The Definitive Guide to TMD, TMJ, and Orofacial Pain

Jun 28, 2024

Orofacial pain encompasses a wide range of conditions that cause discomfort or pain in the face, mouth, jaw, head, and neck regions. Among the most common orofacial pain conditions are temporomandibular disorders (TMD) including temporomandibular joint (TMJ) pain. These complex conditions can significantly impact your quality of life, making it crucial to understand their causes, symptoms, and available treatment options.

The Science Behind Orofacial Pain Conditions

According to the National Institute of Dental and Craniofacial Research, the exact causes of TMD and TMJ pain are often unclear, with symptoms seeming to start without obvious reason. However, recent research suggests a combination of genetic factors, psychological and life stressors, and how someone perceives pain may play a role in the development and persistence of these conditions.

There have been many discussions regarding contributing factors to TMD and TMJ pain. It has been suggested that in some cases one such contributing factor could be malocclusion, or misalignment of the teeth and jaws. When the teeth and jaws are not properly aligned, it can create an imbalance in the muscles, tendons, and bones that control the movements of the jaw. This imbalance can lead to strain, inflammation, and pain in the temporomandibular joint (TMJ), the hinge that connects the lower jaw to the skull.

How Can Malocclusion Lead into TMD or TMJ Pain?

As mentioned earlier, malocclusion may play a significant role in the development of TMD and TMJ pain. Here are six specific conditions where malocclusion may have been associated with these orofacial pain conditions:

  • Traumatic Impinging of Deep Bite
  • Loss of Posterior Occlusion
  • Poor Dental Articulation
  • Anterior Open Bite
  • Functional Shift Caused by Unilateral Posterior Crossbite
  • Anterior Crossbite

If you want to learn more about these conditions check out our blog on the 6 conditions where malocclusion has been associated with TMJ pain and TMD.

Other Conditions That Fall Under the Umbrella of Orofacial Pain

Nerve pain (Neuropathic Pain): Conditions like trigeminal neuralgia, glossopharyngeal neuralgia, or post-herpetic neuralgia can result in sharp, shooting pain in the face due to nerve damage or dysfunction. Another potential neuropathic pain condition is Burning Mouth Syndrome, this is characterized by a recurring burning sensation on the mouth without clear indicators or causes. You can learn more about this condition in our article, Burning Mouth Syndrome: Insights from an Orofacial Pain Specialist.

Muscle Pain (Neuromuscular Pain): Myofascial pain syndrome, muscle spasms, or tension-type headaches can cause muscle pain in the face and jaw, often exacerbated by clenching, grinding teeth, stress, or muscle imbalances. These can potentially be caused by injury, following trauma, or motor vehicle accident.

Migraines (neurovascular Pain):  Severe, recurring headaches often accompanied by nausea, vomiting, and sensitivity to light and sound, which can be caused by or exacerbated by TMD. Many migraine sufferers experience symptoms stemming from dysfunction or misalignment of the temporomandibular joints. Medicine and orthodontic treatment can help correct bite issues and alleviate migraine pain related to TMD.

Sinus and Dental Causes: Sinus infections, dental infections, or dental procedures can lead to orofacial pain, with pain from sinusitis often felt in the cheeks, forehead, or upper teeth.

Joint Pain: Discomfort or soreness in the jaw joints (temporomandibular joints or TMJ) due to injury, arthritis, or TMD, which can radiate to the face, neck, and shoulders.

If you want to learn more about these key aspects check out our page on TMD, TMJ pain, and orofacial pain.

Symptoms of TMD, TMJ pain, and Orofacial Pain

The symptoms of TMD, TMJ pain, and other orofacial pain conditions can vary widely in severity and presentation. According to the National Institute of Dental and Craniofacial Research, some of the most common signs and symptoms include:

  • Pain or tenderness in the jaw, face, or around the ear, often radiating to the neck and shoulders (most common symptom).
  • Clicking, popping, or grating in the jaw joint when opening or closing the mouth.
  • A change in the way the upper and lower teeth fit together.
  • Ringing in the ears/tinnitus, hearing loss, or dizziness/vertigo.
  • Any potential feeling of jaw stiffness.
  • Difficulty or discomfort when chewing, opening the mouth wide, or yawning.
  • Headaches, earaches, or toothaches.
  • Lockjaw or limited movement of the jaw.
  • Tooth sensitivity or loose teeth.
  • Numbness or tingling in the face or fingers.

