TMJ & OROFACIAL PAIN

The specialty of Orofacial Pain is concerned with the prevention, evaluation, diagnosis, treatment, and rehabilitation of pain disorders about the face and jaw. Such disorders may have pain and associated symptoms arising from a discrete cause, such as postoperative pain or pain associated with a malignancy, or may be syndromes in which pain constitutes the primary problem, such as Temporomandibular joint disorder (TMD) pain, neuropathic pains or headaches.

 

Orofacial pain is evolving; the scope of the field is enlarging. At the present time the orofacial pain encompasses:

 

1. Temporomandibular Joint disorders

2. Masticatory musculoskeletal pain

3. Cervical musculoskeletal pain

4. Neuropathic pain

5. Sleep disorders related to orofacial pain

6. Orofacial Dystonias

7. Headaches

8. Intraoral, intracranial, extracranial, and systemic disorders that cause orofacial pain 

 

Temporomandibular joint (TMJ) symptoms are relatively common. Symptoms of TMDs occur in approximately 6-12% of the adult population. TMDs may occur at any age but are more common in women and in early adulthood.

TMJ disorders are thought to have a multifactorial aetiology, but the pathophysiology is not well understood. Causes can be classified into factors affecting the joint itself, and factors affecting the muscles and joint function.

Factors affecting muscles and joint function - myofascial pain and dysfunction

 

This type of TMJ problem is most common. Often it is difficult to determine a single cause, but contributing factors may be:

• Chronic pain syndromes or increased pain sensitivity.

• Psychological factors: these may contribute (as with other chronic pain syndromes).

• Muscle overactivity: bruxism (grinding of the teeth and clenching of the jaw); orofacial dystonias. 

• Dental malocclusion: this was formerly considered to be an important factor; indeed TMJ dysfunction was often considered as a dental problem. However, the evidence does not support this, and TMJ dysfunction is now seen as a multifactorial problem rather than a dental condition.

 

The three cardinal symptoms of TMJ disorders are: facial pain, restricted jaw function and joint noise.

 

Pain

• Located around the TMJ, but may be referred to the head, neck and ear.

• Pain, located immediately in front of the tragus of the ear, projecting to the ear, temple, cheek and along the mandible, is highly diagnostic for TMD.

 

Restricted jaw motion

• May affect mandibular movement in any direction.

• Jaw movements increase the pain.

• Patients may describe a generally tight feeling, which is probably a muscular disorder, or a sensation of the jaw 'catching' or 'getting stuck', which usually relates to internal derangement of the joint.

Joint noise

• Clicks and other joint sounds are common; they are not significant unless there are other symptoms.

Other symptoms

• Ear symptoms - otalgia, tinnitus, dizziness.

• Headache.

• Neck pain.

• 'Locking' episodes - inability to open or close the mouth. Inability to open the mouth is more common.

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The staff at the TMJ & Headache Clinic have expert skills in helping you overcome your pain using a range of manual therapy techniques, dry needling and exercises.  Ensuring you get the best possible care.