In third installment of our TMJ/TMD series, I’ll explain the most common causes of TMD.
Bruxism: This is when you clench your teeth together and move them slowly back and forth in a gnawing/gnashing way. When you clench 2 things happen:
1) The facial muscles (see tmj anatomy) become overworked and hyperactive. This may result in muscle fatigue and soreness in the temples, jaw and even down the neck.
2) The articular disc, which is supposed to act like a cushion (see tmj anatomy) at the actual joint, becomes compressed and flattens out. This results in pain when chewing or yawning in addition to noises like clicking.
It is not clear why bruxism occurs. Possible causes range from stress and anxiety to sleep disorders to lifestyle factors.
A) Stress and anxiety: When we’re stressed or anxious we tend to grind or brux our teeth together. This occurs most often when we’re asleep. The muscles become overused and sore which lead to jaw pain, headaches and facial pain. The disc becomes compressed as well which limits jaw movement, causes pain when chewing or yawning and clicking in the joint.
Psychological disorders are also associated with grinding during sleep. Seventy percent of bruxism is due to stress and anxiety.
B) Life Style: The use of tobacco (smoking), alcohol, caffeine, medications for sleep, depression and anxiety, all cause bruxism in individuals.
In addition, statistics have shown that younger people who are highly educated tend to brux more.
C) Sleep Disorders: people who snore, and those with sleep apnea, tend to brux more.
Injuries: An injury can cause damage to either the facial muscles and to the articular disc or both. If the muscles are injured, then movement of the jaw will be restricted. An injury to the disc may result in it becoming compressed and dislocated forwards. This will restrict movement.
Common causes of injuries are motor vehicle accidents, sports related and even biting down on a popcorn kernel.
Injuries are usually characterized by pain and limited range of motion.
Arthritis: As like any other joint in the body, i.e., a shoulder or hip, it is possible to develop arthritis in the TMJ. Arthritis or osteoarthritis is an over-abundance of inflammation which can occur with age and also as a result of an injury. At the TMJ, the inflammation results in destruction of the condyle or the bone that connects the jaw to the skull. Then the joint doesn’t rotate properly and makes noises that sound like grinding or grating (called crepitus).
Other causes of TMD
Any time the mouth is open for a long time :
1) A long dental appointment.
2) Being put under general anesthetic for an operation. A breathing tube is placed through the mouth in to the trachea and the mouth remains open for the duration of the procedure.
In both cases, the mouth is open for a long time and the muscles become over stretched, causing pain. Usually, this disappears within a few days.
Most acute cases of TMD resolve on their own with very little intervention. Initial treatment is pretty conservative and involves jaw exercises, and habit changes to allow for proper positioning of the jaw. This is so the muscles relax and start healing. Most patients usually feel better within 4-6 weeks. If not, they need further assessment.
If we educate ourselves as to what will cause a problem, it will be so much easier to avoid it.
In the next entry, we’ll discuss the signs and symptoms of TMD…Hope you tune in!
If you have jaw pain, it could be that you’re suffering from TMD. Treatment for TMD is as close as Dr. Robert Axelrad & Associates dental clinic in Brampton, Ontario. We can help. Simply dial (905) 791-3867 today to book a consultation. We’re located at 40 Finchgate Blvd., Suite 121, in the heart of Brampton, Ontario.
We look forward to seeing you soon.
Dr Axelrad and Staff