Headaches, Migraines, Bruxism, and Burning Mouth Syndrome

While TMD and TMJ pain are the primary focus of this blog post, it’s essential to recognize that orofacial pain can also manifest or contribute to other conditions, such as headaches, migraines, bruxism, and burning mouth syndrome.

Headaches and migraines can be exacerbated or triggered by TMD and TMJ pain due to the tension and strain on the muscles and nerves in the head and neck region. Additionally, burning mouth syndrome, a condition characterized by a burning or tingling sensation in the mouth, can sometimes be linked to TMD or other orofacial pain conditions. If you want to learn more about how your headaches and migraines may be linked to your oral health, check out our blog!

Moreover, bruxism is a condition characterized by involuntary grinding, clenching, or gnashing of teeth. This can occur while the person is asleep or awake and typically happens when a person is experiencing periods of stress or anxiety. This can fatigue the jaw muscles and cause pain, which can be combated by orthodontic appliances, myofunctional exercises, oral appliances, and even medication. Bruxism may contribute to the development or worsening of TMD and other orofacial pain conditions. Managing bruxism through stress reduction techniques, night guards, or other methods may be recommended as part of an overall treatment approach.

Orofacial pain in general can be caused by numerous factors and can lead to other physical and even psychological issues. It is crucial that you document all your symptoms as many cases are often linked to one another. Documenting your symptoms is extremely helpful for your doctor to grasp a better understanding of the condition you’re suffering from. An ideal documenting method is keeping a digital or physical journal of all your symptoms and treatments but also include other information such as hormonal cycles, difference and day to day functions, unique side effects, headaches/migraines, pain level fluctuations, etc.

Duly note, pain is perceived different from each person. It is crucial to be descriptive about your pain and understand your pain. Like Dr. Daia says, the condition of one’s pain is like an onion, it had layers and these many layers are different factors affecting the symptoms as well as how they are presented. Make sure you document all changes, habits, and pain so professionals like Dr. Daia can deduce your condition, one layer at a time. Likewise, there are many misconceptions of TMD and TMJ pain and how they can link to other conditions, you can check out our blog to learn more about the most common misconceptions on earaches and TMJ here.

Our team at Daia Orthodontics & TMJ Orthopedics is equipped to provide a comprehensive evaluation and develop a personalized treatment plan to address your specific needs, whether you’re dealing with TMD, TMJ pain, or other orofacial pain conditions.

Treatment Options for TMD, TMJ Pain, and Orofacial Pain

At Daia Orthodontics & TMJ Orthopedics, we understand that each patient’s condition is unique, and we tailor our treatment approach accordingly. Our comprehensive treatment options for TMD, TMJ pain, and other orofacial pain conditions may include:

  • Behavioral Modifications: Correcting parafunctional habits such as nail biting that can cause repetitive trauma to the body and mouth. Spending time to educate the patient on the nature of the condition and what causes it to occur can help combat parafunctional habits. Explaining to the patients that these cases are mostly benign and manageable by medical professionals and their doctors or team can be very beneficial with the incorporation of myofunctional exercise.
  • Occlusal Splints or Night Guards: These custom-made appliances fit over the teeth and help reposition the jaw, reducing strain and protecting the teeth from grinding or clenching. Dr. Daia has several designs for these appliances that are implemented for patients on a case-by-case basis. Dr. Daia will select the appropriate design and appliance for the best fit for the patient. Other TMJ orthodontics methods may also be used to reduce the negative symptoms.
  • Physical Therapy: Specific exercises and techniques, such as stretching, massage, low level laser therapy, proper jaw posture and head posture training, and mobility exercises, can help strengthen and relax the muscles surrounding the TMJ, improving mobility and reducing pain. There are several modalities that are used in addition to specific exercise. The specific exercises and therapies include but not limited to stretches, uppersonic therapy, craniosacral therapy, and light/laser therapy.
  • Stress Management and Relaxation Techniques: Stress can exacerbate TMD, TMJ pain, and orofacial pain symptoms, so techniques like meditation, yoga, counseling, or cognitive-behavioral therapy can be beneficial. Moreover, obstruction of the airway or insufficient airflow can cause stress and may manifest or increase jaw pain and bruxism over time which can lead to TMJ pain. Maxillary expanders, surgery, sleep oral appliances, sleep apnea treatments, or a CPAP machine can be used to resolve a patient’s pain. Many individuals overlook the correlation between sleep apnea and air way construction to malaligned constructure. You can learn more in one of our recent blogs about the connection between sleep apnea, orthognathics, and orthodontics.
  • Medication: Over-the-counter or prescription medications, such as anti-inflammatory drugs, muscle relaxants, or pain relievers, may be recommended to manage pain and inflammation.
  • Injections: In some cases, injections of corticosteroids, local anesthesia, acupuncture, dry needling, botulinum toxin (Botox), or other medications may be used to reduce inflammation or relax the muscles in the affected area.
  • Surgical Intervention: In some cases where conservative treatment options have been exhausted, surgery may be considered to correct structural issues or repair damaged areas of the TMJ.
  • Orthodontic Treatment: In cases where malocclusion is expected as a contributing factor, orthodontic treatment can help realign the teeth and jaws, reducing strain on the TMJ and associated muscles

