Snatch comfort from the jaws of pain

Jaw pain or pain in the temporomandibular joint (TMJ) is discomfort caused between the ears and the mouth or jaw.

According to The American Academy of Orofacial Pain, an organisation of dentists and other health professionals in the US, TMJ is a joint that holds the lower jaw below the skull. This joint is in front of the ear on both sides of the head.

Dr Mythili Kalladka, consultant, orofacial pain, temporomandibular disorders and dental sleep medicine, Manipal Hospitals, Bengaluru, tells Happiest Health that this joint can perform hinge and rotational movements. “Disorders affecting the TMJ and the associated structures are referred to as temporomandibular disorders (TMDs). TMDs can affect the hard tissues of the joint (articular disorders) or the soft tissues and muscles (muscular disorders),” she says.

READ MORE

Keep pain at arm’s length
Swollen feet: sign of an illness?
Breaking bad: how to manage fracture pain
Managing pain during the third trimester

Dr Kalladka points out that a variety of biological, psychological and social factors may cause jaw pain.

The study, ‘Orofacial Pain: Prospective Evaluation and Risk Assessment (OPPERA),’ is the first longitudinal study of temporomandibular disorders to enrol more than 4,000 people over five years. The following are the risk factors the study highlights:

• History of trauma (like motor vehicle accidents)
• Facial trauma
• Oral parafunctional habits (clenching, grinding, nail-biting and jaw bracing)
• Poor oral systemic health
• Smoking
• Multiple painful and painless comorbid conditions such as low back pain, irritable bowel syndrome (IBS), fibromyalgia and sleep apnea
• Psychological factors such as anxiety and depression, and genetic factors

Dr Sriram Nathan, consultant, ENT, Kinder Women’s Hospital and Fertility Centre, Bengaluru, tells Happiest Health that there are several causes for jaw pain which can include infections, spasms, dislocation, TMJ arthritis and in rare cases, tumour or cancer.

Symptoms of jaw pain

Jaw pain can be constant or intermittent ranging from mild to severe, says Dr Nathan.

The pain can be accompanied by other symptoms too. According to Dr Kalladka, the usual symptoms are:

• Sounds in the jaw (like clicking, popping or grating) while opening/closing the mouth
• Stiffness or locking – the inability to open the jaw completely or being stuck in an open mouth position with the lack of ability to close the mouth
• Pain in the ears, jaw, face, head or neck
• Headaches, change in bite (the way the teeth meet)
• Ringing in the ears, dizziness

Treatment of jaw pain

Dr Nathan recalls a case study of a woman in her mid-30s who was experiencing severe pain on the right side of the jaw. She had a history of chewing hard food and also experienced episodes of the forceful opening of the mouth. Her joint was tender and her bite was not proper.

Dr Nathan said to treat the pain, she was given medication and advised dental consultation to improve her bite. She was given anti-inflammatory medication with muscle relaxants and was asked to apply hot fomentation (local moist heat application like a heating pad or a warm damp towel) to ease the pain. After five days of treatment, her pain eased considerably

Maintaining dental hygiene is also important for a person suffering from jaw pain.

Lifestyle modifications, thermal compression therapy (hot or cold), short-term medications, short-term intra-oral appliances, trigger point injections, nerve blocks and physiotherapy are some of the ways to treat jaw pain, says Dr Kalladka.

Dr Nathan adds that jaw pain can be treated by medication and joint rest. Eating semi-solid food and not chewing too much or too hard on the affected side can help ease the pain. Avoiding cold air and water can also help treat the pain, he adds. In his observation, it is also important to chew equally on both sides of the jaw.

According to Dr Kalladka, lifestyle changes should aim at improving general health. Also, those with jaw pain should avoid opening their jaws wide during yawning and tongue cleaning; they should also avoid chewing for long durations. She advises people with jaw pain to eat soft food; avoid crunchy/chewy food such as nuts, popcorn and chewing gum; and large bites of burgers, paani puri (water pancake) and salads. They should also avoid biting with the front teeth directly such as eating a whole apple. Dr Kalladka says that people with jaw pain should cut down on caffeine, get regular physical activity and sleep well.

A proper diagnosis is a key to curing jaw pain, she adds. “Muscle pain should be differentiated from joint pain and other causes of facial pain. After the accurate diagnosis and required treatment, if the pain still does not resolve (in select cases) interventional techniques or surgical procedures may be required,” she says.

Exercises like jaw stretching and strengthening are also advised by doctors. “Slow movements of jaws from right to left and up and down are the exercises that can be practised,” says Dr Nathan.

“However, in case of severe TMJ pain, jaw exercises should be performed as per the instructions of a doctor or a physiotherapist,” adds Dr Kalladka.