TMJ disorders call for conservative care

November 14th, 2023

Opening and closing your mouth is an action taken for granted by most people, but if you suffer from temporomandibular disorders, it can be painful and lead to a myriad of other problems in the head and neck.

Dr. Steven Bender, clinical associate professor and director of the Clinical Center for Facial Pain and Sleep Medicine, said the disorders are often referred to as TMJ because that’s the affected joint.

“TMJ is the temporomandibular joint,” he explained. “Basically, it’s the jaw joint right in front of our ears. They’re the hinges that allow the mouth to open and close, so they affect people’s ability to bite, swallow, speak and even make facial expressions.

Patients suffering with TMJ disorders could experience pain in the jaw muscles, chronic headaches, jaw muscle stiffness, pain in the neck and shoulders, limited movement or locking of the jaw, ear pain or ringing in the ears, dizziness, vision problems, a bite that feels “off” or even grating in the joint when opening or closing the mouth.

Bender said there are various causes of TMJ disorders. Trauma from injuries or disease such as arthritis are common, he said, but the joint can also be hurt by overuse. Someone who habitually chews gum, for example, could hurt their jaw joint. Bender clarified TMJ disorders are much more likely to occur in someone who already has other health issues. According to the TMJ Association, 85 percent of patients with a TMJ disorder suffer from other health conditions.

No matter the cause, Bender emphasizes a conservative treatment plan.

“I normally recommend limiting function for a period of time,” Bender said. “Basically, just rest it. Put ice on the jaw joint for 10 minutes at a time, off for 30 minutes. After that, use heat to increase circulation.

“We might progress to stretching exercises or use medications, like anti-inflammatory drugs or acetaminophen,” he said. “But ultimately, we’d like to do as little as possible.”

According to the TMJ Association, anywhere between 10 and 35 million people in the United States are affected at any one time, and the most severe symptoms are experienced by women in their childbearing years. TMJ disorders have been primarily treated by dentists since the 1930s.

“The main thing I tell our patients about these disorders is that most of the time, even as painful as they may be at first, they are relatively self-limiting,” Bender said. “They tend to come and go over time, but eventually even most people with no care do well.

“If someone is ever told they need their teeth fixed for it, or braces or surgery, they should probably get a second opinion,” he said. “Most of the time patients respond very well to limited, conservative care.”

— Caleb Vierkant

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