What Causes TMJ
TMJ is an acronym for Temporomandibular joint. The term is used to describe a much broader network of problems that relate to the jaws. We will use the term TMJ from here but it is good to note that TMD (Temporomandibular Disorder) is a more accurate term to describe “TMJ”. Nonetheless, TMJ is a disorder that manifests about the jaws and it has a variety of manifestations/symptoms. Some people will have all of these symptoms and others will have just a few or even just one.The symptoms are:
- Chronic headaches
- Jaw Pain
- TMJ noises (popping or clicking sounds)
- Limited Opening
- Ear Congestion
- Neck Pain
- Ringing in the Ears
These symptoms are almost always caused by muscles in the jaw that are overworking. This is about muscles! If you have TMJ symptoms then, as an experiment, try to bring your lower jaw straight forward and hold it there for a moment. If you feel tightness or soreness or tenderness then that is confirmation that you have TMJ dysfunction and that muscles that should be relaxed are working excessively. It’s a sure sign that your lower jaw is forced to be too far back due to your dysfunctional bite. Why do muscles in the jaw overwork?
In almost all cases of TMJ muscles in the head and neck area overworking as a result of a bite that forces the lower jaw to be in an improper and position. Typically, it’s because a person’s bite is too far back. Their lower jaw has to work too hard in order to go into that person’s “bite”. If your arm is sitting by your side passively as you walk down the street then the muscles in the arm and shoulder will be relaxed. But, say if you clenched your fist and flexed your arm so that your forearm was parallel to the ground and walked down the street like this for long periods. Your arm would soon become fatigued, maybe sore…and if you do this long enough it may spasm and become painful. The same is true of jaw muscles that are required to pull the jaw back from what should be a state of relaxation. NO muscle in your body should be tight or sore (unless you were working out at the gym the night before). The same is true of muscles that control the jaw. They should be in a relaxed state when you are not chewing or talking and they will be if your “bite” doesn’t require excessive muscle work to hold the jaw back. All of us should have totally relaxed jaw muscles when we are at rest and we should have bites that only require our lower jaw to come straight up from that relaxed position until our upper teeth touch. If that is the case then there will be no need for the muscles that pull the jaw back to ever overwork. For people with TMJ problems their jaw muscles are always working… Yes, if you grind your teeth during the day or night those muscles may have to work even harder but even if you do not grind your teeth those muscles will be tight and they will be holding your lower jaw back in close proximity to where your bite is and you won’t even be aware of the fact that your muscles are doing this subconsciously. Keep in mind that as a compensatory effort when muscles in the jaw get fatigued other muscles in the area (head, neck, shoulders) will try and assist in taking the load and they will become fatigued, painful, etc.. This is why we get headaches, neck pain, etc., as an ancillary affect of the bite being in the wrong place.
Imagine if we were able to relax the muscles of the jaw and neck. We can do this using a ULF/Tens unit that sends pulses to the muscles in the area we chose over the course of an hour and it acts to relax the muscles. Imagine now if those muscles are relaxed fully and we see that the jaw comes down and forward. That is invariably what happens to jaws when you place their supporting muscles on a Tens unit. The lower jaw (the mandible) relaxes and comes forward. It comes to the natural place of relaxation and neutrality. You want your jaw to be in a state of neutrality when not in use….If your in a proper physiologic bite then you should be able to let your jaw come straight up that relaxed position and you should then find that your lower teeth fit perfectly into your upper teeth. This is a balanced, physiologic bite that will not cause muscles to overwork and it will not provoke TMJ symptoms. This is the “bite” that everyone should be in…one where the jaw is fully relaxed when not in function and then when asked to close into the bite there is a simple closure along that trajectory into the bite. This bite will also render the best facial proportions esthetically and it will produce the best standing airway.
If, however, from that relaxed position you have to use muscles to pull the jaw back into your neck in order for your teeth to fit together then your bite is pathological and not in the position it should be from all physiology standards. The truth is that our bites and our jaw and facial development are the area of the body MOST influenced by developmental and environmental factors. If we are chronic mouth breathers, have allergies, are thumb suckers, have limited tongue mobility (tongue tie) or from several other contributory factory, our bites will deviate from their normal, factory settings and we will be at high risk for TMJ disorders, compromised airways and less than ideal facial proportions.
Almost all patients I see with TMJ problems have retruded lower jaws! This usually manifests as an “overbite” where the upper front teeth are excessively further forward than the lower front teeth. The lower jaw in this case is retruded (set back) from where it should be.