An estimated 10 million American adults—more women than men—suffer from TMJ (also called TMD) disorders.
In addition to jaw pain, swelling, clicking or popping, and immobility, symptoms of TMD may include headaches, earaches, neck pain, and generalized facial pain.
I was a teeth grinder and a jaw clencher.
My dentist showed me how my back molars were showing the effects of my nighttime grinding (what dentists call bruxism), a bad sign for someone like me with a mouth full of fillings whose teeth were starting to crumble. He’d suggested getting those crumbling molars crowned, and wearing a custom-made bite guard (“occlusal splint”) at night to prevent the grinding.
To shorten my story, I followed up on those suggestions. I spent four years in debt for the crowns, which probably saved my teeth. I had the bite guard made, and wore it for years. I stopped chewing gum and taught myself to relax, instead of clench, my jaw when I felt anxious. My jaw pain lessened to occasional episodes of minor soreness.
Finally, many more years later, because my upper and lower teeth didn’t come together well, I got fitted for clear, removable braces, which over two years gradually brought my bite into alignment. I wear a nighttime retainer. So far, not even a twinge of jaw pain or stiffness.
Until recently, I assumed everyone’s TMJ was related to nighttime bruxism and daytime clenching, and that the answer was a bite guard.
But as I began looking into the topic, I learned that TMD is a cluster of disorders with no single cause or remedy, and very little consensus among practicing dentists about managing the common complaint.
In addition to bruxism and nervous clenching, researchers suggest causes of TMD that include malocclusion (teeth don’t come together well), arthritis, facial deformities, chewing on only one side, non-inherited genetic factors, hormones (especially estrogen), and injury or trauma to the jaw.
Many cases of jaw pain are actually temporary and will improve with ice or heat packs, over-the-counter anti-inflammatories, and staying away from hard, chewy foods.
But for severe pain or recurrent episodes, suggested treatments vary widely (often based on the suspected cause of the TMJ): from stress-relief practices or counseling, massage therapy, physical therapy, to prescription anti-inflammatory and/or antidepressant drugs, and various surgical procedures.
Some dentists no longer prescribe night guards for nighttime bruxism, saying that tooth-grinding could be a sign of a serious, life-threatening sleep apnea. Bruxism may be the way the body responds to the need for air, pushing the jaw forward to reopen the airway. They say treating the apnea, if present, will eliminate tooth-grinding, whereas wearing a bite guard may mask the serious underlying problem.
Talk to Your Dentist
Most of us don’t often think about it, but being able to chew well--the first step in digestion--is important to good health. If you can’t chew comfortably, have serious jaw pain, jaw pain that comes and goes, unexplained headaches, or neck pain, schedule a visit to your dentist to talk about TMJ and the options for treating it.
If your dentist suggests a bite-guard to prevent nighttime clenching and grinding, ask about and consider scheduling a test for sleep apnea first.
Margaret Boyles is a longtime contributor to The Old Farmer’s Almanac. She wrote for UNH Cooperative Extension, managed NH Outside, and contributes to various media covering environmental and human health issues. Read More from Margaret Boyles