Temporomandibular Joint (TMJ) Syndrome

The most common symptom associated with TMJ is ear pain. This pain can radiate down into the neck and the throat or up into the temples and back of the head. On occasion, the pain can radiate to the forehead. TMJ frequently simulates other aliments such as ear, nose, or sinus infections. Less common symptoms include ear fullness, ringing in the ears (tinnitus), and dizziness (vertigo). Commonly, patients complain of difficulty and/or pain when opening their mouths.

An otorhinolaryngologist (ear, nose, and throat specialist) commonly diagnoses the TMJ syndrome, but treats only the most minor cases. Frequently it is necessary to refer you to a dentist or an oral surgeon.

The most common cause of TMJ syndrome is teeth clenching or grinding which often occurs while sleeping. Overuse of the jaw joint, as in gum chewing or pen biting, constitutes the next largest cause. When your bite is incorrect, your teeth come together improperly causing stress in the jaw joint. The end result can be TMJ syndrome. Ironically, this frequently occurs after a new filing cap is placed in the dentist=s office. Prolonged jaw opening while having dental work performed can result in a temporary TMJ syndrome.

Treatment is directed toward eliminating any obvious causes. In addition, the jaw joint should be rested for approximately one week. We tell our patients to think of this as they would a chronic knee injury.

Here are some guidelines in helping your TMJ symptoms:

1. A heating pad should be applied to the joint for 15-30 minute intervals 2-3 times a day for at least one week or until the pain resolves.
2. Rest the joint by eating a soft diet such as apple sauce, mashed potatoes, eggs, and pasta. These foods do not require you to open your mouth widely. Hard foods such as uncooked carrots, whole apples, and ,meat should be avoided for at least on week or until several days after the pain resolves.
3. Advil can be useful for pain relief initially.
   Side effects and precautions associated with the use of Advil are listed on the package. Remember, Advil can cause bleeding from the stomach or stomach ulcers and should not be taken if there is a history of stomach ulcers/bleeding problems. If you are unsure as to whether you at risk for bleeding from Advil, contact you regular physician. Do not take Advil for more than 3 days without contracting us or your regular physician. Do not drink alcohol when using Advil.
   Take Ibuprofen 200 mg (equivalent to 1Advil, Nuprin, or Mortin IB) every 4 hours around the clock. This means that you take this medicine every 4 hours even if the pain has not returned. Alternatively, you may take 400mg., or 2 Advil, Nuprin, or Motrin IB every 8 hours, however, this may cause more stomach upset. Either regimen will give you excellent pain relief in most cases and usually more effective than narcotic pain medications. Doubling the dose of Ibuprofen is allowable if the initial 24 hours of medication fails to relieve your pain. Keep in mind, though, that this will increase your risks with Ibuprofen and may increase stomach upset and/or bleeding.
   If Ibuprofen fails to relieve the pain after 3 days, a narcotic pain medication will be prescribed. This medication is helpful in allowing you to fall asleep with the ear pain.
4. Schedule an appointment with your dentist so that he or she may check your bite. Some dentists may create a mouth guard to protect your teeth and jaw joint if you grind or clench your teeth. This is usually worn a night while sleeping.
5. Obviously, it is essential for you to stop any bad habits that may have led to your TMJ syndrome.
6. For many people with high stressed lives, the grinding and clenching of their teeth may be the first sign that the body is tolerating stress poorly. Eventually more serious aliments such as high blood pressure, heart attack, stomach ulcers, and depression may develop If your life is highly stressed, you should seek better ways of coping with stress. Regular aerobic exercise is an excellent way to cope with stress. Psychiatrists ans psychologists are professionals who can help you learn to effectively manage stress. This may not only resolve your TMJ syndrome, but it will probably lead to a happier and healthier life overall.

We enjoy teaching our patients about our diagnosis(es) and treatment plan that we have recommended. We believe that with this education, our patients are mostly to get better and stay better.

These information sheets are intended for use by our patients in conjunction with regular care from Drs. Siegel and Bosworth. Use of these sheets by other can lead to a delay in diagnosis with potential worsening of health. If you are not one of our patients, please schedule an appointment so that we can help you to feel better as soon as possible.