TMJ (Temporomandibular Joint & Muscle Disorders)

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Overview

Temporomandibular joint and muscle disorders, commonly called “TMJ,” are a group of conditions that cause pain and dysfunction in the jaw joint and muscles that control jaw movement.

Researchers generally agree that the conditions fall into three main categories:

1. Myofascial pain involves discomfort or pain in the muscles that control jaw function.
2. Internal derangement of the joint involves a displaced disc, dislocated jaw, or injury to the condyle.
3. Arthritis refers to a group of degenerative/inflammatory joint disorders that can affect the temporomandibular joint.

A person may have one or more of these conditions at the same time.

Some estimates suggest that TMJ disorders affect over 10 million Americans. These conditions appear to be more common in women than men.

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Causes

Trauma to the jaw or temporomandibular joint plays a role in some TMJ disorders, but in most cases, the exact cause of the condition is not clear. For many people, symptoms seem to start without obvious reason.

Because TMJ is more common in women than in men, scientists are exploring a possible link between female hormones and TMJ disorders.

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TMJ Disorders

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In-depth brochure covering causes, symptoms, and treatments for TMJ disorders.

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Symptoms

A variety of symptoms may be linked to TMJ disorders. The most common symptom is pain in the chewing muscles and/or jaw joint. Other symptoms include:

• radiating pain in the face, jaw, or neck,
• jaw muscle stiffness,
• limited movement or locking of the jaw,
• painful clicking, popping or grating in the jaw joint when opening or closing the mouth,
• a change in the way the upper and lower teeth fit together.

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Diagnosis

There is no widely accepted, standard test now available to correctly diagnose TMJ disorders. Because the exact causes and symptoms are not clear, identifying these disorders can be difficult and confusing.

Your doctor will note your symptoms, take a detailed medical history, and examine problem areas, including the head, neck, face, and jaw for tenderness, clicking, popping, or difficulty with movement. The doctor might also suggest imaging studies such as an x-ray.

You may want to ask your doctor about other causes of pain. Facial pain can be a symptom of many conditions, such as sinus or ear infections, various types of headaches, and facial neuralgias (nerve-related facial pain). Ruling out these problems first helps in identifying TMJ disorders.

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Treatment

Because more studies are needed on the safety and effectiveness of most treatments for jaw joint and muscle disorders, experts strongly recommend using the most conservative, reversible treatments possible. Conservative treatments do not invade the tissues of the face, jaw, or joint, or involve surgery. Reversible treatments do not cause permanent changes in the structure or position of the jaw or teeth. Even when TMJ disorders have become persistent, most patients still do not need aggressive types of treatment.

Conservative Treatments

Because the most common jaw joint and muscle problems are temporary and do not get worse, simple treatment may be all that is necessary to relieve discomfort. Short term use of over-the-counter pain medicines or nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen; the use of a stabilization splint, or bite guard, that fits over upper or lower teeth may provide relief. If a stabilization splint is recommended, it should be used only for a short time and should not cause permanent changes in bite. Studies of their effectiveness in providing pain relief have been inconclusive.

Irreversible Treatments

Surgical treatments are controversial, often irreversible, and should be avoided where possible. There have been no long-term clinical trials to study the safety and effectiveness of surgical treatments for TMJ disorders. Additionally, surgical replacement of jaw joints with artificial implants may cause severe pain and permanent jaw damage. Some of these devices may fail to function properly or may break apart in the jaw over time.

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Less Is Often Best In Treating TMJ Disorders

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Fact sheet on treatment for TMJ disorders.

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Helpful Tips

Self-care practices that may help ease symptoms of TMJ:

• eating soft foods,
• applying an ice pack,
• avoiding extreme jaw movements like wide yawning, loud singing, and gum chewing,
• learning techniques to relax and reduce stress,
• practicing gentle jaw stretching and relaxing exercises that may help increase jaw movement. Your health care provider or a physical therapist can recommend exercises if appropriate for your particular condition.

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Additional Resources

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How to Manage Jaw Pain from TMJ Syndrome

Author: mcymer

Posted: February 25th, 2021

Category:

Are you suffering from TMJ syndrome? Here’s how to get relief from jaw pain.

The National Institute of Dental and Craniofacial Research estimates 10 million Americans suffer from temporomandibular joint (TMJ) syndrome, a persistent pain in the jaw. A hinge joint, the TMJ connects your jawbone to your skull. Because of this joint’s smooth sliding motion, you’re able to speak, sing, chew, and yawn. 

The TMJ is made up of cartilage-covered bones separated by a small shock-absorbing disc. Over time, the joint can degenerate due to arthritis that wears down the disc or cartilage. Or, the TMJ can be thrown out of alignment because of an injury or constant grinding of the teeth (a condition called bruxism). 

Whatever the cause, TMJ syndrome manifests as a painful and stiff jaw, dizziness, an earache, or a headache. When you move your jaw, you may hear a clicking or popping sound, as well. TMJ syndrome typically responds well to non-surgical treatments, although severe cases may require surgery.

Treating Pain from TMJ Syndrome

To diagnose and treat TMJ syndrome, you may need to see an oral and maxillofacial specialist, an otolaryngologist (ear, nose, and throat doctor), or a dentist who specializes in jaw disorders. To confirm a TMJ syndrome diagnosis, the doctor may conduct a physical examination and manipulate the jaw to find the pain point. He or she may also order an imaging test such as an X-ray, CAT scan, or MRI to get a closer look at the jaw bone and soft tissues.

Treatment for TMJ syndrome centers primarily on managing the pain with non-surgical therapies. Some remedies your dentist may suggest include:

• Over-the-counter nonsteroidal anti-inflammatory medications (such as ibuprofen, acetaminophen, aspirin, and naproxen). 
• Muscle relaxants or medications used to treat depression, which may reduce pain and control bruxism.
• Hot and cold compresses applied to the jaw.
• Physical therapy to stretch and strengthen the jaw muscles and increase range of motion.
• A specially-made dental splint or mouth guard to keep your teeth and jaw in alignment and prevent grinding.
• A corticosteroid injection into the joint.

Other lifestyle adjustments have proven helpful in managing TMJ syndrome. Slowly chewing your food, eating softer foods in smaller bites, and avoiding chewing gum can help relieve pressure on the jaw. You might also benefit from learning relaxation techniques to loosen tight muscles. Since people with bruxism are at greater risk of TMJ syndrome, treating that condition may prevent joint damage and pain.  

Unless non-surgical methods fail to reduce pain, surgery is rarely performed for TMJ syndrome. One technique your dentist may recommend is an occlusal adjustment. In this procedure, the biting areas of your teeth are smoothed so the teeth aren’t bumping against each other when they meet. This can lighten the force placed on the teeth and lessen pain.

One surgical option is arthrocentesis. This minimally invasive procedure involves small needles inserted into the joint. Fluid is then used to swish away any debris that may be irritating the area. Arthroscopic surgery has also been successfully used to relieve TMJ pain.

Don’t Live with Jaw Pain

A painful jaw can greatly interfere with your quality of life. Instead of ignoring the pain, get help today.

