Temporomandibular Joint Disorder
Temporomandibular joint disorder is quite a mouthful--hence, doctors and patients alike refer to it as TMD. But if you've got it, pronouncing TMD is about the easiest thing your jaws can manage.
TMD (formerly known as TMJ) is best known for its intense and debilitating pain in the temporomandibular, or jaw, joint, located in front of your ears (where sideburns are). But other ailments fall under the rubric as well: "TMD is actually a broad description for a lot of different problems in the entire facial area," says Wilmington, Delaware, dentist Barry Kayne, D.D.S., clinical assistant professor at the University of Pennsylvania School of Dental Medicine and Temple University School of Dentistry, both in Philadelphia, and a TMD specialist. "More frequent symptoms include pain in the temple, in the cheeks, behind the eyes, in the back teeth or in the throat. There may also be a popping or clicking of the jaws, neck stiffness, stuffiness in the nasal passages, ringing in the ears and migrainelike headaches ... really bad pain throughout the entire face."
Whether brought on by growth problems, arthritis or trauma (whiplash, a sock in the jaw or other types of stretching and pummeling), TMD is common: As many as one in three people have it in some form. Sometimes TMD causes occasional jaw pain. For other people, it may be the root cause of earaches or unexplained headaches. Many people with full-fledged TMD suffer from headache--the kind of headache that creates a terrible pain in the sideburn area. If you suspect that you have TMD, here's how you may ease your discomfort.
Give your jaw R and R. "The best home remedy for TMD is to manage your jaw as you would manage a bad knee that's been injured: Provide as much rest for the area as possible, and avoid aggravating the area," says Dr. Kayne. That means you should avoid all unnecessary jaw movements when you're talking or eating. And you should avoid the extensive jaw movements that go along with singing or even yawning.
Stop that yawn. If you feel a yawn coming, restrict it by placing your fist under your chin, advises Andrew S. Kaplan, D.M.D., director of the TMJ/Facial Pain Clinic at Mount Sinai Hospital and associate clinical professor of dentistry at Mount Sinai School of Medicine, both in New York City.
Protect yourself from Old Man Winter. "You should always wear a scarf and hat during cold weather," says Dr. Kayne. "You want to keep your head and neck as warm as possible in order to maintain good blood flow." With good blood flow, he points out, there's less inflammation and less muscle pain.
Unclench your teeth. If you clench your teeth, as do many people who have TMD, pructice this tactic: Place your tongue behind your top front teeth so that it rests against the roof of your mouth, suggests Owen J. Rogal, D.D.S., director of the Pain Center, a multidisciplinary medical center in Philadelphia, and past executive director of the American Academy of Head, Facial and Neck Pain. This position helps separate your top and bottom teeth and relaxes your jaw.
Here's why it helps: Many people react to stressful situations by clenching their teeth, according to Dr. Kayne. "Although stress doesn't cause TMD, it certainly aggravates it," he says. "Making a conscious effort to keep your lips together and your teeth apart in stressful situations certainly helps if you have TMD." (For more tips on how to stop clenching or grinding your teeth, see page 000.)
Position a pillow ... so you sleep on your back. Sleeping on your side or stomach puts pressure on one side of your jaw--and that causes TMD pain, says Dr. Kayne. He recommends a special cervical pillow that will help keep you on your back. "A doctor or physical therapist can tell you the best thickness for you; for most people, it's medium," says Dr. Kayne.
Try the rolled towel insurance. Here's another way to make sure you sleep on your back: "Take a bath towel, fold it up several times, and put it behind the bend of your knees," suggests Dr. Kayne. That way, your knees are bent. "It's a good way to help ensure you're sleeping on your back," says Dr. Kayne.
Straighten your posture. Desk jockeys are particularly vulnerable to TMD neck pain, because they often sit at their desks with their chins jutting forward, Dr. Rogal observes. He advises that if you have a desk job or do a lot of sitting, you should stand up every hour of so and straighten your posture.
Take a pain reliever. Aspirin is a "marvelous" drug for any muscle or joint problem-including TMD, says Harold T. Perry, D.D.S., Ph.D., past president of the American Academy of Craniomandibular Disorders and professor of orthodontics at Northwestern University Dental School in Chicago. Ibuprofen products such as Advil are also recommended. "If you go that route, take aspirin or ibuprofen three or four times a day for 10 to 20 days," says Dr. Kayne. "But be consistent. Once you start, don't interrupt taking the pain reliever unless you notice stomach irritation. And also take a pain reliever after a meal." (And remember not to give aspirin to children because of the risk of Renee's syndrome.)
Eat soft. Whenever TMD acts up, your diet should calm down. "Don't eat anything chewy, crunchy or hard for 6 to 12 weeks," says Dr. Kayne. "That means everything you eat should be cooked or baked. Eat only very ripe fruits and vegetables. No gum, nuts, pizza, bagels, rolls, steaks--nothing that works your jaw." After ten days on a soft diet, you should notice some relief. However, Dr. Kayne advises continuing for a full 12 weeks. "If your condition doesn't improve substantially after that, see your doctor," he says.
Get heated up. When your jaw, head or neck feels achy, apply a heating pad to ease pain. The heat increases blood flow and helps break up muscle pain, according to Dr. Kayne.
Or cool down. When the pain comes along in hard spasms, icing the area is the prescribed therapy, says Dr. Kayne. "Put an ice bag on for ten minutes, then remove it for ten minutes--and continue this process for an hour," he says. Make sure that the ice bag is wrapped in a towel. Note: A bag of frozen vegetables works just as well.