The Snap and Crackle of a Fireplace 

Christmas is absolutely wonderful.  I love this time of year.  We even had the opportunity to hear the snap, crackle and pop of a beautiful fire during the cold spell.  I thoroughly enjoy the beauty and sound of a fireplace.  Although snaps and pops are great in a fire, they aren’t so great if the sounds are coming from your jaw!  Joint sounds are one of the most common recognized signs of temporomandibular disorders, commonly referred to as TMD.  While not all joint sound necessarily points to TMD, it could be an early sign and should always be checked out by your dentist. 

Your temporomandibular joints (TMJ’s) are the joints that slide and rotate just in front of your ear.  They are the points at which the lower jaw (mandible) attaches to your skull and are among the most complex joints in the human anatomy.  If you place your fingers on the sides of your face, just in front of your ears, open and close your mouth, you can feel the movement of the mandible in the temporomandibular joints.  It is here that TMD occurs.

The joint works properly when the lower jaw and its joint (both right and left) are synchronized during movement.  They are very complex joints in that unlike other joints of the body, they can move in all directions while functioning in harmony with the joint on the other side.  Because of this several are muscles involved: some to close, some to open, some to move forward and others to pull back.  Normal function for this group of muscles allows you to chew, swallow, speak, make facial expressions and communicate with little or no thought.

But, if all is not functioning properly, temporomandibular disorders can arise.  They are a collection of conditions characterized by pain in the jaw and surrounding tissues, joint sounds and limitations in jaw movements.  The National Institute of Dental and Craniofacial Research (NIDCR) states that over 10 million people in the United States suffer from TMJ problems at any given time.  While both men and women experience TMJ problems, the majority of those seeking treatment are women in their childbearing years.

A number of things can cause temporomandibular disorders.  Grinding your teeth or clenching them when your bite is not in proper alignment with the stable position of the jaw joints is often a cause.  Trauma to the head, face or jaws can be another cause for the concerns.  Various forms of Arthritis, genetics, hormones, low-level infections, auto-immune diseases, stretching of the jaw as occurs with inserting a breathing tube before surgery and believe it or not, bad posture can also lead to eventual TMD.  Stress plays a major role in joint inflammation and pain in the temporomandibular joints.  It isn’t unusual for me to see a lot of college students with painful jaws during this time of final exams! 

Diagnosing TMJ diseases and disorders can be complicated. For example, facial pain can be a symptom of many conditions, such as sinus or ear infections, decayed or abscessed teeth, various types of headache, and facial neuralgia (nerve-related facial pain).  In most cases a complete evaluation, including a detailed medical history, the patient’s description of symptoms, and physical examination of the head, neck, face and jaw provide information useful for making a diagnosis.  Next week I will go into more detail on causes and treatment of temporomandibular disorders.  I hope you have a blessed Christmas season.