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March 17, 2014  | by Dr. Benjamin Farrow

Headaches and TMJ

Do you or someone you know have headaches or discomfort with opening or chewing? Headaches are complex and can have many contributing factors. We have found that with careful diagnosis, we can relieve some headaches and improve patient's daily activities like eating and sleeping.

What is commonly described as TMJ is truly a broad category of signs and symptoms that effect a patient's ability to function effectively and comfortably. We divide these conditions into two categories:

1) Joint problems (intracapsular disorders): When there is damage to the joint due to injury or recurrent stresses, things can begin to breakdown. In its most acute presentation, these conditions can often limit opening, cause severe, sharp pain on opening and chewing, and can lead to irreparable damage of the delicate workings of the temporalmandibular joint (TMJ). A more subtle sign of such a problem can be a clicking joint or asymmetrical opening. Early recognition and treatment is key to limiting the long-term damage.

2) Muscle Bite problems (occluso-muscular disorders): Disharmony in the bite can be one factor that leads to clenching and grinding (bruxism). Bruxism can not only irreversibly wear and crack teeth, it can also lead to sore and tired muscles and place stress on the TMJ. Many times this will show up as headaches that are present on waking or worsen throughout the day. Common areas that are affected are the face, temples, and neck.

It can sometimes be confusing initially to discern what is the primary cause of headaches and face pain. If there is a suspicion that either of these conditions are contributing, we have found it most helpful to enter a conservative first phase of diagnosis and treatment. This begins with a careful TMJ/Bite exam where we evaluate the muscles, joints, bite, chewing function, and discuss the impact of signs and symptoms on daily activities. A next step is often the fabrication of a custom bite splint designed to stabilize the joint, calm the muscles, and protect the teeth. A series of status checks will help us determine if the problems are primarily joint or muscle or a combination of both. Additionally, a modification of daily activities and physical therapy can make a difference.

Once the muscles are calm and the bite is stabilized, we can pursue a long-term preventative plan that can best maintain ones function and comfort. If you or someone is experiencing headaches or any of the symptoms described above, please reach out to your hygienist or myself so that we can help.