The specialists at Espire Dental will thoroughly review your oral health and recommend treatment options to ensure you live pain-free. We also offer a full spectrum of convenient dental services. Contact us today for a consultation.

Temporomandibular Joint (TMJ) Disorders | TMJ Disorders, TMD

Self-Care

Your doctor will educate you about lifestyle habits you can adapt and self-care measures you can practice at home if they believe these efforts can be effective in reducing your pain.

Over-the-Counter and Prescription Medicines

In some cases, over-the-counter pain relievers may be recommended to relieve TMJ pain. If your doctor doesn’t think they will be effective for your condition, they may prescribe prescription-strength pain relievers, such as ibuprofen or other medications like muscle relaxants, antidepressants, or antiepileptic medications to manage your pain.

Oral Appliances

Hard, acrylic mouth guards, also called “splints” can serve two purposes. They may help stabilize your jaw in a comfortable position. They may also protect your teeth from nighttime clenching and grinding. Usually, they are most effective when your dentist creates a custom oral appliance for you.

Injections

• Trigger Point Injections. Trigger points are sensitive taut muscle bands in your muscles that can cause referred pain. A trigger point injection with local anesthesia can help break down these taut bands, relax the muscles, and alleviate pain.
• Steroid Injections. A steroid in the TMJ may help alleviate pain.
• Botulinum Toxin A (Botox) Injections. Botox may be injected to relieve and relax the muscle.

Physical Therapy

Your doctor may recommend physical therapy, which incorporates exercises that strengthen and stretch your jaw muscles. They may also perform dry needling, a procedure in which fine needles are inserted in the area to help relieve pain and reduce inflammation.

Cognitive Behavioral Therapy

Our psychologists offer techniques to reduce distress, tension, and negative thoughts that exacerbate TMJ symptoms. We also help you learn to cope with pain to lessen its impact on your life.

Massage Therapy

Our licensed massage therapist uses medical massage on the muscles, tissues, and structures surrounding the jaw to relieve pain and TMJ symptoms.

Acupuncture

In some cases, you may be referred for a series of acupuncture treatments to relieve pain. Sterile acupuncture needles inserted at various points in the body are thought to stimulate the body’s natural, pain-relieving abilities.

6 TMJ Exercises to Relieve Jaw Pain

TMJ (also called TMD) stands for a joint in your jaw: temporomandibular joint. This joint attaches your mandible (jawbone) with your temporal bone (skull). Injury, teeth grinding, or arthritis may cause TMJ pain. Occasionally a disc within the jaw joint slides out of place during sleep. Regardless of the cause of TMJ, exercises may be a helpful solution; a study at the University of Oxford shows that exercise may relieve TMJ pain.

TMJ Symptoms

TMJ can be a mere nuisance, or it can be a crippling condition. Some symptoms include:

• Pain in your jaw joint or jaw muscles.
• Jaw, neck, or face pain.
• Headaches.
• Stiffness in your jaw muscles.
• A locked jaw.
• Clicking or grating sounds and accompanying pain when you open and close your mouth.
• Noticeable changes in how your upper and lower teeth fit together.
• Ear discomfort, whether it’s a ringing sound or a stuffed feeling.

TMJ Exercises to Relieve Jaw Pain

1. Place your thumb below your chin and gently press upwards. Carefully open your mouth as wide as you can without pain. Hold this position for about five seconds before closing your mouth again. Repeat five times.
2. Exercise the opposite resistance by gently gripping your chin with your thumb and index finger. Open your mouth as far as you can without pain.
3. Using slight pressure from your fingers, press your chin down as you close your mouth. Maintain this resistance for five seconds. Repeat this exercise five times.
4. Press your tongue against the roof of your mouth. Gently open your mouth as far as you can without moving your tongue. Slowly open and close your mouth five times.
5. Hold a pencil or pen between your teeth without clenching your jaws. The pen/pencil keeps your mouth open just the right distance. Now slowly shift your jaw from one side to the other. Repeat five times.
6. Using the same pen or pencil, shift your lower jaw until your upper teeth are behind your lower teeth.
7. Gently stretch your neck muscles. Cross your arms on your chest, stand straight, and stretch your neck from side to side and from front to back.

Contact Osborne Family Dental for TMJ Pain Relief

If these exercises do not bring relief, or if your TMJ pain increases, contact your dentist. Osborne Family Dental offers quality TMJ treatment within a family atmosphere. Feel free to ask us your questions!

Common TMJ Exercises to Relieve Your Jaw Pain

Jaw pain can be the result of several different things but is commonly associated with issues in the temporomandibular joint. Several simple exercises can be done at home or at work to manage this discomfort.

If you feel severe pain, it is best to consult a dentist for a professional assessment. If pain is mild, following these self-care exercises can gradually reduce the negative impact TMJ has on your life.

What is TMJ?

TMJ stands for temporomandibular joint. This is the hinge that connects your lower jaw (mandible) to your skull, just in front of the ear opening. The TMJ is made up of bone, cartilage, and ligaments, and acts as a mechanism for chewing, speaking, and breathing.

TMJ disorders are common, with over 10 million people in North America experiencing some form of pain related to the jaw joint.

TMJ vs TMD

Temporomandibular joint disorders can be abbreviated as TMD or TMJD. Although these abbreviations distinguish joint disorders from simply the joint itself, TMJ has become a synonymous term when discussing jaw pain.

So for practical purposes, TMJ refers to both the joints that connect your jaw to your skull and also to the group of disorders that cause pain in this area. 

Causes & Symptoms of TMJ

Doctors do not always know the reasons behind TMJ disorders, but there are some known causes and, at times, very obvious origins of jaw pain. Dental exams provide expert insight into potential causes of TMJ and can help diagnose associated symptoms.

Common Causes

• Jaw or head injury
• Arthritis
• Chronic teeth grinding/clenching
• Mental stress
• Orthodontic problems
• High physical impact
• Opening your mouth very widely (ex: like when you eat a hamburger)
• Frequent chewing (ex: chewing gum)

Signs & Symptoms

The symptoms of TMJ can be felt in the jaw, the ears, or other parts of the head. The following symptoms are potential signs that you may have a TMJ disorder:

• Jaw pain
• Jaw noises (clicking, popping)
• Earaches
• Irregular ear popping
• Sore jaw muscles
• Headaches
• Temple pain
• Locked jaw (when open or closed)
• Chewing pain

These symptoms can happen on only one side, or both.

TMJ Pain Relief Exercises

These exercises are all designed to relieve pain symptoms that are a result of TMJ disorders. Ideally, these exercises gradually reduce pain and make your muscles stronger. There may be an initial discomfort when performing these activities, but if pain levels intensify during or after exercises it’s time to visit the dentist.

Some exercise programs combine a series of movements with specific intentions for the muscles and joints. These include Rocabado’s 6×6 Exercise Routine and Kraus’ TMJ Exercises. But common exercises can be categorized into a few movement groups.

Relaxed Jaw

Place your tongue against the roof of your mouth just behind your front teeth. Allow your jaw to naturally drop, leaving your mouth partially open. Hold until the muscles feel relaxed.

Tongue Up Exercise

With your tongue pressed against the roof of your mouth, slowly open and close your jaw several times.

