Jaw pain can affect your daily life from activities such as chewing, talking, or yawning.
TMJ Disorder
The most common cause of jaw pain is temporomandibular joint disorder or TMJ, which is a disorder of the jaw joints and muscles. Injuries to the jaw, arthritis, or genetics may cause TMD. TMD affects up to 12% of the population.
Other Causes of Jaw Pain
- Sleep Disordered Breathing
- Obstructive Sleep Apnea (OSA)
- Upper Airway Resistance Syndrome (UARS)
- Teeth grinding, clenching
- Tension/cluster headaches
- Stress
Symptoms of TMJ Disorder
- A pain that aches in or around your ear.
- Facial pain that aches.
- Muscle soreness of the face, head, and neck
- Tenderness in your jaw.
- Difficulty or pain when you chew.
- Your joints lock.
- Clicking or grating sound when opening, closing, or chewing
- Misalignment of your upper and lower jaw.
Temporomandibular Joint Disorder, or TMD for short, is a condition involving the joints, muscles, nerves, and teeth involved with jaw movement. It could be related to one or all components. When not working harmoniously or in sync, or the chewing system is improperly aligned, a variety of signs or uncomfortable and potentially painful symptoms may result for patients.
The temporomandibular joint is the complex hinge that joins your lower jaw and skull together. It works similarly to a ball and socket but also has the unique ability to glide forward via a series of muscles, ligaments, and fibrous tissues all working together. Many factors can contribute to the development of TMD, including misalignment of the jaw and the way teeth touch, tooth clenching or grinding, arthritis, and posture issues. Anxiety and stress have also been shown to be related to TMD issues.
These factors may lead to inflammation of the joint and/or surrounding tissues, oftentimes triggering the connected pain receptors throughout the head, neck, and face. Common symptoms include jaw pain or soreness extending through the face and neck, jaw clicking or popping, restricted jaw movement or locking, sensitive teeth, loose teeth, irregular or excessive tooth wear, earaches, and headaches, amongst others.
The wide range of possible resulting symptoms is what has historically made correctly diagnosing TMD challenging. If your doctor suspects TMD might be an issue, they will perform a thorough physical examination of the area and overall chewing system, evaluating your jaw movement and noting any related tenderness or discomfort. Oftentimes, they will also take diagnostic images to aid the fact-finding process.
There are a variety of treatments available to assist with properly diagnosing and alleviating some or all TMD discomfort, depending on the nature and severity of the issues causing it. It is important to work closely with your doctor to create a treatment plan that best meets your unique needs.
Jaw Pain Screening
Drs. Lepore and Dougherty may ask you questions such as:
- When did you notice your symptoms?
- Is this a new or recurring issue?
- Do you suffer from head or neck-aches?
- Do you wake up wishing you felt more well-rested?
- How would you rate your stress levels?
In addition to these questions, Drs. Lepore and Dougherty will also thoroughly evaluate your TMJs and the muscles of your head and neck and perform an intraoral exam to see if there are any contributing factors.
While some over-the-counter anti-inflammatory medications can reduce swelling and discomfort, Drs. Lepore and Dougherty recommend a thorough exam to be performed before self-medicating.
Jaw Pain Treatment Options
Depending on your unique symptoms, treatment can vary significantly. Some suggestions might include the following:
Self-Care Regimen – if appropriate, conservative therapy such as resting your jaw, keeping your teeth apart when you are not swallowing or eating, eating soft foods, applying ice and heat, exercising your jaw, and practicing good posture, can be helpful.
Muscle Spasm Relief Regimen – This is usually accomplished with a pain reliever, anti-inflammatory, or muscle relaxant.
Occlusal Guard – Also known as a nightguard, these can be made of a material that is either soft, hard, or a combination of the two. Depending on your needs, it can cover all the teeth or only some of them. It can be made for your upper teeth or your lower teeth. It is worn nightly and helps relieve stress on the joints, particularly the muscles.
For patients experiencing tooth wear due to nighttime grinding and jaw clenching, your doctor may recommend an occlusal appliance - commonly called a nightguard or bite splint - to help alleviate the complications associated with the condition. It is not uncommon for tooth wear to be associated with certain airway or breathing conditions, so your doctor may discuss this with you as well.
