HEADACHES AND THE TMJ FACTOR

 

HEADACHES AND THE TMJ FACTOR

Stress can induce muscle spasms and jaw misalignment problems thereby starting a vicious cycle of tooth grinding (bruxing) and clenching, ultimately leading to muscle tension, imbalance and strain on the chewing and postural muscles with subsequent headaches and/or migraines. This complex of problems are usually referred to temporo-mandibular joint disorder (TMJD) or jaw joint disorder or dysfunction. The jaw joint is also known as the ‘temporomandibular joint’, known for short as the ‘TMJ’.  It can be felt by placing your fingers just in front of your ears, and opening and closing your mouth. The joint allows the jaw to open, close and move sideways and forwards. It plays an important role in jaw functions such as talking, chewing and yawning. It is one of the most complex and frequently used joints in the body.

 

Harmony between teeth, jaw joint and muscles

Since there is a relationship between the teeth, jaw joints, head and neck muscles, and head posture, a problem in any one of these areas may affect the other. People that have lost some, or all their teeth, have worn down their teeth  due to grinding or clenching or have suffered trauma as a result of an accident, can cause compression and change in blood flow of the jaw joint. The reason is that the chewing muscles overwork themselves in an effort to bring balance back to the area. They try to protect the damage being caused, unfortunately they cause more damage in the long term. Overworked muscles begin to tire out and eventually spasm. This causes the muscles to shorten and increase the compression. The patient begins to experience earache, headaches, migraines and related facial pain.  Inability to chew, painful mastication, pain in teeth, changes in the way upper and lower teeth meet are commonly reported. 

 

Temporo-mandibular joint disorders

It is important to understand how TMJ problems can not only affect your dental health but also your overall general health and well-being.

A TMJ disorder  may affect one or both joints, often causing pain and limiting jaw function. Symptoms usually arise in early adulthood, but children and the elderly can also be affected. TMJ disorders are common, with about seven in ten people being affected at some time in their lives. Although about one person in four is aware of the symptoms or reports them to a dentist or medical practitioner, only five people in every hundred seek treatment. Most symptoms of TMJ disorders or pain are mild and do not need treatment. As with pain in other joints of the body, symptoms often go away with time.

Causes of TMJ disorders

TMD is caused by several interacting factors.  The factors most commonly considered include:

Trauma - Acute trauma or injuries to the jaws such as a car accident, a fall or a punch can cause damage to the muscles and/or joint. The acute pain and loss of function is usually responsive to conservative treatment. Sometimes trauma to the joint can cause chronic damage which may eventually contribute to a TMJ problem at a later time.

 

Clenching or Grinding - Some do this while awake but more often it is done while sleeping. Most people grind their teeth while sleeping to some degree. This constant pressure can damage the TMJs over time.

Malocclusion - This term means “bad bite”. Sometimes when the teeth do not bite together in harmony with the shape and position of the joints, it can place pressure on the joints. Missing and misaligned teeth can sometimes put strain on the jaw muscles and place pressure on the jaw joints. 

Psychological factors -  such as emotional stress, depression, and/or anxiety are sometimes associated with the onset or worsening of TMD symptoms. Stress increases both the severity and duration of clenching or grinding while asleep. Also, many will subconsciously clench and/or grind their teeth more while awake during times of stress.  

Posture & Poise - Your job and how you sit and work on a regular basis can contribute to TMJ and related problems. If you work at a computer all day, for example, you may be holding your head in such a way that places strain on your TMJ system.

 

Signs and symptoms of TMJ disorders

Symptoms may include: limited jaw movement; difficulty in opening the mouth; clicking, grating or popping noises from the jaw joints;

pain when chewing, yawning or opening the jaw widely; pain in or around the ears and cheeks; headaches, and occasionally, migraine-like headaches; earaches, loss of hearing or ringing in the ears; face, neck, back and shoulder pain;  muscle spasms and clenching and grinding of teeth; double and blurred vision.

 

Treatment of TMJ Disorders

TMJ disorders are best treated ‘conservatively’, using treatment methods that do not have any permanent effect on the teeth and jaw joint. As TMJ disorders are often temporary, simple treatment methods are used whenever possible to help reduce symptoms and restore jaw function. Relief from symptoms may take time, particularly if the TMJ disorder has developed over a long period. Effective treatment should: lessen or relieve your pain, restore your jaw function, minimize any clicking or popping noises from your jaw joint, and enable you to carry out your normal daily activities.

In some people, the treatment plan may take several months to be effective. For the best results, follow your treatment plan carefully. It may include some or all of the following treatments:

 

Occlusal splints

Occlusal splints (also known as bite plates) is a custom made appliance fabricated of plastic that can be worn over the teeth to maintain the derived bite position and used to take pressure off the jaw joints and teeth. These are usually worn at night and should not have any permanent effect on the position of teeth. Custom made by your dentist, occlusal splints must be adjusted regularly and monitored for some months to help relieve pain.

