|
 The
temporomandibular joint connects the lower jaw, called the mandible, to the
temporal bone at the side of the head. If you place your fingers just in
front of your ears and open your mouth, you can feel the joint on each side
of your head. Because these joints are flexible, the jaw can move smoothly
up and down and side to side, enabling us to talk, chew and yawn. Muscles
attached to and surrounding the jaw joint control its position and movement.
When we open our mouths, the rounded ends of the lower jaw, called condyles,
glide along the joint socket of the temporal bone. The condyles slide back
to their original position when we close our mouths. To keep this motion
smooth, a soft disc lies between the condyle and the temporal bone. This
disc absorbs shocks to the TMJ from chewing and other movements.
 The
temporomandibular joints are complex and are composed of muscles, tendons,
and bones. Each component contributes to the smooth operation of the TMJ.
When the muscles are relaxed and balanced and both jaw joints open and close
comfortably, we are able to talk, chew, or yawn without pain. We can locate
the TMJ by putting a finger on the triangular structure in front of the ear.
The finger is moved just slightly forward and pressed firmly while opening
the jaw. The motion felt is from the TMJ.
We can also feel the joint motion if we put a little finger against the
inside front part of the ear canal. These maneuvers can cause considerable
discomfort to a patient who is experiencing TMJ difficulty, and doctors use
them for making the diagnosis.
and
 |
Both males and females can get TMJ
diseases/disorders. However, 90% of those seeking treatment for TMJ are
women, most between puberty and menopause. Recent research has focused
attention on the relationship between sex hormones and pain. A study
conducted by Dr. Linda LeResche, University of Washington in Seattle,
demonstrated that women on hormone replacement therapy were 77% more likely
to seek treatment for jaw pain than those not undergoing such treatment.
Also, women on oral contraceptive therapy were 19% more likely to seek
treatment. Evidence is emerging in support of a biological explanation for
why there are more women suffering from TMJ pain.
A possible explanation is structural differences, as
in connective tissues, smooth muscle, or cartilage. Several other studies
find an equal distribution of TMD symptoms among men and women, yet claim
that females outnumber males eight to one in seeking treatment. There is
wide speculation as to why this is true. Some feel women utilize the health
care system more than men do; others state that women have a lower tolerance
for pain. However, since women most affected by TMD are between the ages of
18 and 40, it stands to reason that detailed scientific studies should be
carried out to assess the influencing effect of female sex hormones on the
development of the jaw joints and temporomandibular joint disorders. In
studies with baboons, estrogen receptors were found in the females' TMJs,
but none were found in the males. Scientists are unsure whether the presence
or absence of hormones makes a difference in pain, the perception of pain,
or function. It is interesting to note that a past scientific study has
shown that male and female mice experience pain and can respond to pain
differently.
TMJ pain disorders usually occur because of
unbalanced activity of the jaw muscles and/or jaw muscle spasm and overuse.
Symptoms tend to be chronic, and treatment is aimed at eliminating
precipitating factors. Many symptoms may not appear related to the TMJ
itself. Common symptoms include:
· Headache: 80% of
patients with a TMJ disorder complain of headache, and 40% report facial
pain. Pain is often made worse while opening and closing the jaw. Exposure
to cold weather or air-conditioned air may increase muscle contraction and
facial pain.
· Ear pain: 50% of patients with a TMJ disorder notice ear pain but
do not have signs of infection. The ear pain is usually described as being
in front of or below the ear. Often, patients are treated multiple times for
a presumed ear infection, which can often be distinguished from TMJ by an
associated hearing loss or ear drainage (which would be expected if there
really was an ear infection). Because ear pain occurs so commonly, ear
specialists are frequently called on to make the diagnosis of a TMJ
disorder.
· Sounds: Grinding, crunching, or popping sounds, medically termed
crepitus, are common for patients with a TMJ disorder. These sounds may or
may not be accompanied by increased pain.
· Dizziness: 40% of patients with a TMJ disorder report a vague
dizziness or imbalance (usually not a spinning type vertigo). The cause of
this type of dizziness is not well understood.
· Fullness of the Ear: 33% of patients with a TMJ disorder describe
muffled, clogged, or full ears. They may notice ear fullness and pain during
airplane takeoffs and landings. These symptoms are usually caused by
Eustachian tube dysfunction, the structure responsible for the regulation of
pressure in the middle ear. It is thought that patients with TMJ disorders
have hyperactivity (spasms) of the muscles responsible for regulating the
opening and closing of the Eustachian tube.
· Ringing in the Ear - Tinnitus: Because of a complex neurological
interaction between the TMJ joint and the facial and vagus nerve, 33% of
patients with a TMJ disorder experience noise or ringing (tinnitus). Of
those patients, half will have resolution of their tinnitus after successful
treatment of their TMJ.
Other symptoms include:
- facial pain; jaw joint pain; often in combination with neck, shoulder,
back pain and/or headaches
- popping, grating or clicking sounds with movement of the jaw joint
- pain in the joints of the face when opening or closing the mouth,
yawning, or chewing
- swelling on the side of the face and/or mouth
- a bite that feels uncomfortable, "off," or as if it is continually
changing
- limited opening or inability to open the mouth comfortably
- deviation of the jaw to one side
- the jaw locking open or closed
Take this preliminary
to see if your musculoskeletal condition could respond to nutritional
therapy.
 Part 2
|
