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Face and Jaw Pain

There are various problems that can cause jaw pain, clicking, stiffness or spasm (trismus).

One cause of problems may be small bony growths around the joint. These may be due to irregularities in your joint that have always been there or new growths that have developed. Older people may get pain in their jaw joint due to arthritis, when the joint becomes worn with age.

Jaw problems can develop if there are changes in the way your teeth meet when you bite together, for example after having lots of teeth removed. Another cause of jaw joint problems is previous jaw injuries, such as dislocation.

A common problem affecting the jaw joint is called temporomandibular joint dysfunction (TMJD), where the jaw joint does not open or close correctly.

Symptoms of TMJD

The most common symptoms include:

  • pain - usually a dull ache in and around the ear, cheek bone or neck
  • headache, especially in the morning
  • jaw joint clicking - this may make a sound and you may feel a cracking, grating, crunching or popping sensation
  • jaw locking - either open or closed
  • being unable to open your mouth properly

If you suffer from jaw joint problems you may have several of these symptoms or you may just have one. Symptoms may be worse during certain everyday activities such as chewing or yawning, and you may find they are worse if you are stressed.

What causes TMJD symptoms?

The jaw pain, clicking and restricted movement may be caused by problems with either the jaw joint itself or the muscles surrounding it, or both.

Pain can be caused by the ligaments and muscles surrounding the jaw tightening up.

Alternatively the ligaments may become loose, so that the disc of cartilage no longer stays between the jaw bone and the skull when the joint is moved. This may make a noise, either when the disc clicks forward after the mouth is opened or clicks back into place when it is closed. The noise may seem louder to you because the joint is close to the ear. Jaw locking is also caused by the disc slipping and getting stuck out of place.

Why does TMJD develop?

One of the most common causes of TMJD is teeth grinding and clenching, when you regularly push and scrape your teeth together. You may do this at night when you are sleeping, or when you are concentrating on something or feeling stressed. You may not be aware that you are doing it. Jaw problems can also result from nail biting or holding things between your teeth, which you may do more when you feel anxious or stressed.

Diagnosing jaw joint problems

Jaw joint problems are usually diagnosed by your osteopath.

Your osteopath needs to find out what is causing your problems so that he or she can advise you which treatments may be best for you. So it is important to discuss all of your symptoms. He or she will ask where and when you feel pain or clicking.

Your osteopath will look at your teeth for signs of wear due to grinding and examine your jaw joint. This will involve checking the way that you open and close your mouth and feeling the muscles around the area to see if they are tender. Your osteopath may also ask you if you are feeling stressed or anxious because this may be making any grinding or clenching worse.

Treatment for TMJD

Treatment depends on the type of jaw joint problem you have.

Usually your osteopath will be able to help relieve your symptoms with simple treatments. He or she will explain the problem to you and give you advice on anything you can do to reduce pain or clicking, such as not yawning too widely or choosing soft foods.

Your osteopath may give you some jaw exercises to do. The aim of these is to improve the way that the joint works and to strengthen the muscles surrounding it. If stress is causing symptoms, counseling and relaxation therapy can help some people.

Your osteopath may prescribe painkillers to help ease the pain. He or she may also advise you to put a heat pad or ice pack on the jaw joint area to help soothe it. If you use ice, don't apply it directly to your skin. Wrap it in a clean cloth or towel.

If your osteopath thinks that you are clenching or grinding your teeth at night then he or she may suggest that you wear a mouth splint or mouth guard. This is a cover made from hard or soft plastic that fits over your upper or lower teeth. The aim of the splint is to change the way your teeth close together and prevent you grinding your teeth.

The splint is made to fit your mouth exactly. Your osteopath will take impressions of your teeth using a kind of putty and send these to a laboratory where the splint is made.

You normally wear the splint at night and can also wear it at stressful times to prevent grinding and clenching. A splint can start to relieve pain in about three or four weeks, though your osteopath will probably recommend that you keep wearing it for longer.

Your osteopath will refer you to a specialist if your symptoms do not improve. The specialist may prescribe stronger painkillers or other medication to help relieve the pain. If stress or anxiety is making you grind or clench your teeth, he or she may prescribe anti-depressants to help you to relax.

Occasionally, surgery may be recommended. This is not common and is only recommended for a small number of people. It is important that you talk through all of the options with your specialist before having any surgery.