Patient Query TMJ Dysfunction

I experience discomfort in my jaw in front of Conventional remedy:

I experience discomfort in my jaw in front of Conventional remedy:

You may be suffering from a condition known as temporomandibular joint (TMJ) dysfunction. This is caused by an abnormal movement of the jaw bone in its socket at the base of the skull, just in front of the ears. Although it can be caused by dental problems, in many cases there may be no obvious cause.

As you describe, there is usually discomfort or pain in the jaw to the front of the ear, especially when eating. A clicking noise can also occur with jaw movements. Some people may feel the pain in the temples or cheeks.

For most people it is not particularly serious and usually responds well to treatment. During an acute episode it is best to rest the jaw as much as possible and take care particularly when eating.

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Avoid opening your mouth wider than the thickness of your thumb. Cut food into small pieces and do not bite into food with your front teeth. Avoid chewing gum. Try and open your jaw in a hinge or arc movement, taking care not to protrude your jaw. Do not clench your teeth, as this will exacerbate the problem. When sleeping, try to lie on your back, so not to put pressure on your jaw.

You should arrange to be examined by your doctor to confirm the diagnosis. If the pain continues to be severe, muscle-relaxant medication can help to relieve the associated muscular spasm.

If TMJ is being caused by dental problems, visit your dentist. You may need treatment to correct the bite, and he will also advise you on suitable strengthening exercises to help this condition.

Dr Muiris Houston

Alternative remedy:

Pain in the temporomandibular joint (TMJ) comes mainly from stress trauma (physical manifestation of stress) or muscular tension.

The pain you experience may come directly from a muscular or ligament strain, joint wear and tear or, possibly, a derangement of the articular disc in the joint.

Proper alignment of the jaw is essential, and whiplash-type injuries. Tension in the jaw muscles is common, which again may come from misalignment of teeth or be caused by stress. Many patients with TMJ dysfunction habitually grind their teeth when they are anxious.

The osteopath can help to restore normal functioning of the TMJ and relieve pain by working with the patient's head and neck posture, reducing tension in the jaw muscles. This allows the joint to be aligned properly and the articular disc to move freely, which in turn reduces wear and tear in the joint. It is achieved by gentle mobilisation of joints or muscular stretches. Stress factors must also be addressed.

In many cases, the help of a dentist is required to evaluate the alignment or misalignment of the teeth. Orthodontic care may be needed.

Co-operation between osteopath and dentist is often very useful, as reports suggest a holistic osteopathic approach will in some cases reduce or eliminate the need for orthodontic and dental attention.

Karl Prendergast, osteopath

The Irish Osteopathic Association can be contacted at 5 Devon Place, The Crescent, Galway (091-589417 or e-mail karlp@iol.ie)

In last week's alternative remedy for hypothyroidism, by the nutritionist Maria Costello, the final paragraphs should have read:

"Tea and fluorinated or chlorinated drinking water should be avoided as these block iodine receptors.

"I would also advise her to reduce her workout levels to 15-20 minutes of aerobic walking a day. It may be that her hypothyroidism is a residual effect of hormonal stress brought on by her pregnancies."