TMJ / Jaw Pain in Cobourg
TMJ – What Is It?
TMJ – Temporomandibular Joint – is the point where the jaw (the mandible) meets the skull (the cranium). The mandible is the largest and strongest bone of the face. There is an articular disc between the jaw and where it meets the skull. When the jaw moves to allow for things like speaking, eating, yawning, the disc will glide in the joint space to allow those movements to occur properly. This disc is stiff and durable and is designed to resist the long-term effects of pressure and friction.
The TMJ is very involved in chewing and swallowing, speaking and some facial expressions. Often there are asymmetrical and alternating combinations of movements. The Masticatory System, which comprises the head, neck, jaw, TMJ joints, muscles, ligaments and nerves in the region, is consciously controlled by the central nervous system and unconsciously controlled by the brainstem. Things like speed, position and force are determined by these higher centers and brainstem.
What are the Symptoms?
When there are issues with the jaw this can impact eating, sleeping, social communication and even psychological wellbeing depending on the severity.
Anterior disc displacement with reduction is the most common and it can occur in asymptomatic people. When the mouth is closed the disc is displaced but when the mouth is open the disc returns to location when there is reduction. In this situation the range of motion is still full but may not be as smooth as normal. With this condition people may report clicking, snapping and/or popping noises. There is an Opening Click and a Closing Click. This condition can be due to chronic microtrauma, or acute microtrauma, changes in shape to the joint or decreased lubrication of the joint as well as tight muscles or things like overbite. Clenching and grinding are associated with disc displacement as is intensive chewing.
Anterior disc displacement without reduction means the disc does not return to its normal position as the mouth closes. This means that opening the mouth will be limited. There can also be clicking in this condition. Jaw does not return to midline and instead deflects to the affected side.
These conditions can become chronic where sometimes jaw opening can be relatively normal and sometimes pain can reduce as well. They may continue to have clicking in both situations.
If there is Posterior disc displacement this presents as aching in the joint and pain when closing the mouth. This is very uncommon.
What are the Causes?
Disc displacement is when the disc doesn’t move properly within the joint. When this happens it causes momentary catching, clicking, popping or locking. Disc displacement can be with or without reduction and can move in a variety of directions.
Different things can cause TMJ dysfunction including: direct trauma (being hit, sports injury, etc.), having a third molar removed, yawning and sustained jaw opening, whiplash injury can be associated, Oral habits (ex. lip and cheek biting), thumb sucking, chewing fingernails and toothpicks, bruxism (clenching, grinding teeth). These all may not cause the condition but are often associated with it.
How Can Chiropractic Help?
When an individual experiencing TMJ / Jaw issues or discomfort comes into our chiropractic clinic they will go through a thorough history and physical exam. The history will include an overall health history but will also go into specifics of what the jaw issues are impacting, sleep pattern and position, general working posture and many other factors.
In the physical exam we will go through overall posture, range of motion of the jaw and the neck, and then we will assess the joints and soft tissue of the TMJ and neck to determine where the issues are arising from. Based on findings, x-rays may be ordered to fully assess the structure of the spine.
