This article originally appeared on Dr. Danenberg’s blog on October 3rd, 2016.
I saw Monique as a patient about a year ago. She entered my office saying, “My jaw pain is killing me.”
She had a root canal procedure performed on her lower right molar about 4 months before I saw her. She had a crown put on that tooth. Then, she began to have severe pain in that tooth, in her jaw muscles, and in her jaw joint.
At first, she thought that the root canal was failing and was the cause for her pain. That wasn’t the case at all. In a moment, you’ll read how I eliminated her pain in only one appointment.
WHAT IS JAW PAIN?
As a periodontist, I frequently treat jaw pain. Most pain comes from the jaw joint and the muscles that help chew food. This jaw pain may be called temporomandibular joint pain (TMJ) or temporomandibular disorders (TMD). Many of the causes of this type of jaw pain also can damage the jawbone around the roots of teeth.
Here’s the inside skinny about jaw pain:
About 60–70% of adults have experienced some symptoms of TMD. The most frequent complaint is pain either in the jaw joint or in the jaw muscles. Another common symptom is discomfort when opening the jaw, most obvious when eating or speaking. Popping and cracking sounds in the jaw joints when opening and closing may be present. Also, buzzing or ringing sounds in the ears are possible. (1)
9 CAUSES OF JAW PAIN
TMD is multifactorial, and there may be sources that are difficult to identify (2). Below are 9 related causes for TMD:
- Trauma (like a car accident) involving the jaw joint could create damage in the structures of the joint resulting in pain.
- Habits of clenching and grinding the teeth can damage the jaw joint and cause muscle pain. These habits also wiggle the roots of the teeth in the jawbone, which will damage the bone around the teeth and may cause tooth pain. Grinding also may crack teeth.
- Teeth that have been improperly restored by a dentist could cause increased pressure in the jaw joint and increased grinding habits.
- Poor nutrition and unhealthy digestion could cause chronic inflammation that could affect all joints in the body (example: rheumatoid arthritis).
- Emotional stress has been shown to create biochemical changes in the blood system that could increase chronic inflammation throughout the body and joints.
- Lack of sleep increases chronic inflammation in the blood system and can affect joints in the body.
- Excessive estrogen may increase inflammation and damage in the jaw joint.
- Infection in the joint will cause swelling and pain.
- Complications with your airway space that does not allow proper breathing and oxygenation can result in jaw pain.
TREATMENT OPTIONS FOR JAW PAIN
First, the most obvious potential causes must be addressed (3). If the bite is causing muscle and jaw soreness, then the bite must be corrected. Correcting heavy pressures on the chewing surfaces of the teeth by polishing these areas correctly may be all that is necessary to make the bite healthy. If a patient grinds his or her teeth habitually, sometimes a bite guard could be worn during sleep to reduce the pressures in the jaw joint. At other times, orthodontic treatment might be necessary to correct the bite.
Science also shows other factors affecting TMD. Emotional stress and lack of sleep have been reported to aggravate the symptoms of TMD (4). In addition, estrogen imbalance has been suggested to influence TMD, but some of the studies are contradictory (5). Based on these and other published research papers, the following actions could be considered:
- Reduce stress
- Get restorative sleep
- Eat a nutrient-dense, anti-inflammatory diet to improve hormone balance
- Avoid eating foods that contain chemicals, which could damage hormonal balance
- Seek the advice of a myofunctional therapist and an orthodontist who are trained in proper jaw structure and creation of a healthy airway space
- Investigate medications or surgery for TMD as last resorts.
Monique’s pain was related to her bite after her crown was made. The crown was improperly designed and shaped poorly. The chewing surfaces between that tooth and her upper teeth were bumping too hard. Since these pressures were too heavy, her jaw muscles went into spasm, which in turn caused her jaw pain. Monique couldn’t make this pain go away and didn’t know what was causing it.
All I needed to do for Monique was to determine the spots on the crown that were hitting her upper teeth too hard. I then reduced these heavy pressure points by smoothing and polishing the chewing surfaces so that her teeth came together properly. Immediately, she noticed her jaw was more comfortable.
PUTTING IT ALL TOGETHER
Many factors affect jaw pain. The more obvious causes should be explored first. If grinding habits or bite problems exist, these must be corrected. Stress reduction, restorative sleep, and good nutrition to provide proper hormone balance must be implemented to reduce TMD symptoms. If symptoms persist, other treatment options could be considered to make the patient comfortable.