Bruxism, Joint pain, and Biting problems

– Do you feel headaches, face, neck, ears, shoulders… and not sure why?

– Do you grind your teeth or notice your jaw tightening while you sleep?

– When you open your mouth do you hear noises or popping in the jaw or the ear?

– Do you feel a lot of pain and difficulties to chew or when you wake up in the morning? Do you have a hard time opening your mouth all the way?

If you experience any of these problems it is likely to be due to some functional impairment of the masticatory system (muscles, joints, nerves, teeth).

This condition is common in over 50% of the population. Problems such as TMJ (Temporomandibular Joint) can produce significant limitations in masticatory and phonatory functions.

Its origin can be varied but it is clinically proven to be linked to tension, stress, and changes in the position of the teeth.

One of the most common types of pathology is Bruxism. It is a habit of clenching and grinding the teeth and usually occurs during sleep. It leads to irreversible tooth wear as it is like eating ice whilst sleeping. 

Normally, Bruxism is the excessive grinding of teeth while sleeping. Patients may experience jaw pain, joint, or cheek muscle fatigue in the morning. People who share the same bedroom might hear the grinding sound at night. However, patients might not aware of their own condition.

However, patients often turn to their dental clinic due to the symptom of acute pain, as the effect on the temporomandibular joint or the muscles of mastication also radiates to the face, ear, head, and neck.  More than 50% of the headaches, or head and neck strains have this etiology.

Symptoms of TMD

• The pain of the joints (next to the ears) and/or pain of the jaw, cheek, and temporal
• Limitation of mouth opening, pain when opening the mouth
• History of jaw lock
• Clicking sound when opening and closing the mouth
• Deviation of the jaw when opening, pain when chewing
• Some patients experience pain in the ear cavity, headache or migraines

Causation of TMD

The causation is unclear. However, TMD might be caused by multiple factors.

• Malocclusion
• Disharmonization of occlusion. For instance, removal of the molar which causes tooth tipping to space and leads to malocclusion.
• accident to the joint
• The unbalanced function of the muscles due to chewing on one side
• Chewing hard sticky food or chewing bubble gum frequently
• Bruxism
• Stress

In normal joint movement, condyles normally move with articulate discs. However, in disorder condition, the articular disc displaced to the front while the condyle displaces backward. In the mouth opening, the condyle slips over the disc making a “click” sound. When the mouth closing, the condyle gets back to the former position making another “click”. Without proper treatment, this condition might get worse.

At Kitcha Dental Clinic, Chiang Mai, we are specialists in the treatments for teeth grinding (bruxism). The treatment mainly uses an occlusal splint or night-guard.

However, with our technologies, the x-ray of the joints could be done digitally. Furthermore, the CT scan could be used for a diagnostic of joints.

And also, the occlusion adjustments are assisted by the intraoral scanner technology.

Patient self-care before seeing the specialist

1. Refrain from eating hard, sticky or crunchy food. Avoid chewing gum. Take a soft diet. Limit mouth opening. Do not bite on big chunk food.
2. If waking up with muscle pain causing limited mouth opening (1-2 fingers width), use three fingers( index, middle, and ring fingers) to massage and press down on the muscle for 15-30 minutes. After, apply hot compress with a towel soaked in lukewarm water for another 15-20 minutes. These treatments will release pain and increase mouth opening.

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