Globally, 70-80 per cent of people complain of an occasional headache, but in 30-40 per cent the pain is a huge problem. In Poland, the scale of the phenomenon is very similar. Out of ten patients who come to our clinic, eight suffer from severe headaches. They have usually been or are being treated by a neurologist, psychiatrist and several other specialists. They are subjected to many tests that show nothing. In cases where there is no cause and the patient still has a headache, migraine is very often diagnosed. Meanwhile, the truth is that these statistical eight patients suffer from bruxism and/or disorders or dysfunctions of the temporomandibular joints.

Theatrical anecdotes tell of opera singers who, while singing an aria, opened their mouths wide and then could not close them. Such incidents, commonly referred to as "jaw dropping", are rather comical, although not at all funny. And they happen not only when the singer takes a high C, but also, for example, when yawning.

Closing the mouth wide-open is then accompanied by pain and unpleasant noises: crackling, clicking, popping. They are a sign of temporomandibular joint dysfunction (dssż), a malfunction of the joint connecting the upper and lower jaws.

All because of the puck...

The malfunction of the temporomandibular joint, which manifests itself in pain when opening and closing the jaws and in the noises made by the jaw joints, is due to the incorrect position of the lower jaw in relation to the upper jaw and the displacement of a piece of cartilage called the articular disc. Its malposition causes it to stop cushioning the movements of the lower jaw, or mandible, and the temporal bone.

Important, unusual, busy

When we talk about joints, we mean knees, elbows, hips....

The temporomandibular joint somehow escapes our attention. Perhaps this is because it is unusual in several respects, different from the joints of our musculoskeletal system: it is formed by a single bone, the mandible, a mobile bone of the skull, and the temporomandibular joint is the only one that is functionally and anatomically conjugated.

The temporomandibular joint, a complex system of bones, joint discs, ligaments and muscles, is meanwhile very important, often used, essential for, among other things, speaking, taking in and chewing food. It has a complex structure, and this means that its condition affects its overall well-being. It is responsible for moving the jaw forwards, backwards and sideways.

It connects the lower jaw to the skull, and consists of the articular hollow of the temporal bone, the articular process (condyle) of the mandibular head, the articular disc and the articular capsule.

In a healthy temporomandibular joint, this disc always remains between the condyle and the articular fossa. Together with the disc, the condyle of the mandibular head moves on either side. The proper functioning of the joint and the correct position of the disc ensure that the muscles of the head, neck and shoulders work well.

The disc itself is not innervated, but when properly positioned it prevents compression of the nerves and blood vessels in the joint when the jaw is closed. The effect of the compression unbalances the entire joint structure, which in turn affects the nerves, ligaments and muscles of the head, neck and face, bringing pain within them, often confusingly similar to a migraine.

Where does this come from

Disorders of the function of the temporomandibular joint have a variety of causes - from missing teeth, malocclusion and postural defects, improperly made dentures, a tendency to gnash and clench teeth (BRUSHISM), to degenerative changes and pathologies within the joint with or without displacement and blockage of the disc. A separate group of causes is also trauma - to the head or jaw and any situation in which the head is suddenly thrown forward and backward. This is the so-called whiplash injury in traffic accidents. Intubation procedures prior to operations in hospitals also sometimes prove to be indifferent to the function of the joint. Forced opening of the mouth and overstretching of the ligaments and other tissues due to the need to insert a tube into the patient's airway can displace the mandible and interfere with the function of the joint.

Treatment essential

Dysfunctions of the temporomandibular joint mean more than mere discomfort, but can promote the development of many diseases and serious conditions, including permanent destruction of the joint. They therefore require medical attention.

Treatment methods include the administration of painkillers and anti-inflammatory agents, physiotherapy (e.g. ultrasound, heat and cold treatment), as well as the wearing of special appliances, so-called plates or bite splints reducing the harmful effects of clenching the teeth, relaxation techniques allowing the patient to control the tension in the jaw muscles, the state of the teeth - healthy teeth, well-made restorations, orthodontic treatment is the starting point for treatment, and often also a condition for the efficiency of the temporomandibular joints.

The most common symptoms of dssj:

• migraine-like headaches, earaches, pain and pressure behind the eyes,
• a popping or cracking sound when opening and closing the mouth,
• pain when yawning, opening the mouth wide or chewing,
• "limping", blocking or prolapse of the mandible,
• soreness of the jaw muscles,
• sudden change in the mutual position of upper and lower teeth.

Do you have a temporomandibular joint disorder:

• Do you grind your teeth or clench them?
• Do you have frequent headaches and/or neck pain? Does the pain increase when you clench your teeth?
• Do you wake up with sore, tightened masseter muscles?
• Do you grit your teeth under stress?
• Do you find it difficult to open your mouth wide (e.g. when biting into an apple, yawning, singing)? Do you feel resistance or a blocked jaw sensation?
• When you open your mouth, do you feel a click in your joints, hear crackling, rustling or rubbing?
• Do you have a feeling that a tooth is loose or too high?
• Do you have problems with other joints?
• Are your teeth damaged, worn down, loose?

If you answered yes to most of these questions, you have a temporomandibular joint disorder.

If this is the case, we suggest you visit Klinika Unident Union, where dentist Iwona Gnach will answer your questions and help you eliminate the problem. In the meantime, we suggest what you should do to survive the period before the visit:

• Relax your muscles by keeping your jaws apart. Learn to recognise when you are clenching your teeth. Have opposing teeth connected only when you are eating or swallowing.
• Maintain correct posture. When we have correct posture, our head, neck, jaw is in the right position.
• Eat soft foods such as eggs, boiled vegetables, soups. Do not chew gum! Avoid hard foods e.g. nuts, raw carrots (grate them before eating)
• Reducing stress and relaxing more often!
• Using cold or warm compresses. Both relax the muscles and relieve pain. Your doctor will advise you on how and when to apply them.
• Exercise. Your doctor will recommend appropriate exercises to relax the masseter muscles and strengthen the opposing muscles.
• When the pain is persistent you can take painkillers, anti-inflammatory or diastolic medicines. Your doctor will prescribe the appropriate medication for you.