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Canterbury Kent CT1 3HD
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Jaw- & Headaches

Many headaches and jaw problems originate in the dental occlusion. This is another name for the way your teeth meet when your jaws bite together. Another closely related term is the TMJ. The letters TMJ are short for of ‘temporo-mandibular joint’, which is the joint connecting your lower jaw and your skull.  The movement in this joint lets you open and close your mouth and chew from side to side. Up to 1 in 4 people may have some symptoms.  Both men and women are affected equally, although women tend to seek treatment more often than men. 

If your teeth do not fit together properly, you can have problems not only in your teeth themselves, but also the gums, the temporo-mandibular joint or the muscles that move your jaw.  These problems are called ‘occlusal’ problems. Teeth that are out of line, heavily worn or constantly breaking, fillings that fracture or crowns that work loose may all be signs of occlusal problems.  Your teeth may also be tender to bite on or may ache constantly. Loose teeth or receding gums can be made worse by a faulty bite.

TMJ
Clicking, grinding or pain in your jaw joints, ringing or buzzing in your ears and difficulty in opening or closing your mouth could all be due to your teeth not meeting each other properly.

Muscles
If your jaw is in the wrong position, the muscles that move the jaw have to work a lot harder and can get tired.  This leads to muscle spasm. The main symptoms are continual headaches or migraine, especially first thing in the morning; pain behind your eyes; sinus pain and pains in your neck and shoulders.  Sometimes even back muscles are involved.

You may find that you clench or grind your teeth, although most people who do are not aware of it. Sometimes can be caused by anxiety, but generally most people clench their teeth when they are concentrating on a task - housework, gardening, car mechanics, typing and so on.

You may wake up in the morning with a stiff jaw or tenderness when you bite together. This could be due to clenching or grinding your teeth in your sleep.  Most people who grind their teeth do it while they are asleep and may not know they are doing it. TMJ2If you suffer from severe headaches, or neck and shoulder pain, you may not have linked this with possible jaw problems. Or you may keep having pain or discomfort on the side of your face around your ears or jaw joints or difficulty in moving your jaw. These are all symptoms of TMJ problems.If you are missing some teeth at the back of your mouth, this may lead to an unbalanced bite, which can cause uneven pressure on your teeth. Together, all these symptoms are called ‘TMJ syndrome’.

 

 

Depending on the problems you are having, it can be possible to spot the signs of an occlusal problem.  Various muscles may be sore when tested, or the broken and worn areas of your teeth will show you are grinding your teeth - a common sign of an incorrect bite.

If your dentist suspects that your problems are due to an incorrect bite, he or she may help to diagnose the problem by supplying a temporary soft night guard or hard plastic appliance that fits over your upper or lower teeth.  This appliance needs to be measured and fitted very accurately so that when you bite on it, all your teeth meet at exactly the same time in a position where your muscles are relaxed.  You may have to wear this all the time or, just at night.  If the appliance relieves your symptoms then your bite may need to be corrected permanently.

TMJ3In this set of three illustrations of the TMJ, the cartilage is shown as a yellow line. This cartilage sits in between the base of the skull and the ball of the joint to make up for discrepancies of the shape between the two.
When you start opening your mouth, the initial movement in the joint is a pure rotation. With further opening beyond that, the ball of the joint starts to make a forward movement over the raised bone in front of the joint. You can feel this difference when you put your fingers on your joint and try the limited and extensive mouth opening. With the latter you will clearly feel that forward movement of the ball of the joint.
TMJ4 rr
Healthy TMJ: after the initial rotation in the joint, the jaw starts sliding forwards over the bone in front. this will be a smooth movement without crunching or clicking. TMJ syndrome: the cartilage with be deformed and pressurised during the forwards trajectory, resulting in the eventual crunch or click when it drops back to its original spot.

By limiting your mouth opening to approximately 10mm and therefore not allowing the cartilage disk to become crunched up, a lot of the symptoms can be avoided. This does take a bit of getting used to though.

The options open to us to correct this problem more permanently are:

Tooth Adjustment (equilibration)
Your teeth may need to be carefully adjusted to meet evenly.  Changing the direction and position of the slopes that guide your teeth together can often help to reposition the jaw.

Replacement of teeth
The temporo-mandibular joint needs equal support from both sides of both jaws.  The chewing action is designed to work properly only when all your teeth are present and in the correct position.  Missing teeth may need to be replaced either with a partial denture or bridgework. Replacement is not usually done until a diagnosis has been confirmed by using an appliance and this has fully relieved the symptoms.  Relief in some patients is instant: in others it can take a long time.

Medication
Some drugs can help in certain cases, but this is usually only temporary.  Hormone replacement therapy may also help some women.

Diet and Exercise
As with any joint pain, it can help to put less stress on the joint.  So a soft diet can be helpful, as can corrective exercises and external heat. 

Relaxation
Counseling and relaxation therapy may help in some cases.  These techniques help the patient to become more aware of stressful situations and to control tension.