variety of reasons. No matter the reason, we need to stop this habit for a more successful outcome. As a simple solution, you can wear a rubber band on your wrist and every time you catch yourself clenching, give your wrist a little whack. After a few times, your brain will be more cued into not clenching or risk getting whacked again.

Avoid chewing gum for excessive periods. Gum chewing loads the joints tremendously. It also causes the muscles to get stronger over time, leading to more forceful clenching. Chew the gum ‘til the flavor is almost gone and then get rid of it.

Avoid poor posture or ergonomics at work and at home. Cradling a phone between your head and shoulder leads to neck pain and stiffness, which can lead to and exasperate pre-existing TMJ. Even sitting slouched or hunched over leads to muscle strain, which can cause TMJ.

Be aware of the side effects caused by medications you may be taking. Some medicines cause clenching. Be mindful of this so that you are more vigilant against it.

Manage your stress. Stress causes different medical problems, and clenching is one of them. Try other stress relief routines like yoga, stretching, and meditation. Warm baths and massages are excellent for stress reduction. Lavender also has soothing qualities reducing our daily stress.

Working out is a great stress reliever. Find a physical exercise you enjoy and get into a routine. You’ll get fit and reduce your overall stress. Pets (especially dogs) are also a great source of stress relief. They take your mind off of more stressful life events.

A filling or a crown that is not the right size sometimes causes TMJ. When your dentist places a filling or crown, you may not notice that your bite is off since you are numb. So after the numbness wears off, if your chewing doesn’t feel normal, visit your dentist to make the necessary adjustments.

Nighttime Recommendations/Tips

Some people clench in their sleep while others do it while awake. And some people do both. Through careful analysis of the symptoms, Dr. Eslampour can determine what the patient is doing. And if the patient’s diagnosis is a nighttime clencher, then a TMJ Night Guard is prescribed.
The purpose of a TMJ night guard is to prevent clenching. The night guard is custom made for the patient and designed to treat the symptoms. A TMJ nightguard should not be confused with a sports mouthguard or one made by your dentist. A TMJ nightguard is quite different than other mouthguards. When a patient has TMJ, using any other nightguard leads to further problems and more pain.

TMJ – Not Trigeminal Neuralgia

Trigeminal Neuralgia is a painful condition that causes severe pain in particular parts of the face. While not due to a problem with the jaw joints or the muscles, this condition gets lumped with TMJ.

Symptoms are sharp, jabbing, lancing, electric-like pain that always affects the same part of the face. It may be months or weeks between episodes, but the attacks will keep recurring over time. This disease is tough to treat as the pain source seems to be coming from the nerves. The goal of the treatment is minimizing the pain when the disease is active. Therapies aimed at treating the facial nerve bundles may also prove useful, though very technically and economically demanding.

TMJ Dentist – Sonny Eslampour, DDS

Dr. Eslampour has years of training and experience treating patients suffering from TMJ. Our doctor spends the first visit finding out the cause of the symptoms. With the diagnosis at hand, he can then treat the problem more efficiently. As our doctor explains, TMJ reduces the quality of life. TMJ pain early on is more easily managed compared to chronic pain caused by years of TMJ.

Usually, when you have pain in your face or your cheeks or jaws, you start thinking it’s due to a bad tooth. And sometimes that is true. But not all pains are due to toothaches. Occasionally your dentist may diagnose your TMJ pain like a toothache. In these cases, even after the “suspect” tooth is treated, the symptoms remain. And the reason is that the pain is not from the tooth. TMJ instead causes pain.

If you suffer from pain and your dentist cannot resolve it for you, it may be due to TMJ.  If you use a nightguard to treat jaw pain and still wake up with pain daily, then you don’t have the correct type.  If you have had new dental work and you’ve been given a nightguard to use which causes you to have jaw pain in the mornings, you have TMJ waiting to explode. We can help you resolve TMJ symptoms without surgery. Contact us today to set up your consultation with Dr. Eslampour. You can also fill out the form below and we can contact you.