Jaw pain

Jaw pain can come from many different anatomic structures. Jaw pain can come from muscles, bones, ligaments, and from nerves. The history of your jaw problem, combined with a full examination and images (x-ray and/or MRI) helps us to know which problems affect you and to decide which care is better. Wheter it’s splint therapy or dental equilibration (or in some rare cases, surgery) the diagnosis is the basis to make the best decision.

Malocclusion / bad bite

Malocclusion can be defined as a poor relation between the upper and lower teeth.

A malocclusion can be obvious, for example if the teeth are crooked, or it can be more subtle as when people do not have a stable position to close their teeth together, or when there is more pressure on one side than the other.

What you need to understand is that appart from the possible aesthetic defect, any malocclusion, whether big or small, has the power to create muscle tension that can make your bones, your muscles and your joints wear and/or degenerate faster than normal.

Clicking jaw and crepitus

In the jaw, exactly like in the knee, you have a cartilage that we call meniscus (or disk). When the disk displaces anteriorly, it gets stuck between two bones, and when the lower jaw moves, we sometimes hear a clicking noise, that tells us that the disk is out of place.

There are many people for whom the meniscus are displaced from their natural position. This displacement can trigger many consequences, including : poor jaw growth, clicking jaw, jaw pain, muscles tension, misalignment, etc.

Some TMJ clicking can be painful, others are not. It does not matter if you are symptomatic or not, the situation deserves specific attention. A displaced disk can move even more and create jaw/joint degeneration which can lead to a crooked mouth and pain.

We usually equilibrate the dentition or fabricate an equilibrated night guard to reduce the pressure off the joint to reduce the risk of future damage.

Bruxism or muscle hyperactivity

Forever humans have been grinding their teeth. It is normal and natural to bruxe a little. But when we damage our teeth, muscles, bones, joints, nerves, or when we have pain, bruxism becomes a problem. Today, we know 6 possible causes for bruxism or muscle hyperactivity : malocclusion, problematic joints, centrally disordered (from the brain), sleep apnea, some medications and stress level.

There are ways to counter: we can protect from the effects or influence the cause.

We will typically use an equilibrated splint, a dental equilibration, stress level control, medication, physiotherapy, etc.

If your teeth are severely worn, we can also rebuild them with porcelain crowns.

Locked jaw : open or closed

Closed

• The main reason why people get a locked jaw is the displacement of the disk that locks in the joint. We solve the blocking jaw by manipulation (physiotherapy), with medication, an equilibrated splint, a dental equilibration or more rarely with surgery.
• The second reason why the jaw will lock is muscular spasms. The body is thus made, that when a joint becomes ill, painful or inflammed, the muscles can spasm to protect and stop most movement. Physiotherapy is the first thing to do. We combine physiotherapy with an equilibrated occlusal splint, a dental equilibration and the following recommendations:
  
  Tips
  
  • Good tongue posture (on your palate)
  • Eat softer food
  • Avoid biting your nails
  • Drink maximum 1 coffee per day and avoid energizing drinks and other products containing caffeine
  • Minimize alchool consumption
  • Avoid to clench or put your teeth together
  • Exercises program
  • Moist heat application
  • Minimize or stop definitely your nicotine consumption
  • Good quality of sleep

Open

• The jaw locks open when we open too wide, and it « comes out » of its socket. We have to relax and manipulate the jaw to set it back in place. To minimize the risk of locking again, bite correction is recommended.

Clenching

Clenching has mostly same origin as bruxism. However, it is more subtle because there is little or no noise, but almost as much damage. The solutions are the same as for bruxism, a bite splint and/or a dental equilibration.

We can also rebuild the worn teeth.

Osteoarthritis of the jaw

Often, people will talk about arthritis or osteoarthritis of the jaw. By definition, arthritis originates from a systemic problem which means that it’s a disease that originates from the body. Arthritis of the jaw is quite rare. On the other hand osteoarthritis is very frequent. However, the term osteoarthritis is vague when we talk about the jaw. The diagnosis must be more precise to know how things will evolve and know what care to provide.

We can treat with medication, rest, bite splint, dental equilibration, surgery, all according to the case and its severity.

Worn, fissured and fractured teeth

Almost everyone has wear and tear on their teeth. On the other hand, if a little wear can be normal and even tolerated, it can rapidly become excessive if we clench or grind.

When we clench or grind, the applied force is excessive and then, consequences can occur. You can see your teeth getting worn, fissured or fractured.

Many people break fillings, natural teeth, or break crowns because of clenching or bruxism. Many people have little fissures in their teeth. Those are signs of excessive applied forces. It is, in all cases, essential to protect the teeth from this destruction. The dental consequences of clenching or bruxism can be prevented by a bite splint, a dental equilibration or with restorations when the wear is important.

Teeth with receding gum

Gum recession may have many causes : toothbrush, orthodontic treatment, excessive lateral pressure on the teeth. It is more and more obvious that receding gums frequently origin from teeth clenching and⁄or grinding. It is the lateral force exerted during clenching and grinding that causes the receding. We help to protect the teeth from receding gums with a bite splint or a dental equilibration.

Small jaw – receding or fleeing chin

Small or recessed jaws come either from genetic or poor development. Evaluating the origin of the problem will be done by X-ray and by MRI of the jaw.

A crooked jaw comes from either sub-growth on one side, which causes the deviation of the jaw, or an excess growth on one side, which also causes the deviation of the jaw.

We need to assess if these problems need to be treated, and if so, many solutions are available like orthodontic treatment or surgical treatment.

Abfraction – hollow or notches in the teeth, near the gums

When the teeth are sensitive near the gums, or if they have notches that you can feel with the tip of your nails, it’s because of micro-fractures due to excess pressure. This is called an abfraction.

We treat the abfraction itself by placing a white filing in the notch. We should also treat the excess pressure with a bite splint or a dental equilibration.

Tooth pain – sensitivity to cold, hot, sweet

Sometimes, teeth can be sensitive or painful without apparent reason. Also, teeth with gum recession can be sensitive or painful to cold, hot or sweet. In every case, the most frequent cause of pain⁄ sensitivity is the irritation of the nerve of the tooth that comes from “occlusal trauma”. This occlusal trauma happens when a tooth is under more pressure than the others, or it can happen if you clench or grind your teeth. To ease that kind of pain, you can use toothpaste for sensitive teeth, but eliminating the excess pressure with a bite splint or a dental equilibration remains the basic care you should get for long term relief.