Tension Headache and Jaw Pain

The solution for improving the diagnosis and correction of occlusal interferences: synchromyography of neuromuscular stability analysis.

 

Temporomandibular joint and muscle disorders (TMJ disorders) are problems or symptoms of the chewing muscles and joints that connect your lower jaw to your skull.

Causes

There are two matching temporomandibular joints -- one on each side of your head, located just in front of your ears. The abbreviation "TMJ" literally refers to the joint but is often used to mean any disorders or symptoms of this region.

Many TMJ-related symptoms are caused by the effects of physical stress on the structures around the joint. These structures include:

  • Cartilage disk at the joint
  • Muscles of the jaw, face, and neck
  • Nearby ligaments, blood vessels, and nerves
  • Teeth

For many people with temporomandibular joint disorders, the cause is unknown. Some causes given for this condition are not well proven. These included:

  • A bad bite or orthodontic braces
  • Stress and tooth grinding. Many people with TMJ problems do not grind their teeth, and many who have been grinding their teeth for a long time do not have problems with their TMJ joint. For some people, the stress associated with this disorder may be caused by the pain as opposed to being the cause of the problem.

Poor posture can also be an important factor in TMJ symptoms. For example, holding the head forward while looking at a computer all day strains the muscles of the face and neck.

Other factors that might make TMJ symptoms worse are stress, poor diet, and lack of sleep.

Many people end up having "trigger points" -- contracted muscles in your jaw, head, and neck. Trigger points can refer pain to other areas, causing a headache, earache, or toothache.

Other possible causes of TMJ-related symptoms include arthritis, fractures, dislocations, and structural problems present since birth.

Symptoms

Symptoms associated with TMJ disorders may be:

  • Biting or chewing difficulty or discomfort
  • Clicking, popping, or grating sound when opening or closing the mouth
  • Dull, aching pain in the face
  • Earache
  • Headache
  • Jaw pain or tenderness of the jaw
  • Locking of the jaw
  • Difficulty opening or closing the mouth

Exams and Tests

You may need to see more than one medical specialist for your TMJ pain and symptoms. This may include a primary care provider, a dentist, or an ear, nose, and throat (ENT) doctor, depending on your symptoms.

A thorough examination may involve:

  • A dental examination to show if you have poor bite alignment
  • Feeling the joint and muscles for tenderness
  • Pressing around the head to locate areas that are sensitive or painful
  • Sliding the teeth from side to side
  • Watching, feeling, and listening to the jaw open and shut
  • X-rays or MRI of the jaw

Sometimes, the results of the physical exam may appear normal.

Your doctor will also need to consider other conditions, such as infections, ear infections, or nerve-related problems and headaches, as the cause of your symptoms.

Treatment

Simple, gentle therapies are usually recommended first.

  • Learn how to gently stretch, relax, or massage the muscles around your jaw. Your doctor, dentist, or physical therapist can help you with these.
  • Avoid actions that cause your symptoms, such as yawning, singing, and chewing gum.
  • Try moist heat or cold packs on your face.
  • Learn stress-reducing techniques.
  • Exercising several times each week may help you increase your ability to handle pain.
  • Short-term use of acetaminophen (Tylenol) or ibuprofen (Advil, Motrin), naproxen (Aleve, Naprosyn), or other nonsteroidal anti-inflammatory drugs
  • Muscle relaxant medicines or antidepressants
  • Rarely, corticosteroid shots in the TMJ to treat inflammation

Mouth or bite guards, also called splints or appliances, have been used since the 1930s to treat teeth grinding, clenching, and TMJ disorders.

  • While many people have found them to be useful, the benefits vary widely. The guard may lose its effectiveness over time, or when you stop wearing it. Other people may feel worse pain when they wear one.
  • There are different types of splints. Some fit over the top teeth, while others fit over the bottom teeth.
  • Permanent use of these items may not be recommended. You should also stop if they cause any changes in your bite.

Failure of more conservative treatments does not automatically mean you need more aggressive treatment. Be cautious about any nonreversible treatment method, such as orthodontics or surgery, that permanently changes your bite.

Reconstructive surgery of the jaw, or joint replacement, is rarely required. In fact, studies have shown that the results are often worse than before surgery.

 

 

The solution for improving the diagnosis and correction of occlusal interferences: synchromyography of neuromuscular stability analysis.



BTS TMJOINT performs a static and dynamic analysis of the masticatory performance combined to the traditional mechanical and morphological evaluation systems and supplies all the information needed to plan orthodontic therapies and judge their results. Through BTS TMJOINT, neuromuscular stability is an additional, relevant element used to improve prosthesis and rehabilitation therapies. BTS TMJOINT uses synchromyography analysis to perform a functional evaluation of dental occlusion referring to the indexes published in scientific journals.

How it works
Four different probes are applied to the patient’s temporal and masseter muscles: the patient is asked to clench for 5 seconds, the task is repeated twice, with and without cotton rolls.
The results appearing right away in a graphic representation are clear and easy to understand for both physician and patient.
The doctor can easily intervene without taking the probes off the patient’s face, being able in such way to perform an additional post-treatment evaluation. This procedure can be repeated over and over during the same treatment session, leading to better results of the treatment undergone by the patient. 

Applications
Oral rehabilitation: choice of treatment, evaluation of fixed and removable dental prosthesis
TMJ: Pre and post-splint, cranio-cervical-mandibular disorders from malocclusion
Orthodontics: Pre e post-treatment
Documentation and research: Treatment validation, biomechanics research
Forensic testing: Pexpertise, court evidence

Protocols
POC 4

Through a quick 5 second clenching test, in which the activities of the masseter and anterior temporal muscles, right and left are acquired, it provides, as an immediate result, a percentage overlapping coefficient – POC (index of the symmetric distribution of the muscular activity determined by the occlusion) and a torque coefficient – TORS (index to estimate the possible presence of mandibular torque), which makes it possible to establish the role of occlusion on muscular balance. A third index, called IMPACT, allows to evaluate the muscular work, providing information about the occlusal vertical dimension.

POC 6
This protocol adds to the previous 2 capture probes for calculating the indices related to the sternocleidomastoid muscle, right and left. The effects of the teeth touching, on the neck muscles are evaluated.

CHEWING
It analyses the neuromuscular coordination during mastication. The masticatory frequency, the Lissajous curve, and indices of muscle symmetry are calculated.

  • TUFTS University School of Dental Medicine, Boston, MA (USA)
    The TUFTS University School of Dental Medicine is one of the most prestigious dentistry schools in the United States and it is the first American center that has installed BTS TMJOINT. We thank Dr. Hiroshi Hirayama who organized for the occasion a theoretical and practical seminar about the use of BTS TMJOINT, with the purpose of providing education for the device to the residents.
     

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    Literature



    10 years of continuous scientific activity have shown how important is the research of the neuromuscular stability

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