As an Orofacial Pain Specialist, people come to me when they’re suffering from the painful symptoms of a TM Disorder, which you may have heard referred to as TMJ, which is short for temporomandibular joints, which are your jaw joints. For most people, when properly treated, their TMJ problems can be controlled.
But, for some, what began as a common TMJ problem can progress to arthritis in the jaw joints – specifically osteoarthritis. To appreciate why arthritis can impact the jaw joints, let’s review some basic concepts about jaw disorders:
TMJ Disorders & What Causes Them
TM disorders are a group of conditions that affect your TMJs, your jaw muscles, or both. They can have many origins, such as a single traumatic event and or an underlying medical disorder. However, TMJ disorders are most commonly related to other risk factors such as jaw overuse behaviors during the day such as nail and/or cuticle-biting, frequent tooth contact, teeth clenching, gum-chewing, ice-chewing, or gnawing on pencils, pens, your lips, cheeks, or your tongue.
Nighttime bruxism, where you grind and/or clench your teeth while you’re asleep, can play a significant role in causing TMJ in some people. For others, the way their teeth come together and the spatial relationship of their upper and lower jaw plays a role. And, some research points to biological factors as potential initiators of jaw symptoms such as sex hormones, and psychosocial influences such as exposure to stress, chronic pain, catastrophizing, and other emotions.
But the most common initiators of TMJ problems – overuse behaviors and nighttime bruxism – exert a tremendous amount of pressure on your jaw joints and over time, can lead to a reduction in synovial fluid, the lubricant that nourishes your jaw joints and is responsible for maintaining the shape of your articular disc, the natural shock-absorber of your jaw. Because the supportive ligaments that keep your articular disc in place have become weak this all can result in inflamed and unstable jaw joints.
The most common symptoms caused by daytime overuse behaviors and nighttime bruxism are jaw pain, jaw joint clicking, compromised jaw motion, difficultly opening your mouth, joint locking, and changes in your bite. But for some people, bone and cartilage changes also occur and can lead to arthritis in the jaw joints.
The Symptoms Of Arthritis In The Jaw Joints
Once arthritis emerges, it can cause considerable pain, limited jaw movement, bite changes, and even chewing problems. It can also lead to muscle tension, causing headaches, ear pain, and/or toothaches. Some patients even experience gravel-like sounds when opening and closing their mouths due to the dryness and friction in their joints. As jaw osteoarthritis progresses, the bite can become dominant on one side with a gap on the other (for some, this is the only symptom that appears).
Are You At Risk Of Developing Arthritis In The Jaw Joints?
The good news is: not everyone who has TMJ will develop osteoarthritis. In fact, the vast majority of my patients with common TMJ disorders do not. I often see the signs of arthritis in patients who don’t recall ever suffering from a problem related to jaw arthritis. This suggests that our TM joints have a tremendous adaptive capacity and even when injured or persistently overworked, healing and adaptive changes can occur.
If you think (or know) you have jaw joint arthritis and associated symptoms, there’s an excellent chance, with proper treatment, your symptoms can be diminished and the progression of the disease reduced. Treatment can include non-steroidal anti-inflammatory medications, short-term oral steroids, injections of steroid in the joints, and the elimination and/or control of the behaviors that have overworked your TMJs. Bite plates (also called oral appliances, tooth protectors, and night guards) are often used to protect your joints while you sleep. For some, injections of lubricating substances such as hyaluronic acid are helpful over the short term. Only in extreme cases is joint surgery necessary.
Happily, it is rare for TMJ osteoarthritis to advance to such a degree that it causes disabling pain and jaw function limitations. With careful assessment and the proper treatment strategies, getting better is predictably successful.
If you’ve been suffering from a TMJ disorder and are concerned it is progressing, it’s time to seek a professional assessment from an experienced Orofacial Pain Specialist. To find one in your area, hop on over to the website of the American Academy of Orofacial Pain and look for a specialist with Diplomate status.
Live or work in New York City or on Long Island? You can schedule a consultation with me here or call 212-265-0110.