Welcome to the No-Yawn Zone!

Dunkleosteus Jaw, by Travis S. via Flickr

My jaw hurts. Moving my right jaw joint has been painful since Saturday. But, I’m not trying to write a blog post to whine about my life. I swear. Instead, as I began to research why my jaw could suddenly start hating me for no particular reason, I stumbled upon a complex, confusing medical diagnosis that effects quite a few American women: TMJ disorders.

TMJ stands for Temporomandibular Joint. This is the joint that functions as the hinge where your lower jaw (the mandible) connects to the temporal bone, the portion of the skull in front of your ears. The joint’s inherent flexibility allows you to chew, chat, and most importantly, yawn, pain free, when life gets really boring or your caffeine levels drop.

Image from National Institute of Dental and Craniofacial Research at the NIH

Pain in the Temporomandibular Joint affects more than 10 million Americans, according to the National Institute of Health.  Interestingly, the joint pain seems to be significantly more common in women than in men, and occurs frequently in people between ages 20 to 40 (Uh-oh, sounds like me). For many patients, the TMJ pain is temporary, and for others, chronic, severe pain requires surgical treatment.

So, why does this critical joint suddenly become painful? Unfortunately, science does not yet have the answer. According the the National Institute of Dental and Craniofacial Research, a branch of the National Institute of Health:

Trauma to the jaw or temporomandibular joint plays a role in some TMJ disorders. But for most jaw joint and muscle problems, scientists don’t know the causes. For many people, symptoms seem to start without obvious reason. Research disputes the popular belief that a bad bite or orthodontic braces can trigger TMJ disorders. Because the condition is more common in women than in men, scientists are exploring a possible link between female hormones and TMJ disorders.

The roles of stress and tooth grinding as major causes of TMJ disorders are also unclear. Many people with these disorders do not grind their teeth, and many long-time tooth grinders do not have painful joint symptoms. Scientists note that people with sore, tender chewing muscles are less likely than others to grind their teeth because it causes pain. Researchers also found that stress seen in many persons with jaw joint and muscle disorders is more likely the result of dealing with chronic jaw pain or dysfunction than the cause of the condition.

Great- sudden onset jaw pain for no real reason. But, even though the jaw rebels without a cause, it still hurts. The symptoms of TMJ disorders pain and tenderness in the face and jaw joint area, pain when chewing, inability to open the mouth fully, a tendency of the joint to stick or lock, clicking or popping sounds, and a tired and/or swollen face. (Full symptom description from WebMd here) There is no official diagnosis for TMJ problems, because there is no official understanding of what causes the disorders.

To treat this poorly understood pain, the NIH recommends basic steps to ease the stress on your sore joint; soft foods, minimal yawning, ice packs, lifestyle stress reduction, and over the counter pain killers (Mmmm….right now I’m taking Vitamin I….also known as ibuprofen). Dentists and doctors can also recommend jaw physical therapy type exercises. However, it is really hard not to yawn. In fact, the more you read about yawning, or think about yawning, the more likely you are to feel the urge to yawn. And stifling a yawn sucks. But really, yawning is a topic for another post (Did you yawn yet? It’s contagious)

Beyond these intuitive treatments, there are many more extreme, controversial procedures used to treat TMJ pain.  WebMd lists low level laser therapy, electrical nerve stimulation, radio-wave therapy, and ultrasound treatment. WebMd also describes three surgical techniques, used for different types of TMJ pain, but cautions that these surgeries are permanent, and that patients should get second or third opinions from medical professionals before signing up to go under the knife. To the contrary, the NIH website states that:

Irreversible treatments that have not been proven to be effective – and may make the problem worse – include orthodontics to change the bite; crown and bridge work to balance the bite; grinding down teeth to bring the bite into balance, called “occlusal adjustment”; and repositioning splints, also called orthotics, which permanently alter the bite…. Surgical treatments are controversial, often irreversible, and should be avoided where possible. There have been no long-term clinical trials to study the safety and effectiveness of surgical treatments for TMJ disorders. Nor are there standards to identify people who would most likely benefit from surgery.

Although WebMd certainly implies caution about these surgical procedures, the way the NIH describes the complete absence of strong data that proves the merits of these therapies certainly scared me away from ever considering them. However the NIH mentions on-going research using the world’s deadliest poison, botulinum, also known as Botox, to paralyze muscles that may be malfunctioning and causing the joint pain. Not yet proven or approved.

Bummer. But, I’m probably getting a little bit ahead of myself. I have a dentist appointment next week, so I’ll get an official perspective then, if my TMJ is still angry. I can still eat and talk, thank goodness, because those are two of my absolute favorite hobbies.  I am favoring soup and this delicious full-fat cottage cheese I splurged on. And taking enough Vitamin I to keep the joint pain and associated headache down. I’m interested to learn more about these poorly understood pain symptoms, but I’m even more interested in mine going away. Hopefully soon, I’ll have strong, happy jaws again!

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One thought on “Welcome to the No-Yawn Zone!

  1. Hi Kate, I have TMJD and would be happy to talk to you about it at our next datavis meeting. Good news is people usually improve over time. Hope you feel better soon!

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