Resisted Mouth Opening

Place your thumb under your chin and press upwards as you try to open your jaw. Keep the muscle resisted for 3-6 seconds then slowly close your jaw.

Resisted Mouth Closing

Place both index fingers between your chin and bottom lip and grip the bottom of your chin with both thumbs. From an open-mouth position try to close your jaw while applying resisting force with your hands. Hold for 3-6 seconds and open your mouth slowly. 

Goldfish Exercises

With your index finger, apply pressure to the TMJ on one side. Place your other index finger on your chin with mild pressure. Keep your tongue on the roof of your mouth and open and close your jaw 6 times. Try to do 6 sets of this exercise daily.

For a variation, apply index fingers to both temporomandibular joints with mild pressure.

Chin Tucks

With your shoulders back and chest forward, pull your chin towards the back of your throat. Hold this for 3 seconds and repeat the movement 10 times. 

Lateral Jaw Movement

Place a ¼ inch thick object, like a popsicle stick, between your front teeth. Slowly move your jaw left and right repeatedly. When this exercise becomes easier, increase the thickness of the object between your teeth.

Forward Jaw Movement

Place a ¼ inch thick object between your front teeth. Slowly move your jaw back and forwards, until your bottom teeth extend past your top teeth. When this exercise becomes easier, increase the thickness of the object between your teeth.

Everyday Care for TMJ 

TMJ pain relief exercises are designed to remove discomfort by strengthening the muscles that move your jaw joints. Just like any exercise, consistency and repetition will get you better results and build stronger muscles. So it’s wise to practice TMJ exercises every day to relieve jaw pain. 

Your dentist might also recommend the following to help with your symptoms:

• Moist heat (like a warm compress)
• Medication (anti-inflammatories, muscle relaxants)
• Oral appliance (nightguard or splint)

Let Your Dentist Help

If you feel like you might have TMJ, it’s always best to visit your dentist for an accurate diagnosis. A dentist can make decisions about the severity of your condition and recommend the best treatments moving forward. X-rays of your jaw can help evaluate temporomandibular joint disorders. In some cases, you may be referred to another specialist, like: 

• Physiotherapist
• ENT specialist
• Orthodontist
• Oral surgeon

Start slowly and consistently with TMJ exercises and you should see an improvement in the way you feel. In many cases, TMJ symptoms will disappear and you can do more activities freely and pain-free.

How to Gain Pain Relief from TMJD

TMJ Disorders: Gain Pain Relief from Temporomandibular Joint Dysfunction

Many patients describe their TMJ pain as aching pain in and around their ear. They experience difficulty chewing or painful moments while chewing. It is an aching facial pain which may involve difficulty opening and closing your jaw, sensitive teeth or a burning mouth. It fees like a locking of the joint, which is very descriptive of what it is. You may even hear your jaw make a clicking sound.

Peter Milgrom, DDS says, “The prevalence of temporomandibular joint and muscle disorder (TMJD) is between 5% and 12%.” His NIH Feb 8, 2018 article titled Prevalence of TMJD and its Signs and Symptoms acknowledges that the measurement of facial jaw pain and TMJD is complex. Having your jaw get stuck or locked is no fun.

This article will answer some common TMJ questions. It will provide a foundational understanding about TMJ to help you on your journey towards pain relief.

What is Temporomandibular Joint Syndrome?

Temporomandibular joint syndrome (TMJ) is when a person suffers from pain in their jaw joint for what ever reason that caused this medical problems. The TMJ connects the lower jaw (mandible) to the skull (temporal bone) in front of the ear; it is called a syndrome when becoming too invasive for daily activities and healthy sleep patterns .

What causes TMJ disorders?

Things that commonly trigger TMJ disorders (TMJD) include a serious injury to a person’s teeth or jaw, misalignment of the teeth or jaw, excessive teeth grinding or clenching, poor posture, chronic stress, arthritis, and frequent gum chewing. Any of these may cause the jaw joint to lock up.

Since the TMJ disorder involves a hinge action with sliding jaw movement, it is a complicated facial structure that is easily damaged. Your facial bone that interacts with the jay joints are covered in cartilage and separated by tiny and vital disks that work to absorb shock. A healthy set-up normally maintains smooth jay movement. Erosion of the disks, if the discs slip out of alignment, cartilage damage occurs, or an injury from a hard impact to the joint are all ways the joint’s efficiency may diminish.

Taut bands of muscles in myofascial can be trigger points when moving your jaw. An oral pain and maxillofacial specialist can treat the muscle pain and dysfunction prior to changing your bite.

Can TMJ pain disappear on its own?

For most people suffering from TMJ discomfort, it will go away on its own over an extended time. Individuals suffering from acute jaw pain or long-periods of Temporomandibular Joint Syndrome pain should visit a dentist or TMJ specialist treatment.

What is TMD?

TMD stands for Temporomandibular Disorder. It is a condition that involves the temporomandibular joint and its adjoining muscles. Formerly called TMJ (Temporomandibular Joint Dysfunction) by many, TMD can affect any individual at any time; however, it’s typically associated with stress or changes in a person’s emotional status. This means that it is usually triggered by high levels of stress. “TMD” is multifactorial, and subsequently, it will be affected by different treatment modalities.

What muscles in the jaw and head are impacted by TMJ?

A person’s TMJ muscles run along your jaw and cheeks, connecting behind the ears. Commonly these muscles may generate pain — even headaches if the jaw is overused or traumatized. When the muscles a person’s jaw cramp up — such as if you grind your teeth — the pain can spread. It typically impacts your other TMJ muscles alongside your cheeks; additionally, it may extend to the sides and top of your head. This is what causing a TMJ headache.

• Masseter muscle (the primary chewing muscle)
• Eminence and Socket
• Soft disk protects joint
• Ear canal (Plugged ears)
• Temporomandibular joint
• Lateral Pterygoid Muscle bring jaw forward

There are many muscles that our jay movements impacts. Some reflect the occlusal role in TMJ disorders but there are many factors including sleep, breathing and more.

What type of doctor teats TMJ pain?

Typically people suffering from jaw pain talk to their dentist first. The dentist may refer you to an oral and maxillofacial specialist. Another TMJ expert is call an otolaryngologist. This is ab ear, nose, and throat doctor, who is also known as a ENT specialist. Some advanced dental practices specializing in jaw disorders. This type of dentist is called a prosthodontist or a prosthetic dentist. The most important things is to seek further treatment from a TMJ doctor when you need it.

Since it your pain may be a muscular problem rather than joint (TMD) or dental issue, by visiting a maxillofacial specialist you’ll know for sure.

Can TMJ show up on xrays?

Yes. A TMJ x-ray is as known as TMJ Imaging. Your pain specialist may examine your jaw to determine if there is swelling or tenderness if you have other symptoms of a TMJ disorder. For new patients requesting pain help, X-rays of the jaw, including a CT scan may be done to see your bones and joint tissues. An MRI of a person’s jaw may show when problems with the structure of the jaw exist.

What happens during a TMJ surgery?

