Toothache (cont.)

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Temporalmandibular joint (TMJ) disorders

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Disorders of the temporomandibular joint(s) can cause pain which usually occurs in or around the ears or lower jaw. The TMJ hinges the lower jaw (mandible) to the skull and is responsible for the ability to chew or talk. TMJ disorders can be caused by different types of problems such as injury (such as a blow to the face), arthritis, or jaw muscle fatigue from habitually clenching or grinding teeth. Habitual clenching or grinding of teeth, a condition called "bruxism," can cause pain in the joints, jaw muscles, and the teeth involved. People who clench or grind their teeth may wake with a toothache, headache or earache. There may be soreness around the facial muscles and tenderness at the jaw joints. The action of clenching or grinding can cause cracks, fractures, and wear on the teeth. This exposes the underlying layer of dentin and causes teeth to become sensitive to temperature changes and pressure. Additionally, clenching or grinding damages the existing dental restorations and may cause teeth to loosen.

Bruxism is often due to life stress, family history of bruxism, and poor bite alignment. Sometimes, muscles around the TMJ used for chewing can go into spasm, causing head and neck pain and difficulty opening the mouth normally. These muscle spasms are aggravated by chewing or by stress, which cause the patients to clench their teeth and further tighten these muscles. Temporary TMJ pain can also result from recent dental work or by the trauma of extracting impacted wisdom teeth.

Treatment of temporomandibular joint pain usually involves oral anti-inflammatory over-the counter (OTC) drugs like ibuprofen (Motrin or Advil) or naproxen (Aleve). Other measures include warm moist compresses to relax the joint areas, stress reduction, and/or eating soft foods that do not require much chewing. If bruxism is diagnosed by a dentist, a bite appliance (night guard) may be recommended that is worn during the night to protect the teeth. However, this bite appliance is used mainly to protect the teeth and may not help with joint pain. For more serious cases of joint pain, a referral to a TMJ specialist may be necessary to determine further treatment.

Medically Reviewed by a Doctor on 1/11/2013

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