An occlusal appliance is a device that is worn in the mouth overnight and creates a barrier between your upper and lower teeth, eliminating the damage they cause by rubbing against each other. It also promotes improved jaw and bite alignment, which can help address uneven tooth wear. Research has shown that a well-designed hard appliance will help to relax the musculature, reducing wear even when it is not being worn. There are several designs and styles of appliances available to assist with treatment. Your doctor will expertly design your individualized appliance to ensure optimal bite alignment and maximum protection from additional tooth wear. Given the potential for costly dental treatments caused by untreated tooth wear, it is critical to work closely with your doctor to proactively treat the issue before more damage is sustained.
Home Sleep Test – Should Dr. Lepore or Dr. Dougherty notice signs during a screening of sleep-disordered breathing, they may recommend a home sleep test to rule out a sleep disorder. It has been shown that obstructed sleep can cause clenching/grinding and subsequent muscle/TMJ pain. Click here to learn more about the home sleep test: https://sleeptest.com/
If you are at risk for sleep apnea, the Board-certified sleep medicine physician may recommend a home sleep test. Sleep physicians usually use home sleep tests to diagnose sleep apnea in more straight-forward cases.
Dr. Timothy Morgenthaler: For many patients, a home sleep study would be very reasonable. This should be patients who don’t have congestive heart failure, don’t have other sleep disorders, who don’t have other diseases that compromise their respiratory or cardiovascular systems, like COPD, or other underlying lung conditions.
The home sleep test measures your breathing and your blood oxygen levels when you are asleep. When you receive them, a member of the physician’s sleep team will give you instructions on how to use the device. You hook it up before you go to sleep at your regular bedtime. The morning after your home sleep test, you will return the device for the sleep medicine physician to interpret. The physician uses your data to make his/her diagnosis. If the doctor determines that you have sleep apnea, he/she will recommend a treatment such as CPAP. If the test results are unclear, you may need an in-lab sleep study.
Home sleep tests help physicians diagnose more patients with sleep apnea so they can get the care they need. Home sleep testing offers advantages for patients too. You can sleep in the comfort of your own bed. This is especially helpful if you have children.
If you think you have sleep apnea, a Board-certified sleep medicine physician can help. Schedule an appointment at an AASM-accredited sleep center today.
Sleep is a basic necessity of life. Even more important is breathing. When you sleep, air travels through your nose and mouth, down the throat, and into your lungs. The narrowest part of the airway is at the junction where the soft palate, the tongue, and the back of the throat all compete for the same space. When you are awake, the muscles are tight, keeping the airway open. But when you sleep, these same muscles relax, causing the airway to narrow. As the air passes through the narrowed opening, the uvula and the surrounding tissues begin to vibrate, causing a condition known as snoring. If the tongue continues to fall back, it will cause the breathing to become slowed or completely stopped. This is known as obstructive sleep apnea. Sleep apnea can cause fragmented sleep, shorter life span, reduced quality of life, and even death.
A comfortable and effective option for treating obstructive sleep apnea is with a custom-made, removable sleep appliance that a dentist trained in the treatment of sleep apnea can provide. With the sleep appliance in place, the lower jaw is prevented from falling back, keeping the tongue forward and the airway open. Often, this will reduce or eliminate snoring and sleep apnea, providing the body with deep, restful sleep.
Sleep Appliance Therapy – If a diagnosis is obtained either from a Home Sleep Test or Polysomnography (In-Lab) Study of Sleep Disordered Breathing, an oral appliance can be made as a CPAP alternative should the patient be intolerant to/refuse that therapy. Click here to learn more: https://prosomnus.com/getting-started/#products
Surgical options such as arthroscopy and open joint repair restructuring are sometimes needed but are reserved for severe cases. Typically, this is referred to a specialist known as an Oral Surgeon. More often than not, we do not consider TMJ surgery unless the jaw can’t open, is dislocated and nonreducible, has severe degeneration, or the patient has undergone appliance treatment unsuccessfully.
If you are experiencing any of these jaw pain symptoms, call Lepore Comprehensive Dentistry at (727) 608-4690 to schedule your evaluation in Dunedin, FL, today.