This form of surgery, if needed, is known as TMJ arthroscopy. “In some cases, arthroscopic surgery can be as effective for treating various types of TMJ disorders as open-joint surgery. A small thin tube (cannula) is placed into the joint space, an arthroscope is then inserted and small surgical instruments are used for surgery”, according to Mayo Clinic. Occlusal appliances, physical pain therapy, and/or counseling are options that may be encouraged before any jaw surgery recommendations are considered.

Their TMJ disorders page also more extensively covers corticosteroid injections into the jaw joint, TMJ arthroscopy, open-joint surgery, and a modified condylotomy.

Temporomandibular Disorders (TMD) | Michigan Medicine

Topic Overview

What are temporomandibular disorders (TMDs)?

Temporomandibular disorders (TMD) is the name given to several problems with jaw movement and pain in and around the jaw joints.

You may also hear TMD called TMJ or TM problems.

The jaw joints, or temporomandibular (TM) joints, connect the lower jawbone (mandible) to the skull. These flexible joints are used more than any other joint in the body. They allow the jaw to open and close for talking, chewing, swallowing, yawning, and other movements.

Many people have problems with jaw movement and pain in and around the jaw joints at some time during their lives. These joint and muscle problems are complex. So finding the right diagnosis and treatment of TMD may take some time.

What are the symptoms?

Temporomandibular disorders (TMD) can affect the jaw and jaw joint as well as muscles in the face, shoulder, head, and neck. Common symptoms include joint pain, muscle pain, headaches, joint sounds, trouble with fully opening the mouth, and jaw locking.

In most cases, symptoms of TMD are mild and don’t last long. They tend to come and go without getting worse and usually go away without a doctor’s care.

Some people who have TMD develop long-lasting (chronic) symptoms. Chronic pain or difficulty moving the jaw may affect talking, eating, and swallowing. This may affect a person’s overall sense of well-being.

What causes temporomandibular disorders?

The most common cause of TMD symptoms is muscle tension, often triggered by stress. When you are under stress, you may be in the habit of clenching or grinding your teeth. These habits can tire the jaw muscles and lead to a cycle of muscle spasm, tissue damage, pain, sore muscles, and more spasm.

TMD can start when there is a problem with the joint itself, such as:

• An injury to the joint or the tissues around it.
• Problems with how the joint is shaped.
• Joint diseases, such as osteoarthritis or rheumatoid arthritis.
• The articular disc that cushions the joint shifts out of place.

How is a temporomandibular disorder diagnosed?

Although there is no one way to identify a TMD, your doctor can most likely check your condition with a physical exam and by asking questions about your past health. In some cases, an X-ray, CT scan, or MRI is also used to check for bone or soft tissue problems related to symptoms of TMD.

How is it treated?

TMD symptoms usually go away without treatment. Simple home treatment can often relieve mild jaw pain. There are things you can do at first to reduce pain.

• Rest your jaw joint.
• Use medicines for a short time, to reduce swelling or relax muscles.
• Put either an ice pack or a warm, moist cloth on your jaw for 15 minutes several times a day if it makes your jaw feel better. Or you can switch back and forth between moist heat and cold. Gently open and close your mouth while you use the ice pack or heat.
• Eat soft foods. And avoid chewy foods and chewing gum.

Getting physical therapy and learning ways to reduce stress may also help to reduce pain and TM joint problems. Continue to use some of these methods over time to prevent and manage symptoms that might come back. If your pain is chronic or severe or is caused by problems with how the joint is shaped, your doctor may recommend other treatments.

Splints, also called bite plates, are a common dental treatment for TMDs. Splints are usually clear pieces of plastic that fit between the upper and lower teeth. They help reduce grinding and clenching. Splints are used for a short time so that they do not cause permanent changes in the teeth or jaw.

Before you try treatments such as surgery or reshaping or shaving down the teeth, think it over. These treatments cannot be reversed and can even damage the TM joint.

For most people, surgery is not used to treat TMDs. Surgery has few benefits, and there is the chance of causing more serious problems. You and your doctor can carefully weigh a decision to have surgery. Talking with another doctor to get a second opinion can also help you make your decision.

Chronic pain can lead to depression, anxiety, and other problems. If you have chronic pain, talk to your doctor about medicine and mental exercises to manage the pain. Give special attention to treating any related anxiety or depression.

Cause

Temporomandibular disorders (TMD) can result from a single cause or, more commonly, a combination of causes.

The main causes of TMDs include:

• Muscle tension (tightness) and spasm. Muscle tension in the jaw, face, head, neck, and shoulders may make your jaw feel achy, stiff, and painful, especially when moving your jaw. Muscle tension may be:
  • Caused by stress and anxiety and by stress-related habits, such as daytime or nighttime clenching or grinding of your teeth (bruxism), excessive gum chewing, or nail biting.
  • A response to injury or structural problems within the joint.
• Problems in the internal structure of the joint, such as:
  • Displacement of the disc that cushions the joint.
  • Degenerative disease, such as osteoarthritis or rheumatoid arthritis, which causes inflammation and destruction of the joint tissues.
  • Scar tissue or bone damage caused by accidental injury or a blow to the jaw.
  • Disease, such as a tumor, or structural problems present at birth (congenital).

In many cases, TMD symptoms appear to be caused by both muscle tension (tightness) and joint dysfunction. It is not always clear which came first. For example, osteoarthritis can cause changes in the joint, which may then bring on muscle spasms. Conversely, muscle spasms over time hinder jaw function and can eventually cause osteoarthritis in the jaw joint. A similar relationship appears to exist between muscle tension and disc displacement within the joint.

Orthodontic treatment and malocclusion do not seem to trigger TMDs or make them worse.

When jaw joint problems are caused by diseases such as rheumatoid arthritis, treatment for that condition is important. Many other conditions cause symptoms similar to those of TMDs, such as migraine headaches and infections.

Symptoms

Symptoms of temporomandibular disorders (TMDs) are usually mild and temporary and typically do not get worse with time. Common symptoms include:

• Joint pain when the jaw is moving, as when opening the mouth widely, chewing, or yawning. Such pain can occur:
  • Usually on one side of the jaw, but it can be on both sides.
  • Either gradually or suddenly, as when biting down on something hard or following a blow to the jaw.
• Muscle pain or tenderness in the face, ear, head, neck, or shoulders.
• Headaches. In children with TMDs, headaches are often related to grinding the teeth (bruxism).
• Clicking, popping, cracking, or grating that is painful and occurs when opening the jaw (may be a sign of disc displacement). Clicking or popping noises without pain are common and do not require treatment.
• The jaw locking in an open or closed position or not opening wide (disc displacement). If the jaw locks for more than a few moments, a muscle spasm usually follows.

Sometimes pain around the ear, with pressure or ringing in the ears (tinnitus), develops with TMDs. Some people with these symptoms report that they also have hearing loss, although test results show that their hearing is normal.

Symptoms often go away on their own. And they may recur over time without getting much better or worse. Occasional discomfort in the jaw joint or chewing muscles is quite common and usually is not a cause for concern. But for some people symptoms can be very painful, disabling, and last a long time.

What Happens

The course of temporomandibular disorders (TMDs) caused by muscle tension varies depending on the cause of the muscle tension.

