In the last several years that I have been practicing dentistry, I have witnessed one too many patients who have undergone unnecessary dental procedures like root canal treatment or even extraction of teeth because of a missed diagnosis of Temporomandibular Joint Disorders (TMD) or other Orofacial pain conditions. We could call these non dental sources of facial pain.
This little blog of mine is intended to educate patients as well as dental practitioners about such conditions. There is a list of such sources of pain (non dental) that may not be diagnosed by the untrained eye. When it is difficult to diagnose a patient’s dental pain, these potential alternate sources should be considered.
I will specifically elaborate on the TMD or Temporomandibular Joint Disorders in this article. Other Orofacial pain conditions will be discussed in subsequent articles.
The Temporomandibular Joint (TMJ) is located on either side of the face in front of the ears. It connects the jaw bone to the skull. It is one of the most complex joints in the human body, providing not only rotational but also sliding movements. These are what allow the mouth to open or the jaw to move from side to side.
The TMJ also depends on several facial muscles like the Masseter and Temporalis for functions like chewing or swallowing. If a problem arises in any of these supporting structures, a Temporomandibular Joint dysfunction may occur.The following is a list of symptoms that a patient may experience.
- Head aches
- Teeth that don’t seem to meet properly
- Ringing or stiffness
- Dizziness
- Facial pain
- Limited opening of the jaw
- Difficulty in chewing or swallowing
- Pain or pressure behind the eyes
- Neck pain
Factors that may cause TMD
- Poor posture in the neck and upper back muscles may lead to neck strain and abnormalities of jaw muscle function.
- Stress may increase muscle tension and jaw clenching.
- Cartilage wear and tear.
- Patients with other chronic inflammatory arthritis have increased risk.
- People who have had jaw trauma.
- People who have a genetic predisposition to pain sensitivity and increased stress responses may be more susceptible.
- Myofascial dysfunction.
The jaw pain may occur on one or both sides of the face on chewing or on rest, depending on the cause. Diagnosis and treatment of Temporomandibular Joint Disorders may be complex as it mimics several other types of pain. Hence it is imperative that the patient be screened and diagnosed by a dentist who is especially trained in this field.