You typically wear this plastic appliance for a prescribed period of time to verify that this new jaw position solves or reduces the problem. If it does, it has proven that the imperfect bite was the cause of the problem and you may elect to go on and have your natural teeth treated to permanently maintain that new bite position.

If symptoms are not substantially alleviated, the bite position is most likely not the cause of the problem. Your natural bite has not been altered and other causes may then be further explored. 

 

Modified Diet

Minimize chewing and rest the jaw, eat only soft foods. When a small amount of chewing is necessary, try to chew on both sides of the mouth. Do not favor one side. Chewing very large pieces of food and hard brittle foods put added stress on your TMJ. Try to improve your eating habits to avoid these actions. Chew smaller pieces.

 

Physiotherapy

Exercises, massage, gentle movement and muscle stretching can be effective in reducing pain and stiffness and increasing strength and mobility.

 

Sleep on your back 

Many people who suffer from TMJ disorder sleep on their stomach or side. This position puts pressure on the face and seems to encourage teeth grinding. Try sleeping on your back, and you may find your symptoms greatly relieved.

 

Warm or Cold Packs

Muscle relaxation can be achieved by applying warm or cold packs to tender areas.

 

Relaxation and Stress Management

Learn how to relax and lessen stress. Cut down on multi-tasking, and  slow down your lifestyle. This can reduce tension in the jaw joint.  Patients should seek healthy ways to relieve stress through exercise, balanced eating, plenty of sleep and maintaining a positive mental attitude.

 

Medication

In some cases, your dentist may recommend short-term medication to help relieve symptoms. Your dentist may prescribe a painkiller, anti-inflammatory, anti-anxiety agent, sedative or muscle relaxant. Take medication only as directed. Your dentist will be happy to answer any questions you may have regarding medication. Read the Consumer Medicine Information which most prescription medicines have in the box.

 

Orthodontic treatment

Millions of adults around the world – many who never had the opportunity to improve their teeth as youngsters – are now getting braces or invisible liners to correct their malocclusion.

 

Specialist Management

If pain and dysfunction are severe and chronic and initial conservative treatment has not been effective in relieving symptoms and restoring jaw function, your dentist may refer you to a specialist.

 

See a dentist if you suffer from headaches

If you suspect that you have a temporomandibular joint (TMJ) dysfunction or suffering from headaches, you should see your dentist for an examination. Your problem can often be alleviated by correcting your bite and by prescribing a mouth guard to prevent teeth grinding while sleeping. Reducing or eliminating sources of stress and stopping habits such as teeth grinding can also help. Don’t let the stress of life take a toll on your oral health. Having a healthy mouth can mean having a healthy body and that is a resolution everyone should make. 

THE LINK BETWEEN STRESS AND HEALTH

 

THE LINK BETWEEN STRESS AND HEALTH

 

Stress can be defined as the way you feel when you’re under too much pressure.
 All sorts of situations can cause stress. The most common involve work, money matters and relationships with partners, children, family members or work partners. Stress may be caused either by major upheavals and life events such as divorce, unemployment, moving house and bereavement, or by a series of minor irritations such as feeling undervalued at work or dealing with difficult children. 

 

How stress affects your health

When you are stressed, your body produces more of the so-called ‘fight or flight’ chemicals, called adrenaline and nor-adrenaline which prepare your body for an emergency. Adrenaline and nor-adrenaline raises your blood pressure, increases the rate at which your heart beats and perspiration. All of these changes make it easier for you to fight or run away, which was extremely useful to the human race in past times.

Unfortunately these changes are less helpful if you are stuck in a busy office or on an overcrowded train. You cannot fight or run away, and so cannot use the chemicals your own body has produced to protect you. 

Research suggests that a moderate amount of pressure can be positive, making us more alert, helping to keep us motivated, and making us perform better. 

However, too much pressure, or prolonged pressure, can lead to stress. Stress and health are closely linked. Over time these chemicals and the changes they produce can damage your physical and mental health. 

For example, you may start to experience headaches, and indigestion. You may breathe more quickly, perspire more, have palpitations or experience  symptoms such as headaches, muscle spasms, constant tiredness, dizziness, sleeping problems, nail biting and lack of appetite. Over longer term you may be putting yourself at risk from high blood pressure, heart attacks, strokes, impotence and may also affect your immune and nervous system. Stress is known to worsen many immune related medical conditions, such as diabetes. Cortisol produced during stress situations may suppress the body’s immune response, increasing susceptibility to infectious diseases. 

