INTRODUCTION

Why Am I in Pain?
Are you like many other people who suffer pain in your jaw, neck or face, but can't figure out what's wrong? Is the pain intense and reoccurring? Do you have frequent headaches that may be migraines, or may be . . . . something else? That mysterious "something else" may well be Temporomandibular Joint Disorder ("TMJ" or "TMD" for short).

Many people have struggled to deal with a condition that, until ten years ago or so, was considered difficult to diagnose and identify, not to mention treat. Treatment of TMJ was complicated because few dentists, doctors, or orthodontists could agree on the causes and best methods to correct the problem. Some researchers even questioned whether the syndrome was "real" or not. Confused and frustrated patients often didn't even know who to go to for help.

It has been estimated that 25 million Americans have some form of TMJ, although many patients remain undiagnosed, not knowing why they are in pain, or what to do about it.

The symptoms of TMJ have now been studied extensively enough that doctors know the pain is real. In fact, it is too real, too intense, and too long lasting for even the most skeptical dental or medical practitioner not to take it seriously.

What is TMJ?
"TMJ" or "TMD" is a condition where a person experiences pain resulting from the movement of the jaw, the muscles of the jaw, or the joint connecting the lower jaw (mandible) to the skull (temporal region), hence the name "Temporomandibular Joint Disorder" ("TMJ" or "TMD"). The Temporomandibular Joint may easily be felt if you open your mouth wide and move a forefinger directly in front of your ear lobes on either side of your face. By opening and closing your mouth a few times, you can feel this joint as it moves to accommodate your jaw movement. This joint normally works like a hinge, allowing a smooth gliding motion between the skull and jaw bone. However, when it is inflamed, damaged, infected, or strained, pain can radiate out, and surrounding facial muscles may spasm and cause increasing pain.

In a healthy person, the joints work smoothly with the facial bones and muscles to allow the mouth and jaw to open and move forward, backward, and side-to-side. Where there is a problem, however, there may be muscle spasms, joint tenderness, and eventually, jaw bone degeneration.

How Can My Jaw Make My Head Hurt?
You have a large jaw muscle (called the "temporalis muscle") located at the temple, as well as several other muscles extending to the jaw line. When these muscles are strained, due to misalignment of the Temporomandibular Joint, or teeth, the muscles become inflamed and cause pain to radiate to other areas of the face, ears, neck, and shoulders.

Many TMJ suffers report that they experience pain - beginning in a dull, nagging form, and often increasing over time, until it reaches an unbearable level. It has been estimated that as much as 75% of all headaches are related, in some way, to jaw muscle disorders, with most occurring in the large jaw muscle area, near the temples. This head pain is often attributed to being a "migraine," when it, in fact, is not a true migraine, but a severe form of TMJ.

The pain can often be relieved through a series of orthodontic and/or drug treatments (such as taking anti-inflammatory drugs, using an oral splint, the use of a T.E.N.S. unit, changes in diet and lifestyle, as well as the application of a hot or cold compress). The acute pain can often be relieved fairly soon, but it may take as long as two to three months for you to become comfortable. A "soft tissue" problem can often be corrected by a change of diet, lifestyle, and habits that avoid overworking the sensitive jaw.

If you have mechanical problems with your jaw, joint, or disc, you may require orthodontic treatment, such as braces or equilibration. If scar tissue or a bone spur is present, arthroscopic surgery may be required.

In any case, TMJ patients are often required to learn new, healthier ways of expressing and relieving stress, and to avoid excessive or extreme movements that may cause overwork or strain to the jaw area.

Who is Affected?
75% of those diagnosed with TMJ are women, 25% are men. Some doctors believe that women are more prone to TMJ Disorder because their facial ligaments are usually more lax, due to monthly hormonal fluctuations. It is possible, however, that men may suffer in larger proportion than reported, since many people suffering from this painful condition take years to seek out treatment, or to be properly diagnosed. Unfortunately, many people don't seek out professional help until the pain is intense and recurrent enough to intrude into their daily lives.

Where Should I Go to Seek Treatment for TMJ?
Your orthodontist or dentist is a good place to start. Explain your symptoms to him or her, and ask for a recommendation or referral to someone who has had experience treating TMJ Disorder. Family dentists and physicians don't often have much experience with joint problems, especially of the jaw. The job of an orthodontist is to make the teeth fit together so that the jaw is in the correct position, which is why they often treat the problem.

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