Mouth 'On Fire': Help for the Often Misdiagnosed Condition TMD

May 24, 2023 – Dental symptom is nan worst. It tin travel seemingly retired of obscurity and interfere pinch eating, drinking, and mundane activities. But what happens erstwhile nan symptom is not needfully successful your teeth but, rather, astir your face, jaw, and neck? 

Shane G., a 40-year-old finance head based successful Austin, TX, is painfully alert of nan distinction. After sitting successful what he explained was an highly stressful gathering astatine his agency 1 day, he decided to return his laptop to a barroom and decorativeness his activity complete a hoops crippled and a beer.

“I took a sip of beer, and it was for illustration nan corners of my rima were connected fire,” he said. “It was sharp, crisp symptom pinch power attached to it; location was intelligibly thing wrong.” 

The type of symptom Shane was emotion is much commonly known arsenic orofacial symptom and includes complete 30 types of temporomandibular disorders (TMDs) – conditions that impact nan 2 joints that link nan jaw to nan skull (temporomandibular joint), arsenic good arsenic nan jaw muscles and tissues. 

About 5% to 12% of nan U.S. organization has TMDs. Because they are difficult to diagnose and tin overlap pinch different conditions, patients often embark connected what whitethorn look for illustration an endless quest to find relief. 

Fortunately for Shane and others for illustration him, location are self-directed strategies that tin thief easiness nan misery.

He was capable to group up an emergency assignment pinch a knowledgeable dentist who suspected that nan rumor was his jaw muscles. After taking X-rays and measuring for a nighttime defender to reside imaginable grinding and clenching, Shane was referred to a massage therapist. Not only did she place nan guidelines of his pain, but he was capable to find immoderate grade of alleviation aft 1 session.

Not everyone is arsenic fortunate.

There are “practitioners who’re conscionable unfamiliar pinch nan test and a small excessively speedy connected nan trigger to supply irreversible treatment,” said Clifford Chow, DDS, an orofacial symptom master astatine nan Center for Orofacial Pain and Dental Sleep Medicine and an subordinate professor astatine nan University of California-San Francisco School of Dentistry. 

“Unfortunately, pinch nan delay, nan conditions tin alteration and things tin get worse and much difficult to treat,” he said. 

Often Misdiagnosed

Even though they aren't rare, orofacial symptom disorders are often missed aliases mistaken for different conditions by dentists and doctors. And TMDs often travel on pinch different conditions, specified as fibromyalgia and migraines, making test moreover much difficult.

“In dentistry, we person this saying: If you perceive hoofbeats, deliberation horses, not zebras,” said Lisa Crafton, DDS, a dentist successful backstage believe successful Columbia, MD. 

For “the mostly of group who travel successful pinch facial pain, astir of it is muscular,” she explained. “And I consciousness that astir group person it aft an section of stress. Or for some, it could beryllium 2 weeks aft a stressful incident and past each of a sudden, their jaw is sidesplitting them.”

“If you deliberation of a skull, nan little jaw is held successful by muscles,” Crafton said. “So, I ever commencement by thinking, OK, let’s effort muscular release.”

Katie Pudhorodsky, an Austin, Texas-based licensed massage therapist pinch a attraction successful head, neck, and jaw work, has treated Shane and countless others pinch TMD pain. Pudhorodsky has go a go-to for galore dentists who, for illustration Crafton, admit nan musculus constituent in certain TMDs correct away.

Massage tin often thief reside nan symptom linked to 2 of nan astir communal TMDs: myofascial symptom (discomfort aliases symptom successful nan connective insubstantial and muscles controlling nan jaw, neck, and shoulders), and myalgia (muscle symptom that has to do pinch jaw activity – for example, successful nan masticatory muscles, which let you to chew food). 

Pudhorodsky explained that TMD symptom shows up successful a assortment of ways and is often referred, meaning that it hurts successful areas different than nan nonstop location of nan jaw muscles, joints, and tissues. Symptoms see headaches, cervix symptom aliases stiffness, bony pain, sinus pain, a emotion of fullness successful nan ears, ringing successful nan receptor (tinnitus), numbness, and/or tingling. 

The cosmopolitan acquisition is that astir of nan patients Pudhorodsky sees successful her believe are looking for relief.

“They’ve brought this speech up pinch their dentist aliases their aesculapian supplier that they person pain, and they get nan runaround. They get moved astir from master to master until personification says, ‘Hey these muscles are tight; possibly that’s a portion of nan puzzle,'” she said. 

Nataly S., a 32 year-old interrogator from Austin, said that she landed successful Pudhorodsky’s agency aft she had abrupt jaw symptom and what she described arsenic “jaw clicking.”

“I was going done a peculiarly emotionally stressful time,” she said, arsenic she reflected connected nan experience. “I went to my dentist, who recommended that I get a rima guard. But he besides asked maine what my symptoms were, really agelong it had been going on, and said that I would use from TMJ-specific massage.”

Nataly sewage alleviation aft 1 convention pinch Pudhorodsky and continued to do her exercises doubly daily.

“By nan extremity of nan week, nan symptom was gone,” Nataly said.

Four Pillars of Relief

Pudhorodsky sees patients successful personification but besides offers elaborate acquisition and exercises online. Most of her activity is geared toward helping group execute and support muscular alleviation and is based connected 4 pillars: 

• “Pillar 1 is to relax nan muscles and trim trigger points. And that’s done done massage and stretching,” she explained. “This tin beryllium done by a master aliases by yourself astatine home.
• Pillar 2 is to retrain nan muscles that were engaging; these exercises are besides utilized to stabilize nan bite. 
• Pillar 3 is to support due oral resting posture. “That’s looking astatine due oral resting posture. We want our lingua up onto nan tile of our mouth, lips together and somewhat apart,” Pudhorodsky said. 
• And “pillar 4 is to reside bad habits of use; this is erstwhile you commencement to extremity making those bad patterns from continuing on.”

Managing Expectations

Like different symptom conditions, TMDs are analyzable and look otherwise successful different patients. Massage is not nan reply for each type aliases for each person. But by releasing tight muscles and retraining nan joints to move successful a much balanced way, massage tin thief hole portion of nan problem, easiness pain, and, arsenic Pudhorodsky explained, “make room for healing.” 

Chow said patients should beryllium proactive and inquire whoever is treating them what their test is. 

“If they conscionable opportunity that they person a TMD, that’s not a diagnosis; it’s a wide word of disorders, and they’re often nan ones that could miss something," he said. "They person to beryllium much circumstantial successful nan test and much circumstantial successful nan treatment.”