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In The News


Julie Watkins, St. Luke's Hospital



The temporomandibular joint (TMJ) is the part of your lower jaw that connects to the skull. Problems in this area may be called TMJ syndrome or temporomandibular joint dysfunction (TMD) and include pain not only in the jaw but also in the surrounding muscles that control jaw movement.

Injuries to this area may occur due to trauma, grinding the teeth or teeth clenching.

Over 10 million Americans are estimated to experience problems in this area, with women in their childbearing years accounting for up to 90 percent of the cases.

Several factors may help to explain why women develop these problems more often than men. Stress may lead to clenching or teeth grinding. Women are also more likely to develop arthritis, accounting for a large percentage of TMJ problems, and those with fibromyalgia also have TMJ pain.

Scientists are currently looking at a link between estrogen and TMJ dysfunction; therefore, women using hormone replacement therapy or oral contraception can be at a higher risk.

In addition, the collagen that holds the disk in the joint structure of the jaw is thought to be slightly different in women versus men, placing the female jaw at a higher risk of dislocated disks which can later cause a TMJ dysfunction.

Lastly, vitamin deficiencies are more common in women, which may explain why women in their childbearing years are more often affected.

Common symptoms may include problems with chewing or popping sounds in the jaw, headaches, dizziness or ringing in the ears, pain in the jaw joints, face, neck or shoulders, muscle spasms, trouble opening or closing the jaw or lockjaw or swelling on the side of your face.

Your dentist may screen for problems in this area and suggest exercise, a joint injection, pain medication, physical therapy, a dental appliance or surgery as a last resort. It is always recommended that patients with this problem avoid eating hard or sticky foods, reduce stress and avoid extreme jaw movements.

Physical therapy intervention can include hands-on techniques to correct joint movement and muscle imbalances, massage, modalities for pain control such as ultrasound and electrical stimulation, suggestions for eating strategies, corrective exercises and corrective dental appliances to reduce grinding or clenching.

Julie Watkins is a physical therapist with Brain & Spine Therapy Services, part of the Brain & Spine Center at St. Luke's Hospital. For more information regarding treatment of TMJ dysfunction, call 314-205-6551.

This article was published in the St. Louis Post-Dispatch on May 15, 2014.