An Oregon City High School student came to see me today with complaints about tightness in her jaw. She had heard some clicking and popping for a few months and now her jaw felt tight and she was unable to open as wide as she used to.
These are classic signs of a jaw joint problem that many have heard referred to as TMJ for the temporo-mandibular joint or the connection between the lower jaw and the skull.
This joint is unique because it has both a simple ball and socket movement at first and then a complex sliding motion to allow larger jaw opening.
The sliding motion uses a disc of cartilage that is connected by tendons and muscles to move as the lower jaw moves. Sometimes the disc will pop out of position and back that makes a noise in the jaw joint.
If the disc gets stuck in front of or behind the jaw bone instead of directly on top of it, then it can prevent full movement of the jaw and can become painful.
In extreme cases, the joint degenerates to the point where the two bones are directly rubbing on each other and change shape or stop working without severe pain.
Luckily, this young Oregon City girl still was in the early stages of disc displacement. I recommended:
stop chewing gum
eat a softer diet
avoid extreme jaw movements
take a non-steroidal anti-inflammatory medicine like naprosen or ibuprofen
If this does not help, the next step is to construct a removable plastic mouth guard that affects the position of the jaw and usually helps dramatically.
More drastic treatment of TMJ is either orthodontically moving teeth, changing the bite with many crowns, or performing jaw surgery. These types of treatment should be reserved for only the most desperate cases and are rarely provide complete relief of all symptoms.
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