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Neither headache nor toothache, it’s TMJ syndrome

The dull ache in Sue’s left cheek led her to the dentist’s office, where she figured that at best she would need a cavity filled and at worst, root canal. She was surprised to learn that her teeth were fine—and to be referred to a medical specialist. Sue turned out to have temporomandibular joint syndrome, or TMJ syndrome. Working with her doctor, she found that a combination of medication and lifestyle changes—not oral surgery—was the key to relieving the pain.

TMJ syndrome affects women in their childbearing years more than men. Most cases of TMJ syndrome are muscular rather than joint related. The pain is produced when the muscles used for chewing go into spasm. This spasm is commonly caused by clenching or grinding of the teeth (often while sleeping), or a poor bite.

The TMJ joint itself can be the problem. Subtle displacement of the joint by an injury to the head, neck or face also can cause the syndrome.

Just as the causes of TMJ syndrome can differ, so too can the symptoms. Pain may be dull or shooting. It may feel like a toothache or a headache, or the pain may be centered around the cheek or the ear. Sometimes the sufferer can hear the joint popping as the mouth opens and closes. Sometimes the mouth can barely be opened.

Treatment varies according to the causes and severity of symptoms. If the problem is muscular, then appropriate actions may include massaging the muscles, eating soft foods that require little chewing, applying moist heat to the cheeks and taking muscle-relaxant medication. Some patients benefit from wearing a bite splint, a device rather like a dental retainer, which prevents clenching and grinding of the teeth during sleep. Braces or other orthodontia may be needed. Only in severe cases is surgery needed. If you have pain that may point to TMJ syndrome, a good starting point is to call your healthcare provider for a referral.