Temporomandibular joint complaints: Cause and effect

1. The jaw is used unnoticed all day long. Unfortunately, things sometimes go wrong and jaw problems are the result. These temporomandibular joint problems (TMJD) are also called the great disguise. While the doctor is looking for the source of headaches, ear complaints, dental problems and neck pain on the spot, the forgotten jaw is hidden as the cause. Due to small disc shifts, wear, increased muscle tension and trigger points, the temporomandibular joint is capable of an endless series of misunderstood complaints.

2. The jaw is used unnoticed all day long. Unfortunately, things sometimes go wrong and jaw problems are the result. These temporomandibular joint problems (TMJD) are also called the great disguise. While the doctor is looking for the source of headaches, ear complaints, dental problems and neck pain on the spot, the forgotten jaw hides as the cause. Due to small disc shifts, wear, increased muscle tension and trigger points, the temporomandibular joint is capable of an endless series of misunderstood complaints.

The TMJ

1. The temporomandibular joint, the temporomandibularis

TMJ syndrome

1. Damage to the temporomandibular joint usually results in various complaints, mainly pain around the jaw or loss of function. The mouth can no longer be opened sufficiently and there are problems with chewing. All kinds of noises can occur, such as a crackling, gritty, snapping or clicking noise when moving the jaw. Referred complaints may also arise. These are felt elsewhere in the head, or even further down in the body, but come from the jaw. Examples are alleged sinus infections, dental problems, headaches and pain in the temples, dizziness, hypersensitivity to light and other eye problems, neck complaints, shoulder pain and a wide range of ear complaints. If causes for this cannot be found, jaw problems are likely. We also call jaw complaints CMD (cranio-mandibular disorder) or TMJD

The jaw as a genius disguise

1. It is estimated that about twenty percent of people suffer from a jaw problem, but only five percent seek help. The vast majority have no idea that the origin of the complaints lies in or near the temporomandibular joint. Headache or facial pain is usually dismissed as tension headache, stress or migraine, more severe pain is a misunderstood nerve pain. With or without serious ear complaints, one is sometimes sent to an ENT doctor, where after examination it is reported that there is nothing wrong with the ears or that they are even excellent. For neck and shoulder pains, one goes to a physiotherapist who only treats locally. If nothing helps, or really no cause is found, it is unfortunately all too often that the patient is not taken seriously, or is suffering from a stress-related problem. The jaw is the forgotten part of the body

2. It is estimated that about twenty percent of people have a jaw problem, but only five percent seek help. The vast majority have no idea that the origin of the complaints lies in or near the temporomandibular joint. Headache or facial pain is usually dismissed as tension headache, stress or migraine, more severe pain is a misunderstood nerve pain. With or without serious ear complaints, one is sometimes sent to an ENT doctor, where after examination it is reported that there is nothing wrong with the ears or that they are even excellent. For neck and shoulder pains, one goes to a physiotherapist who only treats locally. If nothing helps, or really no cause is found, it is unfortunately all too often that the patient is not taken seriously, or would suffer from a stress-related problem. The jaw is the forgotten part of the body

Diagnostics

1. In the case of jaw complaints, the dental surgeon (or dentist-gnatologist) first of all faces the question whether it is a problem within the temporomandibular joint, such as a disc displacement, anatomical abnormalities, a perforation of the disc, fractures, tumors, inflammation and the like. In addition, the lymph nodes (and salivary glands) must be examined for inflammation or tumor activity, but it must also be checked whether there are actual dental abnormalities such as half or unbroken wisdom teeth, abscesses, cysts, crowns or bridges that are too high and abnormalities in the maxillary cavities. Usually X-rays are taken and possibly scans. A jaw function test

2. In case of jaw complaints, the dental surgeon (or dentist-gnatologist) first of all faces the question whether it is a problem within the temporomandibular joint, such as a disc shift, anatomical abnormalities, a perforation of the disc, fractures, tumors, inflammation and the like. In addition, the lymph nodes (and salivary glands) must be examined for inflammation or tumor activity, but it must also be checked whether there are actual dental abnormalities such as half or unbroken wisdom teeth, abscesses, cysts, crowns or bridges that are too high and abnormalities in the maxillary cavities. Usually X-rays are taken and possibly scans. A jaw function test

Discus shifts

1. Just as a disc in the neck or spine can shift slightly, this can also happen in the jaw. Wear increases the likelihood of disc displacement. The disc (meniscus) is a cartilage disk

Arthrosis of the jaw

1. Osteoarthritis of the temporomandibular joint is actually wear and tear

Jaw muscles

1. The masseter muscles are a major source of chronic pain complaints. What is relatively unknown is that these jaw muscles work closely with the muscles on the side of the face and neck. The neck muscles assist with the jaw function and will therefore also be affected by a reduced function. You can locate the temporomandibular joint by pressing your fingertips directly onto the area in front of the ears. Then when you open and close your mouth you can feel the joint. The movements are regulated by the jaw muscles. If the temporalis muscle is constantly tensioned, the tendon will be pulled too hard: the tendon that connects the temporalis to the jaw bone. Results are sharp headaches in the temples, right next to the eyes. It's called temporal tendonitis and is also called the migraine imitator

Trigger points around the jaw

1. With an irritated nerve, the associated muscle will contract, become shorter and stiffer and become painful. Small knots form in the muscle, the so-called 'trigger points'. Trigger points send pain to distant parts of the body, such as the molars, forehead or ears. Jaw muscles tire and limit movement. A typical example of this myofascial pain syndrome

The relationship between jaw and ear

1. Ear complaints are very common with jaw problems. The bone that separates the temporomandibular joint from the ear is very thin so that inflammatory responses from the jaw easily cause pressure. In addition, the increased muscle tension around the temporomandibular joint can cause spasms in the very deep pterygoidus lateralis muscle and the pterygoidus medialis muscle. The tone of these muscles and surrounding muscles is also important for normal ear function. Disturbances cause a wide variety of complaints: Ear pain, feeling of pressure in the ear, certain types of ringing in the ears, dizziness, subjective hearing loss and moderate to severe hyperacusis (hypersensitivity to sound). Hyperacusis is directly linked to TMJD problems through the shared nerve supply of the tensor tympani

Jaw and teeth

1. If the tension of muscles and ligaments around the jaw is permanently increased, this can also be felt in the teeth. Pain projection to the molars in the upper jaw (or only sensitive molars) is known. The patient has a toothache

Treatment of temporomandibular joint complaints

1. Pain relief and jaw muscle exercises