The Link Between TMJ and Headaches

Millions of Americans suffer from frequent headaches and millions more suffer with Temporo-mandibular Joint  (TMJ) Disorder.  For many people, there's a direct link between the two. Read on for a TMJ primer and tips for how to alleviate TMJ-related headaches.

The temporo-mandibular joints are located on either side of your head, right in front of your ears.  It's where your lower jawbone connects with your skull to let you yawn, talk, eat, and make facial expressions.  Sometimes, the bones that make up this joint get out of alignment, wear down, get injured or become irritated from chronic teeth grinding or jaw clenching.  When that happens, some patients develop TMJ disorder (AKA TMJ dysfunction). According to the National Institutes of Health, Dental and Craniofacial Research (NIDCR), symptoms for TMJ Disorders include:

  • Radiating pain in the face, jaw, or neck,
  • Jaw muscle stiffness,
  • Limited movement or locking of the jaw,
  • Painful clicking, popping or grating in the jaw joint when opening or closing the mouth,
  • A change in the way the upper and lower teeth fit together.
  • Myofacial pain in the face, temple and neck
  • Headaches

TMJ-related headaches cause pain in the area around the ear and temple.  Chronic muscle tension in this area can extend the headache to the back of the head and/or sinus area.  In fact, many patients think they suffer from "sinus headaches" or neck problems only to find out later, their problem is centered in their temporo-mandibular joints.

How do they find out? TMJ disorders are usually diagnosed by a dentist,  neurologist, craniofacial specialist or primary care physician.  Doctors don't know exactly why patients develop TMJ disorders.  Sometimes, patients can connect their pain with a specific incident like an accident.  Usually, however, they can't.  Diagnosing TMJ can be very challenging for both patients and doctors because they reach their diagnosis only after ruling out other common causes for headaches. The TMJ Association says:

Currently there is no scientifically validated test available to correctly diagnose TMJ disorders. Because the exact causes and symptoms are not clear, identifying these disorders can be difficult and confusing. Currently, diagnosis is based on patient's description of symptoms, history and examination of the head, neck, face, and jaw.

Some doctors order x-rays or other forms of radiologic testing to look closely at the bones that make up the TMJ.  But an article published in the Journal of Oral Rehabilitation says radiologic tests aren't necessary or effective in diagnosing TMJ dysfunction, because they don't often show a direct cause for the disorder.

How is TMJ treated? 

Sometimes, TMJ headaches go away on its' own.  If that doesn't, however, doctors may prescribe:

  • Over-the-counter or prescription pain medication,
  • Muscle relaxants,
  • Anti-depressants,
  • Corticosteroid injections
  • Botox injections to temporarily paralyze the muscles.

Dentists may prescribe:

  • Nighttime bight guards to prevent grinding or clenching.
  • Braces and other corrective dental devices.

Cognitive Behavioral Therapy is often effective to reduce stress that can make pain worse. Surgery is saved for the last resort, but the NIDCR considers TMJ surgery to be controversial and recommends that it be avoided whenever possible.

If you think TMJ disorder could be causing your headaches, talk to your dentist or doctor and find out what treatments might be effective for you.

Sources

Journal of Oral Rehabilitation

A Petersson

Volume 37, Issue 10, pages 771-778, October 2010

National Institute of Dental and Craniofacial Research

TMJ Disorders

http://www.nidcr.nih.gov/nidcr2.nih.gov/Templates/CommonPage.aspx?NRMODE=Published&NRNODEGUID={53FD7A9D-B819-4CE4-8AFB-65BBD352BD26}&NRORIGINALURL=%2fOralHealth%2fTopics%2fTMJ%2fTMJDisorders.htm&NRCACHEHINT=Guest#diagnosed