The Temporomandibular Joint

If you place your fingers in front of either ear and open your jaw, you'll feel changing shapes beneath your fingers. You are feeling the joint where the temporal bone of your skull attaches to your mandible (jaw)-the joint that is called the temporomandibular joint or TMJ. This fascinating joint connects your jaw to your head. Ligaments, cartilage, fascia, an articular disc, muscles, nerves and blood vessels run in, around and through the TMJ.

Symptoms Of TMJ

TMJ dysfunction or syndrome occurs when the joint is misaligned or malfunctioning in some way that subjects it to excess pressure. The condition was first identified in 1934 by an otolaryngologist, J. B. Costen.

Among the most common symptoms of TMJ dysfunction are the inability to open the mouth wide and a clicking or popping sound when the mouth opens or closes. In some cases, the jaw can even temporarily lock up.

Other TMJ symptoms can be severe headaches; loss of hearing; tinnitus (ringing in the ears); the sensation of an object in the throat; facial swelling; shoulder, cheek or jaw joint pain; neck ache; tic douloureux (facial nerve pain); pain in or under the ear, the eye or upon swallowing; tooth pain; migraine: nausea; blurred vision and dizziness.

Some researchers have even linked TMJ dysfunction to throat infections, sinus congestion, ear infections and asthma. Others have linked the syndrome to heart, stomach, intestinal, respiratory and emotional disorders.

Who Gets TMJ?

According to John D. Laughlin 111, president of the Holistic Dental Association:

Up to seventy-eight percent of the general public (over 175 million) have some amount of TMJ disfunction. This condition can begin during the birth process... One of the primary causes can be poor nutrition. TMJ affects more women than men, with high stress "superwomen" being very prone to it.

Causes Of TMJ

TMJ may be caused by trauma: a child may fall on its sacrum and in time, through the adaptive body mechanisms, the pelvic imbalance can affect the TMJ, head and neck.

According to Dr. Gerald Smith, a specialist in the field of structural dentistry, dental work specially improperly fitting braces or orthodontia-is the cause of many TMJ problems:

Chronic headaches, scalp tenderness, pains behind the eyes, muffled ear sounds, ringing, hissing or other ear distortions, balance problems, nausea, facial tightness, cervical or lower back pain or restriction of neck motion should all be thoroughly investigated for possible implication in cranial distortions, especially if they appear within days after braces are placed... These same symptoms may surface within a period of six months to several years.

According to Dr. Daryl Curl, who holds degrees in both dentistry and chiropractic, orthotics (braces, crowns, etc.) may contribute to or worsen a patient's head-pain complaint?

Sometimes the head pains caused by ill-fitting dental work can be quite intense. One (very!) dramatic example of the lengths to which dental patients can go to relieve poor-fitting dental appliances is recounted by Dr. Smith:

Periodically we hear reports of bizarre orthodontic patient behavior. These are the individuals who have forced orthodontists or general dentists to remove their braces at gun point. Pain and spasm of the neck have been shown to cause many symptoms that mimic TMJ dysfunction, among them facial pain, spasm and inflammation of the face.

TMJ may be caused by trauma of many kinds, not only those directly affecting the head and jaw and not only those of recent origin.

The Standard Dental/Met

Some of the standard approaches to TMJ and related conditions are muscle relaxant drugs; painkillers: oral appliances, such as a night guard to control bruxism (grinding of the teeth); heat massage and a soft diet to ease the pain of chewing. Biofeedback or psychological counseling is used to combat stress and anxiety, which appear to affect TMJ pain. Other treatments are orthodontics, restorative dentistry to build up the bite, bite plates and physical therapy. In severe cases, surgery has been performed to enter the joint and end the discomfort, yet this drastic step should be taken only after more conservative approaches have failed. According to Dr. Smith:

Surgery should not be done until chiropractic and proper dental support is provided prior to the surgery with the exception of a tumor, fracture or serious pathology.

The Chiropractic Approach

A properly aligned spine helps the TM joint. Spinal and TMJ problems are often found together.

Chiropractic care, especially in the area of the upper cervical spine and skull, often relieves pressure on the spine and the cranial bones.

Sitting in a dentist's chair and keeping your jaw, head, neck and lower spine in an unnatural or uncomfortable position can cause TMJ and spinal damage. It is therefore strongly recommended that if you undergo dental care follow it up with a visit to your chiropractor.

Often a chiropractic spinal adjustment can greatly benefit someone suffering from what had been thought to be only a TMJ problem. Conversely, an unhealthy skull/jaw alignment can put great stress upon the spinal column. There are documented cases of dental problems that, once corrected, have helped chiropractic patients to better hold their spinal adjustments.