• If muscle tension is related to a one-time overuse injury (such as holding your mouth open for a long time during a dental exam), the pain and discomfort may go away without treatment.
• If there is long-lasting (chronic) muscle tension due to stress, anxiety, an injury or blow to the jaw, or habits like grinding the teeth during sleep, treatment (including changing certain habits) may relieve pain and discomfort. If chronic muscle tension is not treated, it may gradually cause changes in the joint structure or osteoarthritis.

TMDs caused by problems in the structure of the jaw joint may:

• Respond well to nonsurgical treatment, if treated early.
• Get worse, if not treated. Long-term consequences include injury to the disc or other tissues in the joint, arthritis, or chronic pain.

Chronic pain

In some cases, TMDs can be extremely painful and disabling and last a long time. Such chronic pain can affect a person’s overall quality of life by increasing stress, making it hard to do a job, and interfering with personal life. Depression and anxiety are common results of chronic pain. Treatments may not relieve pain due to the lasting psychological and biological impact of chronic pain. These biological effects can lead to a sense of helplessness and biochemical changes in the body that perpetuate pain. In these cases, it is especially important to seek treatment for TMD pain and for related depression and anxiety.

What Increases Your Risk

Risk factors for temporomandibular disorders (TMDs) include:

• Stress and anxiety, which can cause facial and jaw muscle tension.
• Repetitive habits, such as grinding your teeth (bruxism), clenching your teeth, excessive gum chewing, eating hard or chewy foods, and nail biting.
• Habits that can cause muscle tension, such as sleeping on one side of your face or with your mouth open, opening your mouth wide when yawning or singing, or holding your head up by cradling your jaw in your hand.
• Injury to the jaw or head. TMDs can result from a direct blow to the jaw, chin, or head; whiplash to the head or neck; overstretching the jaw during dental work or surgery; or other injuries that may lead to joint damage or muscle tension.
• Age and gender. TMDs are more common in younger adults (ages 20 to 50) and in women.^{footnote 1}

When should you call your doctor?

Call your dentist or doctor immediately if you have had an injury to your jaw or face and:

• Your jaw is very painful.
• Your jaw is locked open or shut, or you are unable to move your jaw easily or smoothly (a sign of disc displacement, dislocation, or fracture).
• Your jaw appears to be deformed or swollen.
• There is swelling in the sides of your face.
• Your teeth no longer fit together normally when biting down (malocclusion).
• A severe headache or neck ache strikes suddenly, without apparent cause, or is different from previous headaches.

Call your dentist or doctor if you:

• Have pain when moving your jaw (biting, chewing, swallowing, talking, or yawning) that is not getting better after 2 weeks of home treatment.
• Have had jaw pain for a long time (chronic).
• Have anxiety, stress, or work-related problems caused by your jaw discomfort and pain.
• Continue to have symptoms (such as pain with clicking or cracking sounds or your jaw locks) after 2 weeks of home treatment.
• Notice a change in the way your teeth fit together when you close your mouth.

Who to see

Your treatment for temporomandibular disorder (TMD) may involve several different health professionals.

Initial evaluation can be done by a:

Further diagnosis and treatment may be done by a:

• Dentist who specializes in treating TMDs.
• Physical therapist.
• Facial pain expert.
• Oral and maxillofacial surgeon.

Additional treatment may be provided by:

If a doctor suggests that you try a treatment that might make permanent changes to your jaw, be sure to get a second opinion.

Health and dental insurance plans might not cover diagnosis and treatment. Because some tests and treatments are quite expensive, you may want to check your coverage before incurring expenses.

Exams and Tests

Currently there is no widely accepted standard test for identifying the cause of temporomandibular disorders (TMDs). But your dentist or doctor will most likely be able to accurately diagnose your condition with information from a medical history and physical exam.

Most TMDs are caused or made worse by muscle tension (tightness). Expect your doctor to suggest treatment that does not involve surgery or permanent changes to the jaw (conservative treatment) to relieve your jaw pain, muscle tension, and TM joint problems.

If you have sudden pain after a facial or jaw injury, your doctor is likely to order some type of imaging test, such as an X-ray, a CT scan, or magnetic resonance imaging (MRI).

If conservative treatment has not worked

If conservative treatment has not worked and your jaw is locking in place (a sign of disc displacement), your pain is severe or chronic, or you have other medical problems, such as rheumatoid arthritis, other tests may be needed. These tests are usually done only if knowing their results could change your recommended treatment plan.

If you still have symptoms after the first period of treatment, your doctor may begin to look for problems in the jaw joint structure. Other tests may include:

• X-ray. This test can confirm whether the bones are worn away, broken, or disfigured. If disc displacement is suspected, X-rays may be helpful to show the size of the joint space. A narrow joint space can be a sign that the disc is affected.
• Magnetic resonance imaging (MRI). A view of the soft tissues (ligaments, muscles, and articular disc) is useful in showing disc displacement or damage. Although expensive, MRI is thought to be the most effective imaging technique for assessing TMDs that may involve disc problems.

Treatment Overview

The goal of treatment for temporomandibular disorders (TMDs) is to relieve pain in the jaw and restore normal jaw movement and function. Several treatment approaches are effective. The first treatments that are tried for TMDs are called conservative, because they are simple and temporary. They are not invasive or permanent. They can be stopped or reversed. They include over-the-counter pain medicine and self-care that you can do at home.

Often, simple home treatment measures can successfully relieve jaw pain. Less than 1 out of 10 adults have jaw problems or pain that is so severe that they need medical or dental treatment.^{footnote 2}

For chronic, muscle-related TMDs, standard medical care can include muscle relaxation measures, biofeedback, stress management, or cognitive-behavioral therapy.

For chronic pain caused by a TMD, it is important to seek treatment for pain and for related depression and anxiety.

Dental splints are the most common dental treatment for TMDs. These splints or bite plates are typically used for a short period of time. They can help relieve muscle tension and pain.

Most people do not need permanent dental work or surgery. Permanent dental work might include orthodontic treatments involving permanent changes to the jaw. At best, permanent treatments or surgery may not work any better than physical therapy and temporary treatments. At worst, they can cause irreversible damage. If your doctor recommends surgery or other treatment that involves permanent changes, be sure to get a second opinion before you start treatment.

What to think about

Often, structural problems in the jaw, such as disc displacement, can be improved with conservative (nonsurgical) treatment, especially when they are treated early.

Health and dental insurance plans might not cover diagnosis and treatment. Because some tests and treatments are quite expensive, you may want to check your coverage before incurring expenses.

Prevention

To prevent temporomandibular disorders (TMDs), try to reduce muscle tension in your jaw. You can reduce muscle tension in these ways:

• Relax. If you have a lot of stress and anxiety in your life, try relaxation techniques. See the topic Stress Management.
• Learn to recognize when you are clenching your teeth. Practice keeping your teeth apart, bringing them together only when swallowing or eating. When driving, avoid clenching the wheel with both hands, because often your teeth will be clenched also.
• Do not overuse and stress your jaw muscles. Avoid constantly chewing gum, biting your nails, resting your chin on your hand, or cradling the telephone receiver between your shoulder and jaw.
• Change your diet. Eat softer foods, and use both sides of your mouth to chew your food. Avoid hard or chewy foods, such as popcorn, apples, carrots, taffy, hard breads, and bagels.
• Maintain good posture. Poor posture may disturb the natural alignment of your facial bones and muscles, causing pain.

