Sedation Dentist serving High Point, Greensboro, Winston-Salem and the Triad area.


(Special note to patients, this’subject can be very complicated and is meant to inform you of the complexity when’trying to self-diagnose. The help of a professional is seriously advised in this area. Consult your dental professional for further advice.)

TMJ is not a medical condition; it is a joint that articulates the lower jaw to the base of the’skull. The part of the lower jaw that articulates with a disk that articulates with the skull is called’the condyle. There is a’disk between the rounded joint and the base of the’skull, so unless you have a worn disk there will not be a’direct bone to bone contact. The condyles can come under extreme stress when the mouth is crushing food, the patient is clenching or grinding, or because of oral habits like nail-biting, or chewing gum, and trauma. A small muscle attaches in the front part of the disk and pulls it forward when the lower jaw translates forward, and damage to the’disk or slipping of the disk compromises the area between’the muscle and the disk and causes pain.

Any disorder to the condyles, disk, or muscles supporting chewing is called temporomandibular disorder (TMD), and this is the correct way to talk about problems in this area. TMD can strike at any time in life but seems to show up aft er a traumatic event or during a time of increased’stress. Close to 90 percent of TMD is a result of muscle’spasms and can be corrected with physical therapy, bite’splints, and medications. The remaining disorders may have to be treated surgically or may continue as part of a’systemic condition’such as arthritis.

TMD can also trigger other headaches as your body recruits other muscles to move the head and neck. Headaches can also come from referred pain from areas called “trigger points.” Headaches can be caused by infections, high blood pressure, trauma, bouts of migraine, tumors, teeth coming together in unfavorable ways (malocclusion), and physiological processes that are still being investigated.”Your dentist may request tests, refer you to a specialist, or try to treat dental conditions that may be aggravating your condition. When there is pain in the head and neck region of non-dental origin, care should be taken to rule out the presence of tumors.

Facial pain refers to any of the conditions that cause abnormal and painful conditions in the head and neck region.”There are dentists who limit their practice to this area, and’they are very well informed and can diagnose and treat many conditions. Th ere are many medical specialists who’specialize in the treatment of chronic pain, and they use many forms of therapy to help patients.

Chronic pain often has a psychological component, so referral to a professional for counseling is not uncommon when treating facial pain.

 

Chapter 13: Root Canals, Apicoectomies, and Extractions