The Dangers of Untreated TMJ

What is temporomandibular joint disorder (TMJ)?

Temporomandibular joint disorder is a disorder of the temporomandibular joint, the joint of the jaw that sits just in front of each ear. It causes discomfort and pain that can come and go or become chronic. Because the symptoms are often put down to stress, the disorder frequently goes untreated, and left untreated, its effects can stay with you for years.

Many people live with TMJ without ever seeking treatment. Ordinary daily tasks such as chewing, talking and yawning can aggravate it, so it is hard to simply avoid, and over time it can contribute to other health problems. That is why we encourage anyone with the signs of TMJ to have it looked at by Dr. Frey in Beverly Hills.

How serious is TMD?

Temporomandibular joint disorder is often misunderstood, and it is sometimes misdiagnosed as migraine headaches or as neck and upper back pain. TMJ is not a life threatening condition, but it can have a very real effect on your quality of life.

Chronic jaw pain, headaches, ringing in the ears and difficulty chewing and biting are not issues to shrug off. They deserve the full attention of a temporomandibular joint expert such as Dr. Frey. You do not have to settle for ongoing pain.

What causes TMJ?

You do not simply wake up one day with temporomandibular joint disorder. It can begin in childhood, and mouth breathing is one sign of this, because it points to a misaligned jaw. Those are congenital causes.

Other causes relate to problems with the bite, or to subtler issues such as stress and clenching the teeth during sleep. An injury to the jaw joints or the muscles around them can also lead to TMJ. Some causes are still unknown, although there also appears to be a genetic tendency. Common causes of TMJ include:

• A misaligned bite between the upper and lower jaws
• Grinding or clenching the teeth
• Movement of the soft cushion, or disc, between the ball and socket of the joint
• Arthritis in the joint
• Stress, which can cause a person to tighten the facial and jaw muscles or clench the teeth
• An injury to the jaw, head or neck that affects the joint
• Missing or heavily worn teeth that leave uneven biting surfaces

What are the symptoms of TMJ?

TMJ can lead to chronic pain. It is most common in people between the ages of 20 and 40, and it occurs more often in women than in men. These are the typical TMJ symptoms, along with symptoms related to TMJ:

• Pain in the face, the jaw joint area, the neck and shoulders, or in and around the ears when you chew or open your mouth
• A jaw that gets stuck, or locks, open or closed
• Clicking, popping or grating sounds in the jaw joint when you chew or simply open or close your mouth
• Frequent headaches
• Regular jaw stiffness
• Ringing in the ears (tinnitus)
• Grinding the teeth without meaning to
• A tired feeling in the face
• Pain in the upper shoulders
• Dizziness
• Sleep apnea

What is wrong with my jaw and bite?

Your bite has three parts: the teeth, the masseter muscles and the temporomandibular joint. All three must work together for the bite to function correctly. When they do, you have no facial or jaw pain and chewing is silent. When one of them falls out of alignment, the bite problems that follow create pain in the jaw and face that can radiate down into the neck and shoulders.

The pain comes from the continued stress of a misaligned jaw trying to find alignment. We use the jaw and its joint almost constantly, for eating, talking, breathing during exertion and even yawning, so the pressure of misalignment overworks the muscles and builds tension. That strain produces pain that starts in the joint and spreads outward.

What can happen if TMJ is left untreated?

When TMJ goes untreated, its effects can reach well beyond the jaw. Not everyone experiences all of these, but they are worth understanding.

Sleep, eating and daily life.

Constant pain from TMJ, combined with grinding the teeth, can disturb sleep and lead to insomnia. Many people try to manage the pain on their own with medication, which can dull it without addressing its source. Some begin avoiding the problem by eating only soft foods or liquids, which makes it harder to eat well. Over time, pain that does not let up can also weigh on your mood, your work and your relationships.

Dental health.

Over the long term, the grinding and clenching that often come with TMJ can fracture teeth and wear down enamel. People with TMJ also tend to favor one side of the jaw, which can cause swelling on that side of the face and uneven muscle development, giving the face a lopsided appearance.

Ears, balance and the jaw joint.

Because the joint sits directly beneath the ears, TMJ disorder may contribute to ringing in the ears and, in some cases, lasting changes in hearing. Inner ear involvement can affect balance and bring on vertigo, or recurring dizziness. In more advanced cases the jaw can lock open or closed, and wear on the cartilage in the joint can make it less stable.

No one should have to live with these effects. TMJ can be treated with conservative, non surgical care, and the earlier the bite is addressed, the simpler that care tends to be.

What can cause TMJ to flare up or worsen? Is TMJ dangerous?

A period of new stress, at work or in a relationship, can lead a person to clench their teeth at night, and the TMJ gets worse. Poor posture in the neck and upper back is another trigger: it strains the neck and interferes with how the jaw muscles work. This can happen when you are doing more computer work than usual and not paying attention to your posture. We cover more of what can make TMJ worse on our blog.

These are generally not acute pain conditions. TMJ does not develop overnight; it behaves more like a chronic pain condition. So while TMJ is rarely an emergency, it tends to persist, which is why it is worth having it looked at rather than waiting it out.

How to treat TMJ disorder.

There are many treatment options for TMJ disorder, including:

• Stress reducing exercises and relaxation techniques
• Muscle relaxants, when prescribed
• Mouthguards to prevent teeth grinding
• Avoiding extreme jaw movements
• Forms of laser therapy

For more severe cases, surgery or injections may be used. Dr. Frey treats his TMJ patients in two phases: first finding and holding a comfortable jaw position, then making the corrected bite lasting, often with neuromuscular orthodontics. You can read more about TMJ treatment at our Beverly Hills practice.

Can TMJ go away on its own?

Whether TMJ resolves on its own varies a great deal from person to person. Some people are in the middle of an especially stressful time in their life; when that stress eases, they may stop grinding their teeth and the TMJ may fade. But if the jaw is out of alignment, the condition needs treatment.

Sometimes treatment is as simple as a custom night guard, worn during sleep to stop grinding and clenching. Sometimes it is much more involved. Every case is unique, and in the most severe cases surgery may be necessary. We also look at how long TMJ lasts on our blog.

Are there exercises I can do to help prevent TMJ?

A misaligned bite can lead to TMJ, and there is little you can do about that at home; bringing the bite into alignment is work for Dr. Frey. But for other causes, or to help prevent a relapse after treatment, we give patients these exercises to do at home:

• Relaxed jaw. Place your tongue on the roof of your mouth, behind your front teeth. Consciously let your lower jaw relax downward, so your teeth separate slightly.
• Goldfish exercise. Place an index finger in front of your ear, where the jaw joint is. Put another finger on your chin. Open your jaw halfway or all the way and feel the slight resistance.
• Chin tuck. Sit or stand tall with your shoulders back. Then pull your chin straight back, as if you were trying to make a double chin.
• Jaw resistance. Put your thumb under your chin and create some resistance as you open your mouth. Then pinch your chin between the forefingers and thumbs of both hands to hold it while your mouth is open, and close your mouth against the resistance.
• Tongue up. Hold your tongue against the roof of your mouth, then slowly open and close your mouth.
• Side to side and forward jaw movement. Place an object about a quarter inch thick between your front teeth. Slowly move your jaw from side to side with the object in place. Then do the same while moving your lower jaw forward, so your bottom teeth sit in front of your top teeth.

You will find more detail in our guide to exercises for TMJ.