TMJ (TemproMandibular Joint)

For some of us, our stress shows itself in our jaw. Clenching (pushing the teeth tightly together) or grinding (moving the teeth while they are in contact with each other) are two common results. You may hear these two ideas combined into the term bruxism or bruxing. Clenching and grinding not only cause problems to your teeth, they can also affect your jaw joint too. The jaw joint is called the tempromandibular joint or TMJ for short. It is located near your ear. If you’re having problems with your TMJ, you might also hear the term TMD (TemproMandibular Dysfunction).

Clenching and grinding can happen at any time of day but often we do them at night while sleeping. We may not even be aware of them unless someone else tells us they hear us grinding or the dentist notices signs of the problem or our TMJ decides to let us know.

Clenching or grinding of teeth does leave some evidence behind. Your dentist might see flat spots on your teeth (called wear facets) where certain teeth rub together. There may also be flattened areas or pits where “points” of your teeth should be. Some teeth may even develop a dished out or bowl like appearance on the chewing surface or a “V” shaped notch at the gumline. In extreme cases, your tooth may become shorter due to loss of your tooth structure. Sensitive teeth can also occur if chewing surface enamel is lost or due to the “V” shaped areas at the gumline.

Some teeth develop what dentists call microfractures—small cracks that are virtually undetectable in their early stages. The earliest sign is a twinge when eating certain foods or chewing a certain way. The pressures of clenching or grinding may worsen these microfractures and cause the tooth to break, in the same way that if you keep bending a paperclip in the same spot, the paperclip eventually breaks because the metal gets weak. Teeth that break in this way often need crowns. Some may need root canals in addition to the crown.

While it is true that some people do have clicking or popping of their TMJ without pain or problems eating, sometimes bruxism does cause the TMJ to flare up. You may experience difficulty opening wide, pain, or other bothersome symptoms that make it difficult to eat. It is possible that these symptoms will go away on their own, particularly if you try to rest your TMJ by eating soft foods that don’t require much chewing, trying not to open wide (yawning etc.) and taking anti-inflammatory medication such as Advil or Aleve.

If the symptoms do not improve or you are noticing a lot of damage to your teeth, you may want to ask your dentist about a custom-made appliance to help with your TMJ symptoms and to protect your teeth from wearing down due to grinding. There are also TMJ exercises that your dentist may recommend. In severe cases, physical therapy (PT) or massage therapy may be helpful also.

*Note: The information in this article is not meant to replace the clinical judgement of your healthcare professionals.

Dr. Robb is a general dentist who is accepting new patients. You can make an appointment by calling 440-960-1940.