TMJ headaches or disorders are actually a number of conditions that may have a hand in causing the intense pain and tenderness of the temporomandibular joint (hence, TMJ). This is the ball-and-socket type joint on either side of your head where the mandible (lower jaw) connects to the temporal bone of the skull. Most people who experience the pain associated with TMJ headaches think they’re experiencing a bad migraine, when this is actually more of a dental condition. The similarity in symptoms can make it difficult to diagnose and it may end up not being treated properly.
These types of headaches occur more in women than in men, a factor that may help to confuse them with migraines; most women complain that the pain worsens right before menstruation and during emotional and physical stress. The headache pain usually resonates on either side of the head over the temples, something else that links it to migraines.
Since TMJ headaches are dental in nature, most are caused by some sort of trauma to the jaw, like a severe blow. Yet, since the TMJ itself is an actual joint, any types of degeneration, osteoarthritis, rheumatoid arthritis, or any other forms of inflammation may cause problems. In some cases though, the cause is not always clear. Responses to stress are also thought to be, at least, a contributing factor. Some people clench their jaw when feeling anxious, irritable or when concentrating, keeping the muscles of the TMJ in a contracted position. Clenching the jaw and grinding teeth while asleep is not uncommon either. Any habits that overwork the jaw muscle can intensify the pain of a TMJ disorder.
A migraine-like headache is only one symptom of a TMJ disorder. Other symptoms include pain and tenderness of the jaw, locking up of the joint, difficulty chewing and an uncomfortable bite, aching pain of the face and inside or around the ear, an uneven bite with teeth making premature contact, and jaw clicking or teeth grating when you open your mouth or chew. In most cases, you will experience pain and tenderness of jaw even when it is not moving.
In some severe cases, people may experience related pain in the neck, face and back. Nasal allergies can sometimes occur, also confusing this disorder with a sinus infection and headache. The nasal membranes may swell up from excessive mouth breathing (which is dry) and cause sinus toothaches.
Sometimes you can relieve the pain of TMJ without any medical treatment. If they continue, your doctor or dentist may still recommend treatments that are conservative and non-surgical. There are also some behavioral interventions that may help alleviate pain and correct dental problems. Breaking bad habits can make the biggest difference in TMJ related pain. Refrain from clenching of the jaw, grinding the teeth, and any unnecessary chewing, like on your lip or objects such as pen caps or toothpicks. Keep your jaw muscles as relaxed as possible with the teeth slightly apart. Eating softer foods and cutting food into smaller pieces can help to avoid overworking the jaw muscles. Also avoid chewy and sticky foods, like gum and try not to open your mouth too wide when you yawn.
If non-surgical treatments do not help to relieve the pain of TMJ headaches, your doctor may have to perform a certain procedure. A corrective dental treatment will help to improve your bite and to balance your biting surface. Anything from braces, to crowns and bridges, or even replacing missing teeth can be done and are often helpful.
Corticosteroid drugs may be prescribed for intense pain and joint inflammation. The medicine is injected right into the joint space to provide immediate relief. Arthrocentesis may be performed by inserting a needle into the joint and irrigating the space of fluid and other debris containing inflammatory by-product. Surgery is usually the last and most drastic approach, used if the other approaches don’t work. You may get referred to an oral and maxillofacial surgeon. Surgery may be performed to repair or even remove the disk between your mandible and temporal bone. If advanced osteoarthritis or other severe inflammation is present, a partial or total joint removal and replacement may be necessary to achieve proper bone-on-bone contact. If you suspect that you are suffering from TMJ headaches, consult a dentist for an initial consultation first before visiting your family doctor.