It’s That Time of Year Again… or Why Teenage Patients Have More TMJ Problems in the Springtime
Every spring without fail our office receives an increased number of phone calls from patients (current and former) asking to be seen for suddenly appearing jaw pain. Parents report that the teenagers have pain in their jaw that wasn't there before and they are now experiencing trouble eating, studying, and sleeping. This happens at the same time every year and it is no coincidence. The last few weeks of April and the first couple weeks of May are the busiest and most stressful time of the year for our student patients. They have papers, projects, tests, graduation, and other end-of-year responsibilities that weigh heavily on their minds (and bodies!). This added stress affects the way they sleep, eat, and especially how they use their chewing muscles. When I examine these patients, almost without fail their pain is in the muscles overlying the lower molars and NOT in the actual joint capsules which are located up right in front of the ears. Sore soreness in the chewing muscles suggests that para-functional habits (i.e. clenching and grinding) are the culprit and not actual problems with the joints themselves (i.e. inflammation or degeneration).
The first step to recovery for students experiencing jaw discomfort is to recognize that their pain is probably related to the stressful time of year. Sometimes just realizing that they are clenching or grinding is enough to help them stop. The next easiest thing to do is to take an over-the-counter pain medication like Advil or Tylenol. Third, patients can perform some simple physical therapy on their own jaw by placing their elbow on their knee, making a fist with their hand, and resting their chin on their fist. In this position the patient should perform three or more set of 10 reps where they open hard with their mouth while pushing their chin against their fist. This opening exercise contracts the mouth opening muscles and allows the muscles that are sore (from overuse) to relax. Finally, if none of these home remedies alleviate the discomfort, patients can have a professional night guard made that will change the bite and protect the teeth.
The good news is that once this time of year passes, we see most of these problems go away just as fast as they came. Good luck to all of our patients as they finish another year school!
For the latest on the relationship between orthodontics and TMJ, check out this lecture by the most respected expert on occlusion in the world, Dr. Jeffrey Okeson. He is not an orthodontist and has no motivation to protect orthodontists. he just reports the facts.
NOTE: The author, Dr. Greg Jorgensen, is a board-certified orthodontist who is in the private practice of orthodontics in Rio Rancho, New Mexico (a suburb on the westside of Albuquerque). He was trained at BYU, Washington University in St. Louis, and the University of Iowa in the United States. Dr. Jorgensen’s 25 years of specialty practice and 10,000 finished cases qualify him an expert in two-phase treatment, extraction and non-extraction therapy, functional orthodontics, clear aligners (Invisalign), and multiple bracket systems (including conventional braces, Damon and other self-ligating brackets, Suresmile, and lingual braces). This blog for informational purposes only and is designed to help consumers understand currently accepted orthodontic concepts. It is not a venue for debating alternative treatment theories. Dr. Jorgensen is licensed to diagnose and treat patients only in the state of New Mexico. He cannot diagnose cases described in comments nor can he select treatment plans for readers. Because he has over 25,000 readers each month, it is impossible for him respond to all questions. Please read all of the comments associated with each article as most of the questions he receives each week have been asked and answered previously. The opinions expressed here are protected by copyright laws and can only be used with written permission from the author.