As a board-certified orofacial pain specialist, the majority of people who pass through my door have TMJ problems, and 80% of them are women. The reasons that women are more prone to TMJ problems are very complex (a subject that I cover elsewhere on my website). Happily, I can report that after a treatment period of approximately three to four months, most of my female patients experience diminished and sometimes even the complete elimination of their symptoms. It is not unusual, however, for some women that were symptom-free for a long period of time to find their way back to my office when they’re expecting a baby. That’s because TMJ problems get worse during pregnancy.
Why do TMJ problems get worse during pregnancy? There are 3 main reasons:
- Sleep Disruption
Most women discover pretty early on in pregnancy that their favorite position is no longer comfortable. In many cases, she can’t even find one sleep position that’s comfortable. Add to being uncomfortable, the frequent need to get up to urinate during the night and you have a situation that wreaks havoc on the sleep cycle. Disrupted sleep and brain arousals during the night seem to increase the likelihood of tooth grinding and clenching. Therefore, the pregnant woman that experienced jaw problems in the past is certainly now at risk again. The result is the typical list of TMJ problems: pain, jaw stiffness, morning headaches and jaw clicking and/or locking.
- Morning Sickness
For many women, unrelenting nausea and frequent vomiting characterize the early stages of pregnancy. Vomiting itself puts extreme pressure on the shoulder and neck muscles and causes the jaw to be violently thrust forward. Frequent vomiting can cause the jaw ligaments to be sprained and the jaw muscles to be strained. A traumatized jaw joint can be painful, stiff, and mechanically challenged. Although morning sickness usually lasts only a short time, that can be just long enough for TMJ problems to start or to reoccur.
- The Relaxin Hormone
Relaxin is a very helpful hormone. It helps ligaments in the pelvis stretchier to accommodate the delivery of a baby. The ligaments become more “lax”. During the later stages of pregnancy, relaxin becomes more and more elevated in the bloodstream. While relaxin’s main job is to prepare the pelvis, it also can make the ligaments in other parts of the body more elastic, including the jaw. Here’s a frightening scenario that is experienced by many pregnant women: A visit to the dentist for a routine cleaning becomes a nightmare when her jaw gets stuck in the open position. Hello, relaxin! Relaxin has made the jaw ligaments unstable and allowed the joint to open wider than normal. Sometimes assistance is even needed to get the jaw closed and that can result in pain and soreness for days, or even weeks. The fear of this scary event happening again is very stressful. (In these cases I teach some simple exercises that are very helpful.)
If you’re pregnant, have had TMJ problems in the past, and suspect that they are beginning to resurface, see your dentist before it gets worse. A custom-fitted nightguard, a routine of jaw exercises, and some general relaxation techniques may just be what you need to relieve the symptoms and allow you to enjoy the rest of your pregnancy.
If you are experiencing postpartum TMJ problems, please link to Postpartum TMJ Pain – What Causes It & How To Get Relief.
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