In the past, various procedures such as dental restoration and orthodontic treatment were used to prevent joint sounds from developing into TMDs. Such measures are not only unneeded but also potentially damaging to a joint that may never become painful on its own.

See Home Treatment for other ways to prevent or reduce muscle tension in your jaw.

Home Treatment

If your temporomandibular disorder (TMD) symptoms are mild, try home treatment for at least 2 weeks. If your symptoms don’t get better or if they get worse during this time, call your doctor or dentist.

Home treatment involves reducing your stress, resting your jaw (by eating only soft or pureed foods), taking steps to reduce pain, and exercising your jaw.

To help relieve pain and restore jaw function:

• Try comfort measures such as moist heat, ice, or nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen or naproxen.
• Do jaw exercises as prescribed by your doctor or physical therapist. Also, pay attention to your jaw, and relax it when you are tense.
• Change your diet to decrease jaw strain. For example, avoid hard or chewy foods.
• Manage stress. Many people tend to clench or tighten their muscles when they are under stress of any kind.
• Change your body mechanics, such as by using good posture for sitting and standing.

If you have been diagnosed with a TMD, these home treatment measures will optimize the treatments prescribed by your doctor or dentist, such as a splint therapy or physical therapy.

Medications

You can use medicine to relieve the pain of a temporomandibular disorder (TMD). Short-term use of nonsteroidal anti-inflammatory drugs (NSAIDs), opioids, muscle relaxants, or antidepressant medicines can relieve or reduce inflammation, control pain, and relax the jaw muscles. Be safe with medicines. Read and follow all instructions on the label.

Medicine choices

• Nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen or naproxen, are used to treat inflammation and pain. These are the most commonly used medicines for TMDs.
• Opioid pain relievers (such as acetaminophen with codeine or hydrocodone) are used in some cases of acute, severe pain. Because opioid use can lead to opioid use disorder, they are usually not taken long-term.
• Muscle relaxants, such as cyclobenzaprine (Flexeril) or diazepam (Valium), are used in some cases of acute pain or prolonged muscle spasm. Because they are addictive, sedating, and can cause depression or make it worse, muscle relaxants should be taken at the lowest possible dose and are usually not used long-term.
• Low doses of tricyclic antidepressants, such as amitriptyline, are used in cases of chronic pain. These medicines might also be used if you have a disrupted sleep pattern, which can cause you to grind your teeth (bruxism).

What to think about

Nonsteroidal anti-inflammatory drugs (NSAIDs) do not cure TMDs. But they may reduce pain and inflammation, which allows you to do prescribed jaw exercises that can start the healing process. NSAIDs may be prescribed on a regular basis for 1 to 2 weeks to help reduce inflammation even though the pain has subsided.

Your doctor may prescribe an antidepressant, not necessarily because you suffer from depression but to help treat chronic pain or nighttime bruxism.

Surgery

Surgery is rarely used to treat temporomandibular disorders (TMDs). Surgical treatment does not guarantee a cure and can further damage the temporomandibular joint. Because most TMDs can be treated nonsurgically, most doctors believe that surgery should be the last option tried and should be avoided if possible.

Surgery may be a treatment option for you if both of the following apply:

• Other treatments have failed, and chronic jaw pain and dysfunction have become disabling.
• There are specific, severe structural problems in the jaw joint. These include scar tissue in the joint area, problems with bone alignment, broken or degenerated bones, and occasionally disc displacement or perforation.

The goals of surgery for TMDs are to:

• Relieve pain in the jaw joint.
• Correct any structural problems.
• Restore normal jaw function.

Surgery choices

• Arthrocentesis. This is not a true surgery, since there is no incision. But it is an invasive procedure done by an oral and maxillofacial surgeon.

Surgery may include:

• Arthroscopic procedures, including washing out the joint area (lavage), cutting or removing scar tissue that is blocking joint movement (lysis), cutting tissue that has shortened and is impeding joint function, or shaving part of the disc.
• Open joint arthroplasty, used for disabling joint problems that aren’t easily reached or viewed arthroscopically.

Another type of surgery, called total joint replacement, is rarely done. It has sometimes resulted in permanent jaw damage. Total joint replacement replaces the jaw joint with artificial parts. In some cases the artificial parts have not worked correctly or have broken. The available technology for this surgery is still considered to be experimental and risky.

What to think about

Further pain complications or joint dysfunction can result from temporomandibular joint surgery.

Surgery is not needed in most cases of disc displacement.^{footnote 3} Splint therapy (a dental treatment), jaw rest, and physical therapy, including moist heat and jaw exercises followed by an ice pack, can work very well for treating this condition. If this and other nonsurgical treatment to relax the muscles are not successful, arthrocentesis may effectively treat your condition.

If you are thinking about surgery, get a second opinion on your condition and treatment.

Other Treatment

Many types of treatment can successfully relieve temporomandibular disorder (TMD) symptoms. Different doctors will suggest different treatments, any of which may work to relieve jaw and facial pain.

If a doctor recommends that you try a treatment that might make permanent changes to your jaw or teeth, get a second opinion.

Other treatment choices

Depending on your condition, one of the following choices may be more effective than another. Safe options for treatment of TMD include:

Complementary medicine

Treatments considered safe and effective for some people include:

What to think about

Many different types of treatment for temporomandibular disorders (TMD) have potential for successfully relieving your condition. If your problem is linked to muscle tension, any treatment that helps you relax your jaw muscles with no adverse effects is likely to be helpful. Different treatments work for different people.

Treatments vary greatly in safety, cost, and how well they work.

References

Citations

1. Scrivani SJ, et al. (2008). Temporomandibular disorders. New England Journal of Medicine, 359(25): 2693–2705.
2. Scrivani SJ, et al. (2008). Temporomandibular disorders. New England Journal of Medicine, 359(25): 2693–2705.
3. Tucker MR, et al. (2008). Management of temporomandibular disorders. In JR Hupp et al., eds., Contemporary Oral and Maxillofacial Surgery, 5th ed., pp. 629–649. St. Louis: Mosby Elsevier.

Other Works Consulted

• American Academy of Pediatric Dentistry (2010). Guideline on acquired temporomandibular disorders in infants, children, and adolescents. American Academy of Pediatric Dentistry Clinical Guidelines Reference Manual, 32(6): 232–237. Also available online: http://www.aapd.org/media/policies.asp.
• American Association for Dental Research (2010). Temporomandibular Disorders (TMD). Available online: http://www.aadronline.org/i4a/pages/index.cfm?pageid=3465#TMD.
• American Society of Temporomandibular Joint Surgeons (2003). Guidelines for diagnosis and management of disorders involving temporomandibular joint and related musculoskeletal structures. Cranio, 21(1): 68–76.
• Goddard G (2008). Temporomandibular disorders. In AK Lalwani, ed., Current Diagnosis and Treatment in Otolaryngology – Head and Neck Surgery, 2nd ed., pp. 389–396. New York: McGraw-Hill.
• Okeson JP (2011). Temporomandibular disorders. In ET Bope et al., eds., Conn’s Current Therapy 2011, pp. 1008–1011. Philadelphia: Saunders.

