A guide to understanding and treating temporomandibular disorder

Also known as temporomandibular joint disorder, this baffling and painful condition makes the hinges of your jaw ache, often when you wake up and when you chew or yawn. Sensible lifestyle changes are your best bet for easing the discomfort.

Temporomandibular disorder (TMD) is a common, but often mysterious, affliction of the joints that connect your jaw to either side of your head just in front of your ears.

• By touching these spots as you open your mouth, you can feel the joints move. If you suffer from TMD, however, you don't have to use your fingers to find the spots: pain will probably do it for you.
• You may also feel pain in your ears, neck or shoulders, especially when you chew or yawn. And because the joints are so close to your ears, you might also hear odd popping, crackling or grating noises when your jaw moves.
• In more severe cases, you may even feel as if your jaw is unhinged, your upper and lower teeth are out of alignment or your mouth won't open.
• No matter how severe your symptoms are, don't panic. TMD is frequently a temporary problem that resolves itself over time. Unless your jaw pain is a rare case caused by arthritis or an anatomical problem, derangement of the bones due to disease or injury, or by a birth abnormality, your symptoms are simply telling you that the muscles around your joints are tight and inflamed.

No one has yet discovered the underlying causes of temporomandibular joint inflammation, but its triggers are well known.

• These include emotional stress, a recent injury to the jaw and bad postural habits, such as holding the handset between the side of your head and your shoulder when you talk on the phone or thrusting your chin forward when you work at a computer.
• You're also more likely to develop TMD if you grind your teeth when you sleep or if your teeth don't come together properly when you bite down, which dentists call a malocclusion. Even chewing tough foods like beef jerky or dried apricots can contribute.
• And if you're female, you're also at greater risk. Three times as many women as men complain about TMD symptoms to their doctors or dentists, so hormones may also play some role in the disorder.

• Resting the jaw (soft foods, no gum chewing).
• Heat or cold to ease stress and discomfort.
• Aspirin or ibuprofen to reduce pain and muscle inflammation.
• A visit to a dentist or doctor for an evaluation if self-care measures don't work.

• Stop gnawing. If you routinely bite your fingernails or chew on pencils, here’s a good reason to drop a bad habit: giving your mouth a rest is the best way to give TMD the boot.
• Dispense with your pillow. Until your jaw feels better, try sleeping on your back or on your side without a pillow. This will distribute your body weight more evenly.
• Go to a pain clinic if you don't get relief with self-help measures or medical treatments your doctor or dentist recommend. Pain clinics, which are usually associated with hospitals or universities, are also a good source for second opinions for TMD treatments.

• To find a specialist who can help with your problem, contact the Canadian Dental Association (1-800-267-6354 or www.cda-adc.ca).

TMD can be incredibly painful, if left untreated. Keep this guide in mind and find relief by making simple lifestyle changes.