 

Stress leads to destructive behaviors

Studies also show that individuals with high stress levels tend to increase their bad habits, which can be harmful to periodontal health. They are less attentive to their oral hygiene and may engage in destructive behaviors such as smoking, alcohol or drugs abuse and fall into eating disorders (unhealthy dietary habits), all which can have a negative effects on oral health.  

 

 

How does stress affect your oral health?

Constant stress, anxiety and depressions can affect oral health in several ways. 

 

Bruxism

This refers to forceful grinding or clenching of the teeth, often unconsciously, during the day or at night during sleep.  The exact cause of bruxism is uncertain but stress is considered one of the factors contributing to this habit. The condition has been linked to work stress and personality type. People that, are shy, apprehensive and given to worry, tended towards bruxism. Many people who brux their teeth may not be aware that they are doing so. However, those who sleep with them may be able to hear their bruxing. 

 

Clenching or grinding can lead to problems like: cracked teeth,  sensitivity of teeth,  flattened or chipped appearance of the teeth, headaches,  tiredness of the jaws on waking, and jaw or facial pain. When combined with erosion (the effects of acids on teeth from diet or other sources), bruxism can have devastating effects on teeth and may require extensive corrective treatment.

Treatment for bruxism includes the use of mouth guards/splints and relaxation techniques such as meditation. For more information on bruxism you can visit the following website: (http://www.nlm.nih.gov/medlineplus/ency/article/001413.htm )

 

Dry mouth

Dryness of the mouth can be caused by stress. More often, it may be caused by medications taken to relieve stress, anxiety or depression. Reduced saliva in the mouth  can have many consequences such as: 

 Reduced taste and reduced appetite

 Increased tooth decay because of lack of protection offered by saliva

 Difficulty in wearing dentures because of lack of lubrication offered by saliva

 Increased plaque accumulation and consequent increased gum disease

 

Reduced resistance, poor hygiene and gum infections

People under stress are less likely to eat well, sleep well or be interested in daily hygiene practices. Hence their general resistance to infections fall. The mouth is a place where infection can easily occur. Even periods of exam stress have been found to be associated with increased infections of the mouth, for example around impacted or emerging wisdom teeth.

Stress is also associated with an increased susceptibility to gum infections. While more research is needed to explain the specific role stress plays in gum disease, it is speculated that the hormone cortisol may play a role. When experiencing stress, the body releases increased amounts of cortisol, which can be harmful to the gums and surrounding bone tissue. This damage can cause bone loss which eventually leads to tooth loss.

Aphthous ulcers(canker sores),  burning mouth syndrome, are worsened during times of emotional stress.

HEALTHY LIFESTYLE BEYOND THE SMILE

 

HEALTHY LIFESTYLE BEYOND THE SMILE

 

Healthy teeth and gums are more than just an aesthetic or hygiene issue, it’s a quality of life issue.  Aesthetics are only part of the story when it comes to the importance of oral health and well-being. Healthy teeth, pink gums, and fresh breath―surefire signs of good oral hygiene practices― aren’t just for the vain. A healthy smile tells the world all about us.  

The health of gums and teeth are important and can have wide-reaching effects on overall health.  The same bacteria that cause cavities and gum infection can ultimately devastate other systems in your body as well―systems that your body relies on to function effectively. 

Link between healthy mouths and healthy bodies

Research shows there may be a link between gum disease and other health problems such as diabetes, heart disease, and stroke. When your gums are in good shape, bacteria are prevented from entering the rest of your body. But when you have gum disease, those pockets of space between your teeth and gums allow bacteria to enter your bloodstream potentially causing problems throughout your body. 

Once bacteria are in the bloodstream, they can cause inflammation of arteries that can affect  your heart and other organs. Bacteria irritate arteries in the same way that they irritate gum tissue, causing arterial plaque accumulations that can lead to hardening of the arteries and decreased blood flow. Arterial plaque and blood clots that becomes loose and travels to other parts of your body can cause a stroke. 

 

The systemic link between poor oral health and the health of the rest of your body has even expanded into a disturbing correlation to increased cancer risk. A study conducted last year by the Harvard School of Public Health and the Dana-Farber Cancer Institute showed a link between gum disease and pancreatic cancer, the fourth leading cause of cancer deaths in the United States. 

Although scientists are only just beginning to understand this link between healthy mouths and healthy bodies, dentists are proactively encouraging people to take their oral health seriously and to make it a regular part of a healthy lifestyle.

 

Smoking and Sleep Top the List of Lifestyle Factors Affecting Oral Health

There are many lifestyle factors other than tooth brushing and flossing that can affect a person’s oral health. A  recent study conducted in Japan, identified smoking and lack of sleep as the most significant  lifestyle factors that has an affect on periodontal (gum) health. High stress levels and daily alcohol consumption also demonstrated a significant impact on gum disease progression. Simple lifestyle changes, such as getting more sleep, less alcohol consumption and eliminating smoking, may help patients improve or protect their oral health.  

