Ear ache and TMJ Dysfunction

TMJ ( Tempero Mandibular Joint) dysfunction is a medical problems related to the jaw joint. The TMJ connects the lower jaw -mandible-to the skull, the temporal bone in front of the ear.

Problems in this area can cause Ear ache, head ache and neck pain. At times jaw gets locked in position or difficult to open, and makes clicking sounds when you yawn or opening mouth

The TMJ is comprised of muscles, blood vessels, nerves, and bones and a cartilage disc. You have two TM Joints, one on each side of your jaw.

Muscles involved in chewing (mastication) also open and close the mouth. The jawbone itself, controlled by the TMJ, has two movements: rotation or hinge action, which is opening and closing of the mouth, and gliding action, a movement that allows the mouth to open wider. The coordination of this action also allows you to talk, chew, and yawn.

• If you place your fingers just in front of your ears and open your mouth, you can feel the joint and its movement. When you open your mouth, the rounded ends of the lower jaw (condyles) glide along the joint socket of the temporal bone. The condyles slide back to their original position when you close your mouth. To keep this motion smooth, a soft disc of cartilage lies between the condyle and the temporal bone. This disc absorbs shock to the tempero mandibular joint from chewing and other movements. Chewing creates a strong force. This disc distributes the forces of chewing throughout the joint space.

Causes of TMJ Dysfunction

• TMJ dysfunction can be caused by trauma, disease, wear due to aging, or habits.

• Bruxism: Someone who has a habit of grinding his or her teeth will do so mostly during sleep. In some cases, the grinding may be so loud that it disturbs others, like snoring.

• Clenching: Someone who clenches continually bites on things while awake. This might be chewing gum, a pen or pencil, or fingernails. The constant pounding on the joint causes the pain. Stress is often blamed for tension in the jaw, leading to a clenched jaw.

• Osteoarthritis: Like other joints in the body, the jaw joint is prone to undergo arthritic changes. These changes are sometimes caused by breakdown of the joint (degeneration) or normal aging.

• Degenerative joint disease causes a slow progressive loss of cartilage and formation of new bone at the surface of the joint.

Symptoms of TMJ Dysfunction

• TMJ  dysfunction  may cause ear pain (referred otalgia), ringing in the ears -tinnitus, and mild hearing loss. Sometimes people mistake TMJ pain for an ear problem, such as an ear infection, when the ear is not the problem at all.

• Pain in the facial muscles and jaw joints may radiate to the neck or shoulders. Pain usually appears in the joint itself, in front of the ear, but it may move elsewhere in the skull, face, or jaw.

• When the joints move, you may hear sounds, such as clicking, grating, and/or popping. Others may also be able to hear the sounds. Clicking and popping are common. This means the disc may be in an abnormal position.

• Swelling over the joint can be present, and tender to touch.

• The jaw may lock wide open (then it is dislocated), or it may not open fully at all. Also, upon opening, the lower jaw may deviate to one side. You may find yourself favoring one painful side or the other by opening your jaw awkwardly. These changes could be sudden. Your teeth may not fit properly together, and your bite may feel odd.

Investigation

Imaging: X-rays-OPG-Orthopantomogram, may be taken of the mouth and jaw. CT or MRI may also be used. The MRI was designed for soft tissue and, therefore, will show the location of the TMJ disc in relationship to the jaw and skull bones. That will give the surgeon a better idea as to the proper treatment approach.

Treatment

• Anti inflammatory tablets, Pain killers, and Muscle relaxants.

• Eat a diet of soft foods.

• Apply warm compresses on the area of pain. Try this after a warm compress is applied for 20 minutes.

• The surgeon may fit you with a splint or bite plate, much like a mouth guard in sports. The splint can help reduce clenching and teeth grinding, especially if worn at night. This will ease muscle tension.

• Injection of steroid and local anesthetic into the joint can be very helpful in relieving inflammation and pain.

• Surgery, the last option .If necessary, surgery can be used to replace the jaw joints with artificial implants.