TMJ and Facial Pain
It is a widely recognized fact that TMJ disorders (TMD) can stem from an injury or trauma. Any injury that has enough force to break teeth can permanently damage temporomandibular joints, surrounding muscles, ligaments and tendons. Obvious injuries such as a fractured jaw or traumatic head injury typically happen as the result of a motor vehicle accident or sports injury, and can be pinpointed at a specific time/date. The tougher problems to treat are the more subtle injuries, as they are more difficult to identify. This is usually because the symptoms (and damage) are not immediate. For example, you may have pain in your jaw right now, and it could be from a car accident 5 or 10 years ago.
According to statistics published in the Journal of the American Dental Association (ADA) in 1990, 44-99% of TMJ problems are caused by trauma.
Injuries That Can Cause TMD
Whiplash – Many people think that whiplash is just a neck injury, but the central point of the trauma associated with the rapid movement is the temporomandibular joint. The muscles associated with the TMJ are placed under excessive pressure, opening the jaw and exerting force on the sides of the skull where the jaw is attached to the cranium.
*The Journal of the American Dental Association found that 1 in 3 people who get whiplash experience delayed TMD.
*At the 1990 annual conference of the Radiological Society of North America, a paper was presented indicating that, through the use of magnetic resonance imaging (MRI), a study revealed that there were TMJ injuries in 87 percent of patients who reported whiplash syndromes after automobile accidents.
A Blow to the Lower Jaw – This can cause trauma that is significant enough to misalign, dislocate or even break your jaw. If there has been a change in the anatomy of the jaw, like disc displacement or condylar injury, then a clicking sound will start to occur when moving the jaw.
A Blow to the Side of the Head – This can cause the temporalis muscle to contract. If the temporalis contracts then the mandible (lower jaw) is lifted, causing misalignment. Characteristic symptoms of this type of injury include jaw pain, headaches, migraines and dizziness.
Overextending the Joint – When holding your mouth open for extended periods of time, there is potential for stretching and straining one or both TMJ’s. Stretching the ligaments may allow the TMJ disc to have an unnatural ROM (range of motion). If the disc slips forward past the condyle, it no longer serves its function as a buffer between the bone of the condyle and the cranial socket. This could happen during normal activities of daily life such as yawning too wide, singing, yelling or laughing. This also often occurs after an extensive dental procedure, or if you experience a seizure.
Additionally, repetitive behaviors like jaw clenching, teeth grinding, excessive gum chewing, or any other monotonous behavior can be the source of a microtrauma (minor internal injury). People under a lot of stress may constantly chew gum or clench their teeth. Even though this seems like a minor action, if repeated enough, can cause myofacial trigger points. Damage is done slowly and over a long period of time. So unless the individual is hyperaware of their behavior, they probably don’t even know that they are harming themselves.
Similar to other joints in the body, the TMJ is a multipart structure that acts as a hinge or rotator. This hinge is a ball-and-socket joint. Basically, it enables your jaw to move freely (estimated function is up to 5,000 times per day). Each person has two TMJ’s (left & right). You can feel both of them by placing your fingers in front of your ear lobes and opening/closing your mouth. The TMJ’s are very susceptible to injury due to their anatomical intricacy.
Anytime you encounter an accident or injury, your dentist should screen you for signs of TMJ pain or dysfunction. This should be done right after the accident and then reexamined on a yearly basis. Dr. Klein spends significant time with new patients to learn about their lifestyle and possible injuries. He will discuss imaging results and comprise a treatment plan if a TMJ problem is diagnosed. While some surgeries are available for different TMJ dysfunctions, Dr. Klein takes a conservative approach. To find out more about the treatments offered at Michigan Head & Neck Institute, please visit our website at www.michiganheadandneck.com or call us at (586) 573-0438.
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