Oro Facial Pain Clinic

Oro Facial Pain Clinic

Temporomandibular Disorders (TMD) :

It occur as a result of problems with the jaw, jaw joint and surrounding facial muscles that control chewing and moving the jaw. These disorders are often incorrectly called TMJ, which stands for temporomandibular joint.

What Is the Temporomandibular Joint (TMJ)?

The temporomandibular joint (TMJ) is the hinge joint that connects the lower jaw (mandible) to the temporal bone of the skull, which is immediately in front of the ear on each side of your head. The joints are flexible, allowing the jaw to move smoothly up and down and side to side and enabling you to talk, chew, and yawn. Muscles attached to and surrounding the jaw joint control the position and movement of the jaw.

What Causes TMD?

The cause of TMD is not clear, but dentists believe that symptoms arise from problems with the muscles of the jaw or with the parts of the joint itself. Injury to the jaw, temporomandibular joint, or muscles of the head and neck – such as from a heavy blow or whiplash – can cause TMD. Other possible causes include:
  • Grinding or clenching the teeth, which puts a lot of pressure on the TMJ
  • Dislocation of the soft cushion or disc between the ball and socket
  • Presence of osteoarthritis or rheumatoid arthritis in the TMJ
  • Stress, which can cause a person to tighten facial and jaw muscles or clench the teeth

What Are the Symptoms of TMD?

People with TMD can experience severe pain and discomfort that can be temporary or last for many years. More women than men experience TMD, and TMD is seen most commonly in people between the ages of 20 and 40. Common symptoms of TMD include:
  • Pain or tenderness in the face, jaw joint area, neck and shoulders, and in or around the ear when you chew, speak, or open your mouth wide
  • Pain or tenderness in the face, jaw joint area, neck and shoulders, and in or around the ear when you chew, speak, or open your mouth wide
  • Limited ability to open the mouth very wide
  • Jaws that get “stuck” or “lock” in the open- or closed-mouth position
  • Clicking, popping, or grating sounds in the jaw joint when opening or closing the mouth (which may or may not be accompanied by pain) or chewing
  • A tired feeling in the face
  • Difficulty chewing or a sudden uncomfortable bite – as if the upper and lower teeth are not fitting together properly
  • Swelling on the side of the face
  • May occur on one or both sides of the face
Other common symptoms of TMD include toothaches, headaches, neck aches, dizziness, earaches, hearing problems, upper shoulder pain, and ringing in the ears (tinnitis).

How Is TMD Diagnosed?

Because many other conditions can cause similar symptoms to TMD – including a toothache, sinus problems, arthritis, or gum disease – your dentist will conduct a careful patient history and physical examination to determine the cause of your symptoms.

Sleep Apnoea & Snoring

  • Sleep apnoea is when a person stops their breathing for prolonged periods or breathes insufficiently during sleep. Left untreated, it can result in interrupted sleep, fatigue, a lack of focus during the day, and, in more extreme cases, hypertension, depression, and, an increased chance of heart disease.
  • While snoring can often be overlooked, it also can lead to similar problems, as well as sleep apnoea itself. Studies have shown that snoring can thicken the arteries that take blood to your brain, increasing the likelihood of vascular disease. Rather than being a mere annoyance, snoring be a sign of more serious health problems.


As apnoeas occur when you’re asleep, it’s far more likely for your partner or family to notice them than yourself. They’ll also be the best source of information for many of the common symptoms of sleep apnoea, including overly loud snoring, or choking or snoring whilst asleep. But there are many symptoms that you can identify in yourself. These include:
  • Frequent sleepiness or fatigue during the day
  • Restless or fitful sleep
  • Waking repeatedly throughout the night
  • Feeling out of breath, tired, or very thirsty upon waking
  • Tossing and turning at night
  • Grinding your teeth at night
  • Waking up with headaches


The most common cause of sleep apnoea is an obstruction in the throat. When we sleep, our muscles naturally relax; but in case of sleep apnoea, the muscles relax too much or in the wrong way, causing the soft tissue around the neck to collapse and block the airway. This is particularly worse when your lower jaw is small and held back. Poor posture, such as a forward head position, can affect the throat muscles, as well as force your jaw back, placing further pressure on your airways. Sometimes sleep apnoea and snoring can also come from obstruction at the nose and the base of the tongue and these must be properly diagnosed for successful treatment.


What is Bruxism?

The habitual, involuntary grinding or clenching of the teeth, usually during sleep, as from anger, tension, fear, or frustration.

About 50-95% of the population are bruxers, half of whom become chronic enough to require treatment. Bruxism can occur at any time, but it’s most common at night while sleeping. Because it happens during sleep, most people don’t know they brux until their dentist tells them that they are showing signs of bruxing. Often a spouse or family member hears the grinding sound. When diagnosed early, teeth grinding can be treated before it causes permanent damage to the teeth.

How do I know if I grind my teeth?

There are several telltale signs. Sore or tender jaws, morning headaches, earaches and neck pain are common signs of moderate to severe bruxing. Others may notice their teeth have become more sensitive over time, or that their teeth look flat or worn. Other physical indications of chronic teeth grinding are chipped teeth; increased sensitivity to hot or cold foods and beverages; and loose or broken fillings. To be sure, it’s best to ask your dentist or hygienist. They can give you a definitive answer, and recommend the best treatment options.

Causes of teeth grinding.

Most often, bruxism is related to stress. It may also be a response to pain elsewhere in the body, or the result of misaligned teeth. Alcohol, caffeine and other stimulants can aggravate the condition, causing more severe grinding or clenching.

What are my treatment options?

When bruxism is serious enough to cause pain and/or physical damage to your teeth, your dentist may suggest you wear a bite plate at night. A bite plate is a soft, removable tray made of a clear, tasteless polymer (plastic) material. It is custom-fit to either your upper or lower teeth and worn at night to prevent grinding in your sleep. A bite plate can be custom fitted during your regular dental visit.