John R. Bennett, MD
1255 East 3900 South #301, Millcreek, Utah 84124
756 East 12200 South, Draper, Utah 84020 22 South 900 East, Salt Lake City, Utah 84102
Temporomandibular Joint (TMJ) Disorder
The TMJ, or jaw joints, become easily inflamed when over-used, typically from clenching one’s teeth when stressed, and grinding teeth while asleep. As the nerve to the jaw joints is the same nerve as to the ear, jaw pain and ear pain can become virtually indistinguishable. TMJ pain radiates into the ear, down the jaw and neck, and up into the scalp. There is often grinding and popping in the joints, or one or both joints can become less mobile as the individual protects the joint, often unconsciously. There is pain with yawning and chewing. Stress can often trigger the pain, or it can become chronic.
The first step to stopping the pain is stopping the contact of the teeth. The teeth should never touch unless you are chewing, and the teeth should just barely come together while chewing. To break the habit, you must start paying attention to the teeth. I recommend a quick mental check every hour to see if the teeth are touching, and teach yourself to relax the jaw, even as the lips are kept together. When you are feeling stress, check and see if the teeth are touching. It may take months to break the habit, but it is a habit that can be overcome. The lips should be closed, but the teeth should never touch.
While breaking the clenching habit, a soft diet should be used. No hard breads, no hard vegetables, no hard meats, and no gum. Eat only soft foods. Warm soaks to the area of the jaw joint, and massaging the surrounding muscles is helpful. Anti-inflammatories such as Motrin are helpful. Prescription muscle relaxants such as Flexeril help some people, but as they make most people very sleepy, they usually are only helpful at bedtime. Getting help for stress and anxiety often prove very helpful. Working with a Physical Therapist is very helpful.
If you wake up with ear/jaw pain, or your spouse has noticed you grinding your teeth at night, the only thing that helps this is a bite block. Cheap ones can be purchased at all drug stores. They tend to be bulky, but if they work for you, that may be all you need. Dentists and Oral Surgeons can also make a much nicer form-fitted bite block, but these can get expensive.
If these measures do not help you, and other causes of the pain have been ruled out, then a referral to an Oral Surgeon or Dentist who treats TMJ dysfunction is the next step.
Remember: the teeth should never touch! Please call Dr. Bennett at 801-328-2522 if you have any questions, problems, or concerns.