TMJ and Tooth Pain:Causes,Connections, and Relief Strategies

Certainly the most common complaint of patients with TMJ/TMD is muscle pain which may range from slight tenderness to extreme discomfort. Tooth pain may arise from temporomandibular joint disorders, gum disease, or dental problems. TMD is an umbrella term covering pain and dysfunction of the muscles that move the jaw and TMJ- the joint which connects the mandible to the skull. A misaligned jaw can put strain on the tissues around the teeth and result in discomfort. You should see a doctor if you experience TMJ or tooth discomfort in order to determine the cause and the best course of action.

In this article, we will discuss the signs, symptoms, cause and treatment options for the tooth pain and TMJ.  Tooth pain and TMJ issues can have a detrimental influence on your ability to speak, eat, and even sleep. If these conditions are not treated, they may get worse and result in other health problems. You should consult your dentist for a proper diagnosis and treatment. 

Causes of TMD

There are various factors that are related to temporomandibular disorders. They mainly increase the chances of disease occurrence rather than the main causative factor. Common causes are-

1. Factors that increase the risk of temporomandibular disorders:

• Personality and behaviour
• Occlusal imbalance, improper tooth treatment

2. Initiating factors that cause the onset of TMD- 

• Trauma
• TMJ overload
• Parafunctional habits

3. Factors that interfere with healing of TMD-

• Stress
• Grinding and clenching
• Emotional trauma

Causes of tooth pain-

1. Cavities
2. Abscessed tooth
3. Cracked tooth
4. Broken dental restoration (like a filling or crown)
5. Teeth grinding (bruxism)
6. Gum disease

Symptoms of TMJ/TMD–

Functional disorders of TMJs are the most common findings for masticatory dysfunction. Inflammatory disorders arise from any localized response of tissues that make up the TMJ. Two major symptoms of functional TMJ problems are

1. Pain
2. Dysfunction

Other symptoms associated with TMD are-

3. Headache- A practitioner should be knowledgeable enough to differentiate headaches that are likely to respond to dental therapies.
4. Otologic- “Does tooth jaw and ear pain common in TMJ?” Yes
   • Ear pain can also be due to TMJ pain perceived more posteriorly.
   • Patient can also complain of sensation of fullness in the ear or ear stuffiness.
   • Tinnitus
   • Vertigo 
   • Altered hearing

Symptoms of tooth pain associated with TMJ/TMD-

Dental signs and symptoms are mainly associated with breakdown created by heavy occlusal forces to the teeth and their supporting structures. Though, dental symptoms are common but, only some of patients complaint of these symptoms-

1. Tooth mobility- it can be because of loss of bony support and unusually heavy occlusal forces
2. Pulpitits(Pulp inflammation)- 

  It’s a very common question”Can TMJ cause tooth sensitivity?”

Yes, TMJ tooth sensitivity is very common. Chronic application of heavy forces on teeth can create the symptoms of pulpitis. Patients mainly complain of hot and cold sensitivity. Pain usually occurs for short duration and is reversible in nature but in severe cases, due to excessive trauma pulpitis become irreversible.

3. Tooth wear

Diagnosis of TMJ and tooth pain-

Self-care techniques combined with professional evaluation are frequently used to identify and treat TMJ problems and tooth discomfort. Following are some common approaches to diagnosis and treatment:

Clinical examination-

1. History- Your dentist will ask about your chief complaint, location of pain, characteristic of pain like pain intensity, pain behaviour, whether it’s throbbing, dull or sharp. He will also ask about aggravating factors like any emotional stress, sleep disturbance or any kind of medication.
2. Inspection- during clinical diagnosis, patient is asked to perform various functional movements of jaw like maximum mouth opening, left jaw movement, right jaw movement, centric movements.
3. Palpation- TMJ is palpated by the professional and the joint vibration movement is examined during mouth opening.
4. Auscultation- TMJ sounds are evaluated with a stethoscope to any kind of friction in TMJ.

Radiographic examination- 

OPG,Transcranial radiographs, tomography, CT, MRI, Arthroscopy are common methods of radiography to diagnose the TMJ/ TMD.

Treatment of TMJ and tooth pain

1. Various medications like NSAIDS, analgesics, local anesthetic, etc can be used in the management of TMJ/ TMD but they don’t treat the underlying cause.
2. Different physical therapies e.g. thermotherapy, coolant therapy, ultrasound, phonophoresis, TENS are used for TMD pain management.
3. To address the underlying cause of your tooth discomfort, such as gum disease or tooth decay, your dentist may recommend fillings, root canal therapy, or other dental operations.
4. Occlusal splints can be given to correct the bite problems.
5. In severe cases, where TMD can’t be managed by different therapies, surgery is also indicated in such cases.  REFERENCES
   1. Okeson JP. Criteria for optimum functional occlusion. 7th edition. St.Louis:Mosby;2013.
   2. Veeraiyan DN. Temporomandibular Disorders. 2nd edition. JP;2017.