Post-Injury or Post-Traumatic TMJ Pain Assessment and Care

Injuries or trauma to the jaw, face, or head area can have significant impact on the temporomandibular joint (TMJ). Whether from accidents, falls, sports-related incidents or other events, damage like dislocations, fractures, ligament tears, disc displacement, muscle strains or temporomandibular disorders (TMD) may occur. Symptoms can sometimes share similarities to other diagnoses of TMJ related conditions or TMD. Daia Orthodontics & TMJ Orthopedics, our post-injury or post-traumatic TMJ evaluation involves thoroughly assessing any TMJ area trauma and resulting dysfunction/damage. We offer various treatment options ranging from TMJ orthotics, physical therapy, and can even connect you with oromaxillofacial specialists and orthodontics associated with jaw surgery. If you want to learn more about our treatment options, check out our trauma page.

Managing TMD, TMJ Pain, and Orofacial Pain

While seeking professional treatment is essential for addressing the underlying causes of TMD, TMJ pain, and other orofacial pain conditions, there are also self-care strategies that can help manage symptoms and promote overall well-being. As stated in the TMDs and the orthodontic patient advice sheet from the British Orthodontic Society, some practical measures that can help manage symptoms include:

  • Apply Moist Heat or Cold: Applying a warm compress or ice pack wrapped in a damp towel to the affected area can help reduce inflammation, relax the muscles, alleviate pain, and help increase blood flow.
  • Eat Soft Foods: Avoiding hard, crunchy, or chewy foods can reduce strain on the jaw and prevent further irritation. Some patients find certain foods can trigger symptoms.
  • Practice Stress Relief: Engaging in stress-reducing activities like exercise, meditation, or deep breathing can help relax the muscles and minimize teeth clenching or grinding.
  • Maintain Good Posture: Proper posture of the jaw, head, and neck can help align the spine and reduce strain on the muscles around those areas.
  • Avoid Overuse: Resting the joint by avoiding excessive opening of the mouth. Also limit activities that require prolonged or excessive opening of the mouth, such as yawning, singing, or chewing gum.
  • Use Over-the-Counter Pain Relievers: Medications like analgesics, acetaminophen, or non-steroidal anti-inflammatory drugs (NSAIDs) can help alleviate pain and inflammation when used as directed.

Temporomandibular disorder is the second most common chronic musculoskeletal condition after chronic low back pain according to the medical journal on TMDs and Orofacial Pain from the University of Minnesota School of Dentistry. So if you’re experiencing symptoms of TMD, TMJ pain, or orofacial pain, it’s crucial to seek professional help. At Daia Orthodontics & TMJ Orthopedics, our experienced team provides comprehensive care to help you find relief from TMD, TMJ pain, and orofacial pain. Through detailed evaluations including medical history reviews, clinical exams, and advanced imaging when needed, we identify the root causes and develop personalized, effective treatment plans. Our compassionate staff guides you every step of the way, ensuring you receive the highest quality care tailored to your needs.

Don’t let TMD, TMJ pain, or orofacial pain continue to impact your quality of life. Schedule a consultation with Daia Orthodontics & TMJ Orthopedics today, and take the first step towards a pain-free future!

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