TMJ Symptoms
Many TMJ patients are unaware of the cause of their condition. A number have TMJ symptoms that do not interfere with their lives. Patients with TMJ often grind their teeth (bruxism) to find a comfortable bite. This causes flat areas on the tops of the teeth called occlusal wear facets. Wear facets often fit together revealing the bite that the body has been trying to create. Constant grinding also flexes ands dissolves tooth roots. A notch at the bottom front of the tooth called an abfraction. Many hygienists confuse this for overzealous tooth brushing, but many patients who never brush have them.
When a patient's jaw joints or jaw muscles are irritated, there can be deviation of the lower jaw to one side on opening. This is called mandibular opening deviation. For various reasons, the human face does not always grow symmetrically. Facial asymmetry can cause TMJ problems. Continual jaw muscle spasm can cause muscle shortening with limited opening. Looking at the side of a person's face, you can often make out the lower jaw. The bottom of the lower jaw is usually parallel to the floor. However, many TMD patients have a sharp downward angle. This TMJ symptom is call a steep mandibular plane angle.
TMD suffers often have speech abnormalities that contribute to their muscular and functional problems. It is not always known whether the TMJ problems caused the speech abnormalities or whether the speech irregularities are a reflection of the TMJ problems. A dished out profile can be a symptom of a TMJ problem. It is often seen in patients who have a shortened facial height which forces the TMJ towards the ear. As a protective reflex, the body uses the chewing muscles to pull the jaw joint forward. This can cause muscle spasm and pain. Like a dished out profile, a short lower facial third can be a reflection of this same problem.
Another TMJ symptom is when the corners of the mouth get red, swollen and painful. It's called angular chelitis and is also seen when denture patients have worn out dentures. An imbalance in the chewing and facial muscles sometimes causes an abnormal lip posture which can cause the face to look peculiar. The horizontal facial fold under the lip and above the chin can be excessive. This is called a deep mentalis crease. It is not uncommon for a TMJ patient to have a forward head posture. This abnormal posture causes the head to be positioned forward. It stretches the anterior neck muscles and pulls the lower jaw backward into the patient's ears.
It is not unusual to see swelling of a TMJ patient's face. This TMJ symptom is called facial edema. Some sufferers have unusual movements of their necks (cervical torticollis) and lower jaws. (mandibular torticollis). Headaches plague TMJ sufferers. The most common TMJ related headache is a located on the side of the head over the area of the temple. This is called a temporal headache and is often misdiagnosed as migraine.
The temporomandibular joints are located just in front of the ears. Tenderness and deep pain in the TMJs and surrounding areas can also cause ear ache and decreased hearing. With time ringing in the ears (tinnitus) can occur. Eventually, the middle ear can be effected causing vertigo or dizziness. These problems along with combinations of other TMJ symptoms can cause difficulty sleeping (insomnia). TMJ sufferers often have pain in one or both of the jaw joints and TMJ pain is common. The jaw joints may have clicking and popping noises. These are called TMJ noises. This can progress to lock jaw.
Because of uncomfortable jaw joints, many patients clench and grind their teeth. Grinding patients experience dental hot and cold sensitivity. The clenching and grinding can cause over development of the supporting jaw bone. Bone bumps that grow horizontally out into the cheeks are exostosii (singular, exostosis) and bone bumps in the middle of the palate and on the inside of the lower jaw are torii (singular, torus). These patients often have multiple root canals as a result of their teeth dying from the constant grinding pressure.
The imbalance of a TMJ patient's facial, chewing and neck muscles can cause difficulty swallowing. This is called dysphagia. Because of the instability of the jaw, head and neck, cervical problems are common. This can lead to occipital headaches located at the back of the head. Postural problems are a typical TMJ symptom. This abnormal posture may be due to the adjustment of the body to mouth breathing and the need to hold the head forward to breath better. In severe cases, forward posture can cause thoracic outlet syndrome and paresthesia of the finger tips
Dr David Kaffey - Providing services in cosmetic and neuromuscular dentistry and tmj treatment to the areas of Malvern, Wayne, West Chester, King of Prussia, Exton, Devon, Villa Nova, Newtown Square, Berwyn, Radnor, St. Davids, Valley Forge, Main Line, Paoli and Philadelphia, Pennsylvania.
Main Line Cosmetic Dentist
12 South Valley Road Paoli, PA 19301 | Ph. 866.930.1921
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