TMJ Issues, More Common than you Think - What can you do about it?
Research shows that more than 10 million people in the U.S. experience TMJ disorder and most of them are women. In fact, 90% of TMJ sufferers are women in their childbearing years. It's hard to calculate exactly how many people have a TMJ disorder because so many people don't connect their symptoms with this disorder. Those who have it, generally experience headaches, muscle pain, neck pain, tooth, ear aces, sensitivity to cold and clicking of the jaw.
I interviewed local dentist Dr. Nick Yiannios, who has a practice in Rogers, Ark., and happens to specialize in TMJ. He was able to tell me much more about this problem that so many people - especially young moms - deal with
What is TMJ?
The first thing you have to know is that everyone has TMJ because TMJ stands for the anatomy part: temporal bone mandible joint. So, since we all have jaws, we all have TMJ. When a person has problems with this area, it is technically termed TMD, which stands for temporomandibular joint disorder. In some cases, it may be annoying but in others, it's downright unbearable.
While many dentists will blame a person's bite for problems with a clicking jaw or mouth pain, Dr. Yiannios believes TMJ issues usually come from old trauma to the part of the jaw that functions as a hinge. "Dentists usually think muscle pain in the mouth happens because the bite's not right," Yiannios says. "They don't think about the hinge as a player. The hinge is always a player."
If at some point in your childhood, you fell on your chin, or the side of your face or the back of your head, or as a teen or adult, you were in a car accident or played an impact sport you might have hurt your jaw without realizing it. Unknown to you, the injury might have made your jaw shift. Imagine your jaw is a doorjamb. You have the vertical and horizontal sides of the doorway which meet to create an angle, and you have the door itself opening and shutting at the doorjamb. A carpenter might keep shaving down a door that won't shut properly, but every few weeks the door hits the jam again and he has to keep shaving the door. The problem won't be fixed until he finally sees that the hinge is misaligned. If you continue to only look at the bite (addressing the teeth only), you'll overlook what is many times the root problem - the hinge.
A Deeper Look
The routine x-rays we get at our dental visits are not enough to catch a problem with misalignment in the jaw. The images are 20% distorted and are not able to show torn ligaments or cartilage beyond the bone. Yiannios uses MRIs and CAT scans to get a clear sense of what the hinge is doing. Using an MRI allows the professional to measure the sides of the jaw in milliliters and get a number-based, unbiased assessment of the problem instead of just an opinion. There are cases in which a child takes a blow to the jaw; the injured side might have stunted growth while the unaffected side continues to grow normally. By the time this child becomes an adult, one side of the jaw can be 5ml shorter than the other. No one would catch this without an MRI.
How does misalignment in the hinge translate to muscle pain? Going back to the doorjamb idea, if the door isn't aligned and doesn't hit the jam right, the muscles learn to brace for it to be forced shut. Muscles around the jaw overcompensate to make up for the deformity in the bone, much like if you had an orthopedic problem with your spine, you would feel back muscle pain because they're working harder to make up for the spine. When muscles work too hard, they get sore. Other reasons for TMJ problems can be orthodontic issues, torn ligaments or torn cartilage.
Fixing the problem
Once you've had a scan and have your diagnosis, you're ready to move on to getting rid of the problem. The cure might lie in the hands of a different kind of medical professional. Yiannios warns to be careful of stents (mouth guards). They rarely work because they're usually given to patients without a proper diagnosis. "If your hips are out of whack and a chiropractor gives you a lift to put under a foot, what does that do?" he says. "It's a crutch at best. That's what happens with dentists who don't see the whole picture to see what's happening all the way within the hinges of the jaw. They only see the teeth and put in a splint for the bite."
In Dr. Yiannios' case, after he reads, reviews, and thoroughly does his examination, if the patient is not a candidate for treatment in his office, Dr. Yiannios' will propose opinions for the patient and refer the case to his professional group who he has been collaborating with for years. The key is to think outside the box sometimes. Few cases will require surgery, but there are other ways that once you have a diagnosis you can begin to repair the bite or the hidden areas around the hinge.
The bottom line is, if you think you have problems with your TMJ, there are different ways to address it. If it's really bothering you, it could be worth it to have your jaw properly scanned and measured through an MRI or CAT scan. Once you have a diagnosis, you can follow specific, individualized recommendations for improving your TMJ issues.