Dr. Shiel received a Bachelor of Science degree with honors from the University of Notre Dame. There he was involved in research in radiation biology and received the Huisking Scholarship. After graduating from St. Louis University School of Medicine, he completed his Internal Medicine residency and Rheumatology fellowship at the University of California, Irvine. He is board-certified in Internal Medicine and Rheumatology.
Melissa Conrad Stöppler, MD, is a U.S. board-certified Anatomic Pathologist with subspecialty training in the fields of Experimental and Molecular Pathology. Dr. Stöppler's educational background includes a BA with Highest Distinction from the University of Virginia and an MD from the University of North Carolina. She completed residency training in Anatomic Pathology at Georgetown University followed by subspecialty fellowship training in molecular diagnostics and experimental pathology.
TMJ pain disorders usually occur because of unbalanced activity, spasm, or overuse of the jaw muscles. Symptoms tend to be chronic, and treatment is aimed at eliminating the precipitating factors. Many symptoms may not appear related to the TMJ itself. The following are common symptoms.
Headache:
Approximately 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.
The temporomandibular joint (TMJ) is the area directly in front of the ear on either side of the head where the upper jaw (maxilla) and lower jaw (mandible) meet. Within the TMJ, there are moving parts that allow the upper jaw to close on the lower jaw. This joint is a typical sliding "ball and socket" that has a disc sandwiched between it. The TMJ is used throughout the day to move the jaw, especially in biting and chewing, talking, and yawning. It is one of the most frequently used joints of the body.
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 person who is experiencing TMJ difficulty, and doctors use them for making the diagnosis.
What are TMJ disorders, and how are TMJ
disorders caused?
TMJ disorders are a group of complex problems of the jaw joint. TMJ disorders are also sometimes referred to as myofacial pain dysfunction and Costen's syndrome. Because muscles and joints work together, a problem with either one can lead to stiffness, headaches, ear pain, bite problems (malocclusion), clicking sounds, or locked jaws. The following are behaviors or conditions that can lead to TMJ disorders.
Teeth grinding and
teeth clenching (bruxism) increase the wear on the cartilage lining of the
TMJ. Those who grind or clench their teeth may be unaware of this behavior unless they are told by someone
observing this pattern while sleeping or by a dental professional noticing
telltale signs of wear and tear on the teeth. Many patients awaken in the
morning with jaw or ear pain.
Habitual gum chewing or fingernail biting
Dental problems and misalignment of the teeth
(malocclusion). Patients may complain that it is difficult to find a
comfortable bite or that the way their teeth fit together has changed.
Chewing on only one side of the jaw can lead to or be a result of TMJ
problems.
Trauma to the jaws: Previous fractures in the jaw or facial bones can lead to TMJ disorders.
Stress frequently
leads to unreleased nervous energy. It is very common for people under stress
to release this nervous energy by either consciously or unconsciously grinding
and clenching their teeth.
Occupational tasks such as holding the telephone between the head and shoulder may contribute to TMJ disorders.
Temporomandibular Joint Disorder (Tmj) - Symptoms ExperiencedQuestion: For temporomandibular joint disorder (tmj), what were the symptoms and signs you experienced?
Headaches can be divided into two categories: primary headaches and secondary headaches. Migraine headaches, tension headaches, and cluster headaches are considered primary headaches. Secondary headaches are caused by disease. Headache symptoms vary with the headache type. Over-the-counter pain relievers provide short-term relief for most headaches.
Dizziness is a symptom that is often applies to a variety of sensations including lightheadedness and vertigo. Causes of dizziness include low blood pressure, heart problems, anemia, dehydration, and more. Treatment of dizziness depends on the cause.
Muscle spasms are involuntary muscle contractions that come on suddenly and are usually quite painful. Dehydration, doing strenuous exercise in a hot environment, prolonged muscle use, and certain diseases of the nervous system may cause muscle spasms. Symptoms and signs of a muscle spasm include an acute onset of pain and a possible bulge seen or felt beneath the skin where the muscle is located. Gently stretching the muscle usually resolves a muscle spasm.
Tinnitus is a ringing or swishing that seems to originate in the ear or head. Most of the time it is not a serious problem (it is however, a nuisance to those that suffer from the condition). Causes of tinnitus include loud noise exposure (firearms, loud music), medications, and other diseases (Meniere's disease). Treatment options are limited for tinnitus. Tinnitus can be prevented by wearing hearing protection when exposed to loud noises.
Stress occurs when forces from the outside world impinge on the individual. Stress is a normal part of life. However, over-stress, can be harmful. There is now speculation, as well as some evidence, that points to the abnormal stress responses as being involved in causing various diseases or conditions.
Toothache usually refers to pain around the teeth or jaws. In most instances, toothaches are caused by tooth or jaw problems, such as a dental cavity, a cracked tooth, an exposed tooth root, gum disease, disease of the jaw joint (TMJ), or spasms of the muscles used for chewing. A toothache can also be caused by a problem that does not originate from a tooth or the jaw, like diseases of the heart (angina or heart attack), ear infections, and sinus infections. A thorough oral examination, which includes dental X-rays, can help determine the cause.
Bruxism is the medical term for teeth grinding. Bruxism may be caused by stress or anxiety and often happens during sleep. Symptoms and signs include jaw pain, headache, and abnormalities in your teeth. Treatment may involve practicing stress-management techniques, cutting back on caffeine and alcohol, avoiding gum chewing, training oneself not to grind the teeth, and wearing a mouth guard.
Stress may be considered as any physical, chemical, or emotional factor that causes bodily or mental unrest and that may be a factor in disease causation. An important goal for those under stress is the management of stress in our lives. Elimination of stress is unrealistic, since stress is a part of normal life. We can however, learn to manage stress through techniques such as exercise, relaxation, meditation, time management, and support systems so that we have control over our stress and its effects on our physical and mental health.
Oral health problems in children include thumb sucking, tongue thrusting, lip sucking, tooth decay, and early tooth loss. Get tips on how to prevent these problems in your child.
Although teeth grinding can be caused by stress and anxiety, it often occurs during sleep and is more likely caused by an abnormal bite or missing or crooked teeth.
How Do I Find Out if I Grind My Teeth?
Because grinding often occurs during sleep, most people are unaware that they grind their teeth. However, a dull, constant headache or sore jaw
is a telltale symptom of bruxism. Many times people learn that they grind their teeth by their loved one who hears the grinding at night.
If you suspect you may be grinding your teeth, talk to your dentist. He or she can examine your mouth and jaw for signs of bruxism, such as jaw tenderness and abnormalities in your teeth.
Why Is Teeth Grinding Harmful?
In some cases, chronic teeth grinding can result in a fracturing, loosening, or loss of teeth. The chronic grinding may wear their teeth down to stumps. When these ...
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