TMJ Syndrome

WHEN JOHN, a stock analyst, came to see me about constant headaches, it seemed obvious that they were a result of the recent stock market crash. He’d had occasional headaches in the past but they had become regular and debilitating. He had been to various doctors and tried a variety of pain pills and muscle relaxants, but nothing gave more than temporary relief As he told me, he was tired of taking pills and tired of getting no results and of course he was more than tired of the headaches.

When I told John he needed to adopt some stress-reduction techniques, he told me that he had tried with no results and was tired of’ being told that everything was caused by stress. When I told him that I thought his problem was not caused by stress but simply worsened by it, he was surprised. It turned our that John was suffering from symptoms associated with TMJ disorder. I worked with him on reducing stress, particularly the actual stress in his jaw, recommended certain supplements, and referred him to a dentist who worked on the structural problems in his jaw. Within a few months John’s headaches had completely disappeared.

Very few patients come to me complaining of TMJ disorder-most have never heard of it. In fact, TMJ disorder is usually defined by its symptoms: headaches; pain in the temples, neck, shoulders, and back; diminished hearing; and “sinus trouble.” But the source of the problem is actually constant jaw clenching or teeth grinding. Over a period of time, the muscles that control the temporomandibular joints (where the jaw joins the skull) develop nodules or “trigger points” that produce the symptoms when aggravated.

What causes people to clench their jaws and grind their teeth? Just what you would think: stress. But today there is some question whether stress exacerbates an already existing condition or causes the condition in the first place. Some believe the real cause of clenching and grinding is malocclusion of the jaw. The teeth don’t fit together properly and, over a period of time, the muscles must compensate for this poor fit, causing the pain and various symptoms of TMJ disorder. Many people go through life with malocclusion of the jaw and never have any symptoms or even, in fact, know that their teeth don’t align properly. But for others stress is the precipitating factor.

If you suffer from persistent headaches, unexplained neck and back pain, stuffiness or swelling or pain in your sinus area that doesn’t respond to sinus treatments, you could be suffering from TMJ disorder. A simple self-test is to feel your temples and clench your jaw. You’ll feel a muscle tense up under your fingers at the temples. Press on that area with the jaw relaxed: if you feel severe pain and tenderness, it indicates that you’re tensing your jaw, the muscles are tender, and TMJ could be the cause.

Another easy test is to gently put the ends of your little fingers into your ears and press them forward, toward the front of the ear, while opening and closing your mouth a few times. Most people will feel nothing but if you feel the head of your jawbone pushing against your fingers, you could well have TMJ disorder.

Other clues include:

• clicking sounds when you open or close your mouth
• clenching or teeth grinding during the day or when sleeping
• tenderness in the facial muscles upon awakening.

What’s the solution? There are natural approaches that can help but a trip to a dentist is the first step. He will check your bite. It’s usually not a major ordeal; often it’s just a matter of correcting one or two teeth that are too high or low. For the most severe cases only a dentist who specializes in TMJ problems may be able to give permanent relief.

The next step you should take is to see if dealing with stress will help relieve your symptoms.

You should eliminate caffeine from your diet, as people who drink a great deal of caffeine tend to clench their jaws far more frequently than those who abstain. Low blood sugar can also cause people to clench their teeth.

There are two nutrients that are helpful in fighting TMJ syndrome: calcium and pantothenic acid.

Some researchers have made a connection between TMJ disorder and allergies. If you’ve had food allergies in the past, you should try to eliminate any foods from your diet that might be causing a reaction.

If you suspect that jaw clenching and teeth grinding may be causing symptoms, try using a mouth guard for a few nights. You can buy one inexpensively in a sporting goods store. Put it into hot water so it becomes pliable, then put it into your mouth and bite down on it. If you sleep with it in your mouth for a few nights and notice that your symptoms have diminished, it may be worth discussing with a dentist either correcting your malocclusion or making you a permanent (and more comfortable) mouth guard.

I tell my patients who are jaw clenchers that they must force themselves to become conscious of the problem. I suggest that they make a habit of feeling their jaw during the day to see if it’s tense and, if it is, to relax it. Ultimately they get into the habit of keeping their jaw relaxed. Tell yourself throughout the day, “lips together; teeth apart,” which is the proper position. One woman told me that she snapped a rubber band that she wore around her wrist every time she felt her jaw clenching, and it helped her unlearn the habit. If you’re one of those people who holds the phone against your shoulder by tilting your head, stop! It’s a habit that can encourage TMJ disorder; so can chewing large pieces of food (cut food into small bits) or constantly chewing hard and brittle foods.

One final suggestion: many people who suffer from TMJ disorder sleep on their side. This position puts pressure on the face and seems to encourage teeth grinding. Try sleeping on your back, and you may find your symptoms greatly relieved.

NATURAL PRESCRIPTION FOR TMJ SYNDROME

• Consult a dentist to see if your teeth align properly.
• Learn stress-reducing techniques for dealing with the anxiety in your life.
• Eliminate caffeine from your diet.
• Eliminate sugar from your diet if you suffer from low blood sugar.
• Buy a mouth guard from a sporting supply store to see if wearing it for a few nights relieves your pain: If it does, ask your dentist to make you a permanent one.
• Try specific techniques to learn to relax your jaw throughout the day.
• Sleep on your back.
• Avoid holding the phone against your shoulder by tilting your head.
• Avoid chewing very large pieces of food and hard brittle foods.

IN ADDITION TO YOUR DAILY SUPPLEMENTS, TAKE

• Calcium: 1,200 mg. at bedtime.
• Panthothenic acid: 200 mg. daily.

IN ADDITION: I’ve used acupuncture successfully on patients with TMJ syndrome to relieve persistent jaw and neck pain as welt as relieve headache. They say it “works like a miracle.”