Temporomandibular Joint and Facial Pain Center

Teeth clenching and grinding is an involuntary activity that can occur at night and/or during the day. It is observed in the great majority of adults and often goes unnoticed without producing any noticeable adverse symptoms. Conditions that bring the patient to the physician include tooth sensitivity, wear, looseness and fracture, necrosis of the dental nerves, injury to surrounding tissues, temporomandibular disorders, headache and dysfunction. Teeth clenching and grinding observed in children is evaluated as a normal process.

Causes of Teeth Clenching and Grinding

Teeth clenching and grinding has many causes, including factors such as stress and personal characteristics, sleep patterns, breathing disorders during sleep, traumatic injuries, central nervous system disorders, illegal drug use, drug treatments, alcohol, caffeine and smoking.

What Is Temporomandibular Disorder?

Temporomandibular disorder is a complex condition encompassing problems affecting the system made up of the masticatory muscles, the temporomandibular joint, part of the head and neck muscles, the joint ligaments, the teeth, the cheeks, the lips and the salivary glands. The number of patients who consult dentists with complaints of temporomandibular joint disorder increases every year. The reason for this increase is not that this condition did not exist before, but that dentists and ear, nose and throat specialists have increased their knowledge on this subject and are now able to diagnose these conditions.

What Are the Symptoms of Temporomandibular Disorder?

Temporomandibular (jaw) joint disorder has many signs and symptoms. Some of these signs and symptoms are:

• Pain that starts suddenly or develops gradually in the area in front of the ear, in the temporomandibular joint, in the facial and neck muscles and in the temples,
• Feeling of pain and fatigue in the face,
• Pain and fatigue while chewing or speaking,
• Difficulty yawning and opening the mouth,
• Clicking or popping sounds when opening and closing the mouth,
• Limited mouth opening or jaw locking,
• Opening of the jaw with deviation to one side,
• Swelling of the face,
• Tooth pain,
• Feeling that the teeth do not close normally,
• Ear pain,
• Ringing in the ears,
• Hearing problems in the ears,
• Headache,
• Pain and pressure around the eyes,
• Dizziness.
• Pain related to the masticatory muscles is caused by excessive activity of these muscles during teeth clenching and/or grinding; they can also cause head, neck and headache. Pain related to the temporomandibular joint, however, is caused by changes in the hard and soft tissues within the temporomandibular joint.

What Are the Causes of Temporomandibular (Jaw Joint) Disorders?

Temporomandibular joint disorders have multiple causes and include many conditions affecting this region. The general view is that several factors together give rise to the condition. Some of these factors are;

• Direct trauma to the jaws (accident, blow, sports injuries, falls, collisions),
• Dental treatments requiring the mouth to be kept open for a long time,
• Excessive opening of the mouth during general anesthesia,
• Activities such as teeth clenching and/or grinding, lip biting, nail biting, gum chewing,
• Abnormal relationship between the lower and upper teeth.

How Is It Diagnosed?

What is important in the diagnosis of temporomandibular joint disorders is that the dentist has the skill and knowledge to accurately evaluate these data and establish the differential diagnosis. The clinical examination of these disorders takes approximately 30-35 minutes. After obtaining the necessary information from patients regarding health problems and oral diseases, the specialist dentist attempts to reach a diagnosis through a detailed examination including the temporomandibular joint and head and neck muscles. If necessary, MRI or other imaging methods may be used for diagnosis.