Take oral health seriously - Follow best healthy lifestyle practices

To maintain healthy teeth and a healthy mouth, you can take the following best practice steps. By following these simple steps and encouraging others to do so as well, will not only significantly increase your chance of having a lifetime of good oral health,  but will also ensure a better overall health.  

Get a regular check-up from your dentist

Everyone should visit their  dentist and oral hygienist regularly to have their mouth and teeth examined. Parents are encouraged to take their children for their first dental visit  by age one or within six months of the appearance of the first teeth.  Adults should see a dentist every six months for an examination and cleaning.  This will help prevent problems and stop small problems from getting worse.  Individuals who are pregnant or who have periodontal disease, diabetes, HIV infection, or some other health conditions may need to see a dentist more frequently.  It is also important to have the mouth as healthy as possible prior to the start of any radiation therapy to the head or neck or prior to any heart valve, knee or hip replacement surgery.     

 

Periodontal risk assessment

Warning signs of gum disease may include: puffy, red, sore, shiny or sensitive gums, bleeding when you brush or floss, bad breath that won’t go away. Red gums that bleed easily when you brush or floss are a sign that a visit to the dentist should be tops on your to-do list. Loose or separating teeth and persistent bad breath are signs that the disease is making its way to the supporting tissues of your teeth.  Left untreated, gum disease will ultimately lead to permanent tooth loss. You should see your dentist immediately if you notice or experience any of these problems. 

Sometimes the only way to detect gum or periodontal diseases is through a periodontal evaluation. A periodontal evaluation may be especially important if you: have heart disease, diabetes, osteoporosis, receiving chemotherapy for cancer, or are thinking of becoming pregnant. 

To find out if you are at risk for periodontal (gum) diseases, please visit the following web site for a free risk assessment test (http://www.perio.org/consumer/4a.html). 

 

Practice good oral hygiene 

Brush and floss your teeth at least twice a day. Brushing and flossing in the morning and before you go to bed is key to removing any bacteria and plaque in your mouth that can lead to tooth decay and gum disease. No matter how expensive or high-powered your toothbrush is, only floss will reach areas in between teeth where dangerous plaque accumulates. Use an antibacterial mouthwash to kill bacteria in your mouth and help keep your breath fresher. 

 

Eat a healthy balanced diet

Good health requires good nutrition, but if you don’t have strong teeth and healthy gums, your ability to eat properly is diminished. Your choice of foods becomes restricted, and you may have difficulties getting all the nutrients you need. Lack of a balanced diet leads to chronic infections of the mouth, putting strain on the body’s immune system

 

Avoid social activities that can harm oral health

Avoid activities such as smoking, oral piercing and recreational drugs that might harm your mouth or teeth. 

It’s important to know that all types of tobacco including cigarettes, cigars and chewing tobacco are harmful for your oral health. In addition to containing nicotine ― which is addictive ― they have been all been known to cause: gum disease, tooth loss, oral cancer, lip, tongue, pancreatic cancer and esophagus, colon, bladder, voice box cancer

Almost 75% of gum disease in adults is caused by smoking. Also, your gums may recede as a result of smoking. This may lead to tooth decay and an increased sensitivity to hot and cold food and drinks.
 Read more about this topic on the following website: (http://www.youroralhealth.ca/content/view/100/141/#smoking) 

Use a mouth guard

People who participate in any sporting activities that might pose a risk of injury to the mouth and/or teeth are recommended to wear a mouth guard for protection.  Preventing a tooth injury or other mouth injury is much less expensive than the cost to repair such an injury.   

 

Check your mouth regularly

Check your mouth regularly to become familiar with what is normal for you. This will help you recognize when something in your mouth looks or feels different or abnormal.

Warning signs of oral cancer may include: numbness and tingling

open sores that don’t go away within a week to 10 days, unexplained bleeding, lumps or thickening on the bottom or sides of your tongue, cheeks, or roof of your mouth. If you notice any of these signs, or have any concerns, call your dentist immediately.

 

Healthy teeth and gums -  a great investment in quality of life 

Poor oral health can negatively impact not only your physical health but also your social and emotional well-being.  Maintaining good oral health, is essential to your ability to eat, talk, taste, chew, and smile effectively.

Feeling better, looking better, eating better all add to the quality of your life. The more you take care of your teeth and gums now, the less you’ll spend on them in the future. No matter how old you are, how devoted you are to your trusty toothbrush, or how big your fear of the dentist is, be sure to maintain that beautiful smile of yours throughout your lifetime. Not only will you look spectacular, but you’ll increase your overall vitality and well-being.