All my friends seem to have jaw pain.
As we stepped deeper into our 30s, I was prepared to hear about bad backs and difficult knees. But the mouthfuls were unexpected. Some were ground their teeth at night and needed mouth guards. Others have doctors inject botulinum toxin, commonly referred to as Botox, into sore jaws. And we’re all now extremely familiar with a new body part: the TMJ, or temporomandibular joint, which connects the jaw to the skull.
TMJ is a common, convenient shorthand for jaw pain, but the correct term for the condition is temporomandibular disorder, or TMD. There are several types of TMD, all related to jaw bones and muscles.
About 10% to 15% of adults have some form of temporomandibular disorder, estimates Dr. Thomas P Sollecito, professor and chair of oral medicine at the University of Pennsylvania School of Dental Medicine. “The vast majority do not require treatment,” he says. TMD may clear up on its own, or may be painless and not require intervention.
So how do you know if the clicking noise your jaw makes is a problem? Do you have TMD or have you just been sleeping strangely? We asked experts.
What are temporomandibular disorders (TMDs)?
TMDs are “disorders or symptoms related to the structure and function of the jaw system”, explains Dr Karyn A Kahn, a dentist at the Cleveland Clinic.
According to the National Institute of Dental and Craniofacial ResearchTMDs fall into three main categories: disorders of the temporomandibular joint, disorders of the muscles used for chewing, and headaches related to jaw tension.
Because TMD includes a range of disorders, symptoms can vary. “There are many different signs and symptoms that may suggest a patient is experiencing a temporomandibular disorder,” says Kahn. These include a clicking or popping sound in the jaw, facial pain, tooth fractures due to grinding, limited jaw movement, and even seemingly unrelated issues such as headaches and earaches.
Women tend to experience TMDs more than men, although no one is exactly sure why. Some studies have found a link between estrogen and temporomandibular pain, Kahn says. Sollecito says others have also suggested that women experience stress differently, and are more likely to clench their jaws. “And some people think women are just looking [medical] care more than men,” he says, which means more recorded cases in women.
What causes TMDs?
TMDs have a variety of causes. They can be the result of physical trauma (for example, being hit in the jaw), genetics, anatomical factors such as how your jaw is aligned, and lifestyle habits such as chewing gum or eating very sticky foods such as bagels.
Temporomandibular disorders have also been found to overlap with some chronic pain conditions such as migraine headaches, fibromyalgia, chronic back pain and chronic pelvic pain in women, says Dr. Clark Stanford, professor of prosthodontics and dean of restorative dentistry at the University of Iowa.
TMDs can also result from emotional distress. Stress can lead to jaw tension and teeth grinding, both of which strain the muscles of the jaw, causing pain. Stanford’s diagnostic process involves a complete clinical examination as well as a psychological assessment. One recent patient struggled with acute jaw pain for several months. As they talked, he learned that she had recently lost a close friend, and as a result, she was dealing with work stress and personal grief.
“It sounds weird for a dentist to ask about what’s going on in your life,” says Stanford. “But many times, once [patients] understand why they clench their teeth all the time, they understand the need for an intervention to reduce that habit.”
to newsletter promotion
How are TMDs treated?
In general, experts recommend starting small when it comes to TMD treatment. For those who grind their teeth at night, doctors often prescribe a night guard — a plastic, container-like device — to help protect their teeth.
So-called self-help therapies are also useful tools. Stanford says this can include daily exercises to loosen the jaw, awareness of sleep habits and education about what foods can make pain worse. In some cases, cognitive behavioral therapy and other stress reduction techniques may also be helpful.
In cases where TMD is primarily the result of jaw clenching, doctors may recommends botulinum toxin, commonly referred to as Botox. When injected into the masseter muscles on the sides of the jaw, it reduces the amount of muscle contraction in the area and reduces tightness and pain, Kahn explains.
In some advanced cases, open joint surgery on TMJ may be required, Kahn says. But this is only if “all conservative therapies have been tried and failed” and the jaw pain “inhibits their quality of life”, she says.
If you experience jaw pain, consult a doctor or a dentist. But if your jaw occasionally makes a clicking sound and you have no pain, you’re probably fine. Sollecito estimates that a third of people click a jaw.
“I don’t get excited about pops and clicks,” says Stanford.
