Jaw pain: what causes it?


My jaw has been clicking since an extended visit to the dentist some months ago. Sometimes my jaw hurts, feeling as if top and bottom are wired together, and sometimes it hurts on yawning and chewing but nothing that isn't fixed by an over-the-counter painkiller. My GP gave me 10mg amitriptyline but it made me so dopey in the mornings that I gave it up. A course of Indian head massage helped my general inability to relax. But I never know with a minor joint condition like this if I should exercise my jaw by chewing or rest it by eating baby food? Are there any long-term, negative effects of this kind of problem, or is it best to just learn to live with it, take the occasional aspirin and keep clicking? How much does it really matter?

Dr Fred Kavalier answers your health question:

The click in your jaw is coming from your temporomandibular joint (TMJ), and technically you have a condition called TMJ dysfunction. The TMJ is the joint between your jawbone and your temporal bone (which is part of the skull). It is quite a complicated little joint, which is capable of withstanding the incredible muscular force that is needed to chew food. Inside the TMJ, there is a tiny cartilage, similar to the cartilages that are inside the knee joints. Every time you open and close your jaw, the cartilage slides forwards and back. If the cartilage gets bruised, torn or stretched, it fails to stay in the right position. The click occurs as it slips back into its correct position as you open and close your jaw. If the cartilage fails to return to its normal position, you may find that your jaw gets partially locked temporarily. TMJ dysfunction only matters because it can be painful and it can interfere with chewing. It often gets better without any specific treatment. The best advice is to be gentle on your TMJ, and avoid any chewing that exposes it to intense muscular forces. Chomping on big, crispy, raw apples and day-old French bread will only make things worse. But it is certainly not necessary to restrict yourself to baby food. Taking the odd aspirin or ibuprofen is a good idea. Tense people seem to get more TMJ problems, so anything you can do to relax will also help. If you want to see a tiny cartoon movie of what is happening inside your TMJ, have a look online at www.rad.washington.edu/tmj/anatomy.html.

Please mail your questions for Dr Fred to health@independent.co.uk. He regrets that he is unable to respond personally to questions.

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