TMJ (Jaw Joint) Disorders - The Migraine Connection
by Dr. Phillip Durden
Over years of study and clinical practice, I have worked with a number of patients that suffer from chronic headaches. Often many of these patients' symptoms could be traced back to jaw joint (TMJ) and obstructive sleep disorders which trigger jaw clenching, resulting in the classic "migraine".
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TMJ Dysfunction: What is it?
TMJ itself stands for temporomandibular joint, a complex system of bone, muscle, nerves and soft tissue located just in front of each ear. These joints are flexible, allowing the jaw to move smoothly, up-and-down and side-to-side; enabling us to talk, chew and yawn.
The TMJs are the most frequently used joints in the body, and are prone to misalignment, which can lead to chronic recurrent headaches as well as ear, facial and neck pain. It is not certain how many people have TMJ disorders, but some estimates suggest that over 10 million Americans are affected, and this condition appears to be more common in women than men.
“It's all in Your Head”
Until recently, symptoms of head and facial pain appeared unrelated, and were frequently undiagnosed or misdiagnosed as migraine, tension headache, neuritis, neuralgia, or stress. When standard treatment remedies for these types of disorders proved unsuccessful, patients were frequently labeled as “hypochondriacs” or mentally unstable.
Today we know that many of these unexplained, undiagnosed and therefore untreated symptoms are actually related to a group of problems called TMJ Dysfunction. TMJ Dysfunction is considered “The Great Imposter” because problems within this disorder can produce a myriad of symptoms which, at first glance, might seem unrelated to the jaw complex.
Common symptoms may include any of the following:
•Headache or facial pain
•Neck or shoulder pain
•Tingling in the arms or fingers
•Pain when chewing or yawning
•Clicking, popping, or grating sounds in the TMJ
•Ringing or stuffiness in the ears
•Limited jaw opening or locking
The Diagnostic Process
Our TMJ assessment includes a detailed medical and dental history, along with thorough documentation of symptoms and pinpointing painful areas in the facial, neck, head and jaw. We work closely with physicians to rule out possible causes related to other health conditions.
If a TMJ disorder is suspected, we will then use digital xray images and analytical technologies, such as JVA (Joint Vibration Analysis), Jaw Tracking, EMG and imaging to show the alignment and relationship between the jaw and skull to help us arrive at an appropriate course of treatment.
Because the cause of TMJ Disorders is multi-faceted and often unclear, current research supports the use of conservative, reversible treatments. Surgery is rarely indicated and is always the last resort.
•Many patients respond to therapy which is based on achieving proper position of the joint(s) and allowing the body an opportunity to heal itself. We often use an orthotic appliance to stabilize and correct jaw alignment, along with physical therapy to help maintain fluid joint movement and keep the muscles relaxed during healing. Medications may also be necessary to reduce inflammation.
•Other options to address TMJ disorders include making changes to the bite through restorative dentistry to rebuild broken-down teeth or minor tooth reduction (occlusal adjustment) to adjust the bite and better support proper jaw position.
If you think you have a TMJ Disorder
I always recommend that my patients keep a daily journal to document the details of their symptoms, including the time(s) pain occurred and what they were doing, along with the level of pain and specific location. We use forms that allow the patient to chart this information, which gives us invaluable details in developing their treatment plan.
Chronic pain is one of the most prevalent causes of depression and stress, with the resulting effect of diminishing quality of life. If you or a loved one is suffering with these types of symptoms, I encourage you to contact our office and let us help you take back control of your health.
Reference: National Institute of Dental and Craniofacial Research, www.nidcr.nih.gov