Credits

Current as of:
October 27, 2020

Author: Healthwise Staff
Medical Review:
Adam Husney MD – Family Medicine
Martin J. Gabica MD – Family Medicine
Kathleen Romito MD – Family Medicine

Joint splint TMJ

Description

Soft TMJ Trainer (Articular Splint) is designed to treat myofascial pain syndrome in
TMJ dysfunction, and can also be used for rapid diagnosis. Thanks to the patented pterygoid
shape of the base of the splint, the effect of soft decompression and relaxation of the muscles of the maxillofacial and cervical region is created. The
TMJ-trainer has the shape of an ideal dental arch and fixes the interposition of the jaws according to the first class,
correcting the position of the lower jaw and lateral parafunction.The trainer easily adapts to the individual
features of the dentition of each patient, without causing discomfort to the patient.
Dense medical silicone, from which the trainer is made, is much softer and stronger than the material of tires produced by the
vacuum method, long-term use of which leads to dissociation of the bite.
TMJ-trainer allows:
– to remove unnecessary load on the TMJ
– to eliminate pain syndrome
– to start treatment immediately
– to limit the effect of bruxism
– to diagnose conditions accompanied by head and neck pain
– causes of TMJ dysfunction
– violations of the occlusal surfaces of the dentition
– reverse swallowing (with displacement of the lower jaw)
– bruxism
– oral breathing
– decreasing bite with pathological abrasion of teeth
– acute and chronic stress
– overload during athletic sports
According to recent studies, about 35% of the population suffers from dysfunction TMJ, but
are actively seeking treatment for only 20% of them.Moving from doctor to doctor, such patients never get help …
The temporomandibular joint (TMJ) is one of the most active joints in the body,
involved every minute when swallowing, speaking and chewing food. Extraction of one or more teeth,
depulpation, overestimation of fillings, as well as unsuccessful prosthetics can provoke the appearance of a painful
syndrome called Kosten’s syndrome, which usually occurs on the 10th to 12th day after
dental procedures. The intensity of pain in these patients usually increases with chewing,
limiting the mobility of the lower jaw. Pain dysfunction of the TMJ manifests itself in a different nature of pain,
both aching and acute.
Most often, pain in such patients is localized in the ear, chewing, buccal, temporal and frontal
regions, radiating to the upper and lower jaw, and even to the teeth, which often leads to unnecessary repeated
dental interventions. Pain can be felt by the patient in the joint itself, accompanied by clicking
and difficulty opening the mouth (intra-capsular causes of dysfunction) and in the muscles surrounding the joint – with
extra-capsular causes of dysfunction.In such patients, bruxism is often observed – a symptom of clenched jaws,
periodically arising in sleep or during stress, as well as asymmetry of the shoulders and shoulder blades, revealed during
orthopedic examinations. It is possible to effectively relieve pain in such patients only by careful correction of
occlusion, which will relieve excess tension in the muscles surrounding the TMJ and relieve the joint itself.

About MRC Devices | Myofunctional Research Co.

TMJ MBV ™
The principle of operation of many anti-snoring devices is that they allow the patient’s lower jaw to be pushed forward, increasing the height of the bite due to the increased thickness of the base and thereby facilitating the opening of the oropharyngeal lumen.But most of these devices are made of acrylic, and rigidly fix the lower jaw in the anterior position, as a result of which the condyles are pressed against the articular tubercles. As a result of the use of rigid anti-snoring devices, patients often complain of pain in the TMJ. This often leads to the need to suspend treatment.

The TMJ-MBV ™ Splint (a variant of the TMJ ™ for Oral Respiratory Patients) was developed to treat patients who suffer from both TMJ dysfunction and snoring.This device is prefabricated from soft and flexible medical grade silicone in two versions (high with 11 mm base and low with 7 mm base) and is fitted by the patient.

Although the TMJ-MBV ™ looks more massive than the standard TMJ ™ Occlusal Splint, it is as easy to use as the latter. The increased size is mainly due to the higher vertical sides, which make it more comfortable to use, as it does not fall out of the mouth (and this is especially important for patients with mouth breathing).

The device has an increased base thickness from 4.5 to 11 mm. However, the air holes in the front and side of the device allow the bite height to be varied from 5 to 8 mm. Thus, this device is no less convenient than its standard version, and in it the condyle is not fixed in one position, as in other rigid devices for fighting snoring. As a result of treatment, the long-term health of the TMJ is significantly improved. The unique shape of the device allows it to be used even for problems such as the deepening of molars.

The TMJ-MBV ™ is made of the same soft and flexible silicone as the standard TMJ ™ splint. Thanks to this, the device allows for lateral and A-P movements of the lower jaw and thus provides greater patient comfort. The TMJ-MBV ™ is most suitable for patients with TMJ dysfunction.

There are many machines for the treatment of snoring and sleep apnea, but perhaps none of them cover all aspects of treatment.The new TMJ-MBV ™ facilitates the advancement of the lower jaw and provides better retention in the mouth. Most importantly, however, its use contributes to improved temporomandibular joint health.

TMJ-System ™ – devices for the treatment of TMJ dysfunction
The series TMJ ™ is a series of soft intraoral devices designed specifically for the diagnosis and treatment of TMJ dysfunction.

The devices of this series have a thickening at the base, which facilitates gentle decompression of inflamed joints.In addition, they help to correct the position of the lower jaw and stretch tight and painful muscles, resulting in immediate pain relief.

Long-term treatment helps to reduce painful sensations. The patented wing-shaped base and double-jaw design also helps to reduce bruxism (teeth grinding).

“BACK TO SYSTEM PAGE

Why does the jaw hurt and what to do about it

1. Bad teeth

The jaw can begin to ache if a person has caries, pulpitis or other dental problems.Unpleasant sensations will appear in the part of it where the affected tooth is located. Sometimes the pain spreads from it to the sides along the nerve.

What to do

You need to go to the dentist and treat a bad tooth. The specialist will decide whether it is necessary to remove it or whether it is enough to put a seal.

2. Chronic sinusitis

If the sinuses, which are located under the eyes in the zygomatic bone, become inflamed, ^{pain in the upper jaw and teeth may appear. In addition, other symptoms occur:}

• nasal inflammation with thick mucus;
• postnasal drainage, when mucus flows down the back of the pharynx and a cough appears;
• Difficulty breathing through the nose;
• Pain or tenderness in the areas around the eyes, cheeks, near the nose;
• deterioration of smell and taste;
• Pain in the ears, throat or head;
• bad breath;
• fatigue.

Chronic sinusitis develops with nasal polyps, as well as due to respiratory tract infections, deviated nasal septum, allergies or pathologies that reduce immunity. In some people, sinus inflammation occurs due to intolerance to acetylsalicylic acid.

