If you’ve attributed headaches, neck pain and clenched teeth to stress, you may want to look into a particular disorder that has been linked to those symptoms. Temporomandibular Joint Disorder (TMD OR TMJ) relates to problems with the joint that connects the lower and upper jaws. “Any type of misalignment of the bite can be a factor,” says Dr. Ruth Gomes, a dentist practicing at Viva Smiles in Clayton. “Misaligned or missing teeth are contributing factors, for example.”
TMJ causes a surprisingly wide array of symptoms, including pain in the face and neck, clicking or popping of the jaw, clenching or grinding, swallowing problems, dizziness, ringing in the ears, tingling of the fingertips, and nervousness or insomnia.
Some patients get immediate relief from Transcutaneous Electrical Nerve Stimulation (TENS), a widely used pain management tool. TENS helps relax the jaw and relieve discomfort. Gomes’ diagnostic and treatment approach includes computerized technology that records the lower jaw’s movements and how it closes in relation to the upper jaw.
“I then identify a new jaw position that leaves the patient’s jaw muscle in a more relaxed state,” she explains. “This is done by fitting the patient with a plastic jaw-repositioning appliance that is custom designed and fitted. In the majority of cases, our patients see incredible improvements of their TMD symptoms the day after they start wearing the appliance.”
While this technique is successful for many patients, other options include reshaping the enamel of the teeth; ‘reconstruction,’ which involves replacing missing teeth or making the teeth higher by using crowns to permanently realign the bite; and moving teeth to optimal position with orthodontic appliances, such as braces or Invisalign.
Some chiropractors also treat TMJ. “All dentists, chiropractors and medical doctors specialize in different treatment regimens that don’t always duplicate each other,” says Matthew Berman, D.C., of Berman Chiropractic & Wellness. “If you have TMD, every time you open and close your mouth you put wear on the tissues of the joint. This can cause severe problems if not treated properly.”
Berman notes that chiropractors specialize in bone and joint issues, so they are well suited to assess and treat TMJ. Like Gomes, Berman begins with a thorough medical history and chiropractic exam. He also considers lifestyle issues in determining potential causes of the disorder. “If your TMJ is related to stress, several muscle-relieving exercises or stress-relieving therapies may be diagnosed,” he says. “One of the main therapies would be massage. Treatments such as heat, ice, electric stimulation and ultrasound are used when needed. The emphasis is on rehabilitation and return of motion.”
Berman uses a treatment protocol that includes facial and cranial muscle releases and techniques that involve a gentle touch to the cranial and facial bones to relieve pressure and pain. “I also use cold laser therapy, which speeds recovery time, decreases pain and decreases inflammation,” he adds. Berman also considers other postural problems that may contribute to the problem. “A good rule of thumb is that the place of pain may not be the originating point of the pain,” he says. “It’s important to look at other structural issues in your body. Do you have scoliosis? Is one leg shorter than the other? Are your feet pronated or do you have foot pain? Is your pelvis rotated or do you experience back pain?”
The National Institute of Dental and Craniofacial Research (NIDCR) is working to identify risk factors that contribute to TMJ. According to the NIDCR, “The findings may lead to a better understanding of the onset and natural course of TMJ disorders and potentially to new diagnostic and treatment approaches.”