The temporo-mandibular joint (TMJ) is used hundreds of times per day. Pain affecting our jaw joint will be annoying at the very least or it can prevent you from daily activities when it's severe.
Despite its fairly complex structure, the jaw is actually quite a simple mechanical unit. Any form of impact to it can result in various types of damage. The jaw joint allows a large number of possible movements but it prefers just simple up and down. If someone gets punched or falls onto their chin it can lead to compressive force which can damage the cartilage in the joint as well as strain the joint capsule. Biting down awkwardly on something hard can also lead to a similar, but not as severe damage. Depending on how long the issues have been present and how serious they are, some can be completely corrected with osteopathic treatment, others can only be eased. Other still need attention to a dentist or specialist.
The most common issues we see are muscle problems which can easily be addressed, followed by issues with the disc which stabilizes the jaw joint. These problems can cause clicking in the jaw joint when opening or closing the mouth, or chewing. The clicking can come from either just simple crepitis in the jaw joint or from an actual 'slipping' of the joint. If the capsule is still reasonably healthy and the disc is in reasonably 'good shape' we can have a significant impact on this condition. In such cases the jaw clicking is not very noisy. Where the damage is quite extensive, there is little than can be done osteopathically. In such cases we can suggest the next best step for you.
The positioning and health of your neck is actually quite important to your jaw mechanics too. Clicking of the jaw joint can simply be caused by inappropriate neck posture. If your upper neck if tight, restricted or sitting incorrectly then it will put pressure on your TMJ and it will sit incorrectly. Over time the muscles will begin to tighten into these positions and lead to considerable (but reversible) dysfunction.
Other systemic conditions can also affect the jaw joint. Diabetes, inflammatory arthritis or stress can all affect the jaw joint in a variety of manners from changing the internal joint chemistry or mechanical changes which can cause the TMJ to become problematic. In these cases aside from osteopathic care, other forms of treatment may be necessary to give as much resolution of symptoms as possible. We would discuss these with you and help you find the next step.
The balance of the jaw joints (TMJ's) is very dependent on the way your teeth fit together. This can often change either when teeth grow or when recent dental work has been performed. Dentists will generally check your dental occlusion (the way your teeth fit together) after any work they do, but often things can change sometimes weeks or months after the procedures. Bruxism (grinding your teeth) is another common cause for both dental and TMJ concerns. Due to the loading placed on your TMJ when you grind your teeth it can create a variety of problems. The most common ones are simple muscle tightness in the early stages of bruxism which osteopathy can easily remedy, whilst more advanced or long standing tooth gringing may require special night-time braces. Osteopathy can quite effectively address the TMJ concerns you may have in most cases, but we would need to work together with your dentist, orthodontist or specialist to fully remedy the situation in complex cases.
For example when a tooth is removed, the two teeth to either side of the extracted one tend to begin leaning in towards the gap. This can cause a 'bump' which makes that side of your teeth seem higher than the other side. Bone grows and changes slowly, so a checkup with your dentist may be necessary, even though the extraction was performed months ago. Similarly if you had braces removed a little while ago, your teeth can continue to change slightly still for a little while and this can lead to problems. In any case we can work together with your other dental professionals to remedy your TMJ problem as well as the cause.
Bruxism can be caused by many issues. Most commonly stress is the culprit, but the diagnosis of the cause generally doesn't fall within the realm of what osteopathy can remedy. While we can address your TMJ symptoms we would also need to address your stress too. In milder cases we can help you find some simple stress relieving methods, other times we may recommend you see a specialist to help.