What to do

You need to see a general practitioner or ENT doctor. The specialist will examine the sinuses and prescribe treatment. This could be ^:

• Corticosteroids to reduce inflammation. They are used as nasal spray, tablets or injections.
• Saline solutions for nasal irrigation. They help wash away irritants and allergens, and reduce mucus production.
• Preparations for allergies. If she is the cause of sinusitis.
• Antifungal agents.
• Monoclonal antibodies. Medicines with this composition affect the immune system and help get rid of nasal polyps.
• Antibiotics. Use when sinusitis is caused by a bacterial infection.
• Immunotherapy. It is performed if a person has allergies.
• Aspirin desensitization. This is a method of accustoming the body to an allergen. The medicine is taken under the supervision of a physician, gradually increasing the dose.
• Operation. It will be needed if the cause of chronic sinusitis is polyps or curvature of the nasal septum.

Also, doctors advise to rest more, humidify the air in the room, make warm compresses and rinse the nose.

3. Bruxism

This is when a person unconsciously clenches his jaw ^{and grinds his teeth. This happens in a dream or in reality. Usually, the causes of bruxism are an unstable emotional state, stress, anger, tension.}

The risk of manifestation is higher in those who smoke, consume alcohol, coffee, drugs or certain medications. Also, the condition often occurs in young children or in people who suffer from Parkinson’s disease, dementia, epilepsy, nightmares and other nervous disorders.

In addition to pain in the jaw, bruxism is characterized by:

• quite loud grinding of teeth;
• Flattened, chipped, or loose teeth;
• worn out enamel;
• toothache or tenderness;
• Fatigue or tightness in the muscles of the jaw that prevents it from opening or closing completely;
• Neck or face pain;
• Sensation that the ear hurts, although it is completely healthy;
• dull pain in the temples;
• damage on the inside of the cheek;
• Sleep disorders.

What to do

You need to contact a therapist or neurologist ^{so that a specialist can determine the cause of bruxism and select a treatment. In some cases, it is not required: it happens that children outgrow the problem, and in adults, the jaws do not creak so much as to take special measures. If the pathology is clearly expressed, then the doctor may prescribe:}

• Splints or mouth guards for teeth. Constructions are made of acrylic or soft material to protect teeth from pinching.
• Tooth correction. Sometimes a person needs restoration of damaged teeth, and in some cases, crowns are necessary.
• Stress management. For example, various methods of psychotherapy.
• Medicines. These can be drugs that reduce muscle spasm, reduce stress.

In addition, the person needs to change behavior. So, you need to learn how to control the position of the jaws. This may require a consultation with a dentist.

4. Trigeminal neuralgia

This chronic disease affects ^{the trigeminal nerve, branches of which run along the face and lower jaw. The reasons may vary. For example, a nerve is too close to an artery that presses on it and causes the characteristic symptoms. Also, pathology occurs with the aging of the body, the development of multiple sclerosis, brain damage by a tumor or stroke, and after facial injuries.}

Neuralgia is characterized by:

• severe shooting pain, reminiscent of electric shocks;
• Spontaneous attacks occurring when chewing, talking, touching the face, or brushing teeth;
• The duration of attacks is from several seconds to several minutes, and they can be repeated every day for days, weeks, months, or disappear for a long time;
• Constant aching pain, which then turns into severe, spasmodic;
• localization of unpleasant sensations in the jaw, teeth, lips, cheeks, less often in the eyes or on the forehead.

What to do

You need to see a neurologist. He will conduct an examination and prescribe therapy. They usually start with medication. It can be ^:

If none of this helped, as a last resort, an operation is prescribed. The doctor can move or remove the vessels that press on the trigeminal nerve.

Sometimes stereotactic brain radiosurgery helps: a focused dose of gamma radiation is directed to the part of the brain from which the trigeminal nerve emerges.It is slightly damaged so that it does not transmit signals. This helps to relieve pain. Relief does not come immediately, and recovery after such an operation takes about a month. The doctor can also damage the trigeminal nerve on the face with the help of injections of glycerin, balloon compression or radiofrequency thermal exposure directly to the branches of the nerve.

5. Heart problems

People with heart attack, pericarditis, angina pectoris, or aortic dissection may experience chest pain ^{. Usually burning, pressing, it radiates to the back, neck or jaw, sometimes passes to the hands.Unpleasant sensations can last from several minutes and intensify with exertion. Difficulty breathing, cold sweats, dizziness and weakness, nausea or vomiting are sometimes also troublesome.}

What to do

If you already have a diagnosis of angina pectoris, if you experience dangerous symptoms, you need to drink the medications prescribed by your doctor.

In other cases, with the appearance of acute pain in the heart, radiating to the jaw, you need to urgently call an ambulance, because it may be a heart attack or aortic dissection.

6. Temporomandibular joint disorder

Disease ^{affects the joint that connects the mandible to the skull. The exact cause of the disorder is unknown, but experts believe it is a combination of a number of conditions. The pain in the jaw occurs due to the destruction of the intra-articular disc, arthritis, or injury. Risk factors include prolonged grinding of teeth, connective tissue diseases such as systemic lupus erythematosus.}

What to do

Tell the doctor about the pain in the jaw.After the examination, he will prescribe ^{one of the following therapy methods:}

• Medicines. Use muscle relaxants, tricyclic antidepressants to relieve muscle tension. And over-the-counter analgesics can help relieve pain.
• Non-drug methods. These include special splints and mouth guards, psychotherapy sessions, physiotherapy.
• Surgical treatment. A doctor may perform arthrocentesis – inserting a needle into a joint to draw out fluid that accumulates there during inflammation.A corticosteroid solution can also be added to reduce inflammation. Sometimes a condilotomy is done – the head of the lower jaw joint is dissected, this helps to reduce pain by shifting the axis of the load on it. And in some cases, the joint needs to be replaced altogether.

7. Tumors and cysts of the jaw

These rare diseases affect the soft tissues and bones of the jaw ^{. The exact cause of cysts and tumors is unknown, but they are often associated with genetic syndromes.}

Neoplasms are all different, they can grow quickly or slowly, displace teeth and destroy bones, and sometimes dissolve on their own, without treatment.

What to do

Need to see a dentist. He will take ^{X-rays (CT or MRI if necessary) and take a biopsy from the suspicious area.}

Treatment is usually surgical, sometimes even jaw reconstruction or dental prosthetics have to be done. But this does not guarantee a complete cure: some tumors are able to return even after removal.

8. Giant cell arteritis

In this disease, ^{the artery wall becomes inflamed. Why this happens is unknown, but usually the pathology develops at the age of 70-80, and in women it is twice as likely as in men. Risk factors include heredity and a history of polymyalgia rheumatica.}

The symptoms of giant cell arteritis are as follows:

• persistent headache in the temple area;
• Soreness of the scalp;
• Pain in the jaw when chewing or opening the mouth;
• increased body temperature;
• fatigue;
• sudden and sharp decrease in body weight;
• Deterioration or loss of vision, double vision, especially in people with pain in the jaw.

The pathology is dangerous because it can lead to irreversible blindness, stroke or aortic aneurysm.

What to do

With these symptoms, you need to go to a therapist. He will conduct ^{examinations, but even before receiving accurate results, he will prescribe medications to alleviate the condition.}