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.
Ear pain: About 50% of patients with a TMJ disorder notice ear
pain and do not have signs of ear 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 disorder 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: Of patients with a TMJ disorder, 40% report a vague sense
of dizziness or imbalance (usually not a spinning type vertigo). The cause of this type of dizziness is not well understood.
Fullness of the ear: About 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): For
unknown reasons, 33% of patients with a TMJ disorder experience noise or ringing
in the ears
(tinnitus). Of those patients, half will have resolution of their
tinnitus after successful treatment of their TMJ disorder.
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.
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