In awe of the jaw

Have you ever noticed a weird clicking noise when you yawn? How about a stiff jaw when you wake up in the morning? Or maybe your jaw sometimes locks when you’re chewing?

Problems with the jaw joint are very common and usually only temporary. If you’re experiencing jaw pain, it’s often caused by inflammation in the joint or tight muscles. If you’re experiencing noise such as clicking, the cartilage of the jaw could be sticking or moving out of its normal position between the bones of the joint. And if the jaw is locking, it’s usually because the cartilage disc is getting in the way when the jaw moves.

“When my patients come in for an exam I check how their jaw feels and its movement,” says dentist Dr Loveleen Tiwari from Clearly Dental Kew.. “That doesn’t necessarily mean that it’s going to need treatment – some people may just have clicky jaws. Sometimes people present with a problem, saying their jaw is giving them pain.”

Jaw issues generally concern the temporomandibular joint (TMJ) – ironically, quite a mouthful to say – which connects your lower jaw to your skull. You have one TMJ on each side of your jaw, both of which slide and rotate in front of each ear to control the movements involved in speaking, eating and facial expressions. Each TMJ is made up of two bones – the temporal bone (at the side and base of the skull) and the mandible (the lower jaw) – separated by a disc of cartilage. Sound complicated? It is – in fact, the TMJ is one of the most complex joints in the body. But all you really need to know is when it might need some support.

What causes jaw problems?

The most likely cause of jaw issues is temporomandibular joint disorder (TMD), a condition affecting the movement of the jaw, which can be very painful (and can affect your ability to get a good night’s sleep). The usual symptoms are:

• Pain in the jaw, especially in the morning or late afternoon
• A sensation of locking in the jaw, making it difficult to open or close your mouth fully
• An aching pain in front of the ear, which may spread behind the eyes and to the face, and even the shoulders, neck or back
• Clicking, popping or grinding when you open your mouth or chew
• Dizziness
• Headaches, which may spread up to the temple
• Numbness or tingling in the fingers
• Numbness in the skin of the cheeks
• Earaches or buzzing in the ears (if it’s not related to an ear infection)
• An uneven or uncomfortable bite.

TMD can be caused by stress, teeth grinding, an injury (such as a blow to the head), an uneven bite or conditions such as osteoarthritis, rheumatoid arthritis, fibromyalgia and gout. Dental issues such as new fillings or dentures can also be a contributing factor. Sometimes, however, there is no clear cause.

“With the majority of my patients, the cause is stress,” says Dr Tiwari. “It’s not that common to find arthritis in the jaw.”

Beyond TMD, you might also experience muscle spasms in your jaw if it’s in the wrong position. This can also cause headaches or migraines, especially when you first wake up. You might also experience pain in your sinuses, neck, shoulders, behind your eyes and in your back.

What should I do?

In most cases, jaw problems go away by themselves, but if it is bothering you, see your dentist for advice – especially if the pain keeps returning and it’s affecting your sleep or ability to eat or drink. They may take X-rays or other scans, give you jaw joint exercises or fit you with a specialised mouthguard. In some cases, you may be referred to a TMJ specialist physiotherapist, and occasionally, surgery is required.

These short-term measures may help you manage the pain when it flares up:

• Over-the-counter painkillers, such as paracetamol or ibuprofen
• Ice packs or heat packs (whichever is most helpful for you)
• Massaging the muscles
• Relaxation and stress management techniques
• Cut foods into small pieces, and opt for soft foods (such as pasta and soup) where possible
• Avoid chewing gum or biting nails
• Avoid clenching your jaw or opening your mouth too wide (such as yawning)
• Don’t rest your chin on your hand.

Dr Tiwari says it’s a good idea to get your dentist to look at your jaw if it’s giving you grief.

“Jaw issues can impact on day-to-day neck pain, headaches and a poor ability to concentrate,” she says. “It also means someone might not be able to eat properly, and may have to eat a soft diet and that means they’re not going to get the same enjoyment out of eating, or the same nutrition.”

Sources

• www.hey.nhs.uk/patient-leaflet/jaw-joint-problems
• www.hopkinsmedicine.org/health/conditions-and-diseases/temporomandibular-disorder-tmd
• www.healthdirect.gov.au/temporomandibular-joint-disorder
• www.nhs.uk/conditions/temporomandibular-disorder-tmd
• www.dentalhealth.org/jaw-problems-and-headaches