Temporomandibular dysfunction (TMD), or pain and problems involving the jaw, are relatively common in the general population. Habits such as grinding or clenching your teeth, working with a forward head posture, increased stress, trauma, structural changes in the joint, and repetitive habits such as chewing gum can all contribute to pain in the temporomandibular joint (TMJ). However, the symptoms of a TMJ disorder are not always straightforward and often require careful evaluation to properly diagnose.
When we think of problems with the TMJs, the first things that come to mind are clicking, popping, or pain in the joint. There may also be associated difficulty with fully opening or closing the mouth. To understand where some of the other TMJ dysfunction symptoms can come from, it is important to have a basic appreciation of the anatomy of the joint and its surrounding structures.
The TMJ itself sits directly in front of the ear canals, with one TMJ being located on each side of the face. Inside the joint is a disc that provides a cushion between the bony surfaces of the mandible and the temporal bone of the skull. There is a capsule that surrounds the joint. Then, there are numerous muscles and tendons that manipulate the mandible, allowing you to talk and chew. Many of these “soft tissue” structures share connective tissue (fascia) with structures in the neck and the face. Additionally, the jaw sits very close to the trigeminal nerve. This cranial nerve (which comes directly from the brain), provides nerve signals to the muscles of the jaw, but also to structures in the ear, and some sensation of the face.
Because of the TMJ’s close relationship to the ear, one of the first symptoms of problems in the joint is ear pain that can mimic that of an ear infection. It is not uncommon for us to see people who have gone through multiple unsuccessful rounds of antibiotic treatment for ear pain when, in reality, their jaw was the culprit. Swelling around the TMJs can also put pressure on the structures of the middle and inner ear, resulting in sensations of dizziness. Finally, irritation of the trigeminal nerve can cause referred pain up into the head or down toward the neck, producing headaches, sinus pain or pressure, and neck pain.
Because of this wide array of potential symptoms resulting from temporomandibular dysfunction, treatment must be comprehensive. We will typically treat individuals from the mid-back up to their head and face to ensure comprehensive care for their TMD. Physical therapy can be a very beneficial intervention to reduce pain associated with TMD, improve mobility of the jaw and neck, and eliminate associated headaches, ear pain, and neck pain. We enjoy working with you and your dental team to ensure that you receive the best care for your TMD symptoms.
