Pain in the head, clicking may be TMJ syndrome

ON CALL

January 05, 1993|By Dr. Simeon Margolis | Dr. Simeon Margolis,Contributing Writer

Q: My problem is a frequent clicking noise and sharp pain just in front of my left ear when I yawn or chew. What can be causing this problem and what can be done about it?

A: Your description best fits the temporomandibular joint (TMJ) syndrome. The TMJ joins the lower jaw bone (mandible) and temporal bone of the skull directly in front of both ears. It's a very busy joint that moves whenever you chew, talk, swallow or yawn.

The TMJ syndrome is often mistaken for migraine headache, toothache or sinus infection because the pain can be felt in the temples, cheek, lower jaw and teeth.

TMJ syndrome can be one manifestation of bodywide arthritis, but more often it comes from excessive wear and tear on the TMJ itself, leading to degeneration of the cartilage lining the joint. Such degeneration can result from an improper bite due to misaligned teeth, chewing only on one side of the mouth, constant gum chewing, nail biting, chewing on the inside of your cheek or habitually clenching or grinding your teeth together. (Many people who grind their teeth are unaware of the habit.)

Try first to identify and alleviate daily stresses or tension that may be contributing to clenching or grinding your teeth. Make a conscious effort to relax and eliminate habits that contribute to the TMJ syndrome: Try to suppress yawns, chew evenly on both sides of your mouth, stop chewing gum, avoid hard, chewy foods.

Several times a day, exercise your jaw by bringing your lower teeth out beyond your upper teeth 10 times. During particularly painful periods, take aspirin or other over-the-counter pain killers and apply moist heat or a heating pad over the TMJ at least twice daily.

If the symptoms persist, check with your dentist, who may find some tooth abnormality that is contributing to your discomfort. He can also fit you for a device that covers the surfaces of your back teeth to keep you from grinding your teeth at night, if that is a problem.

Dr. Margolis is professor of medicine and biological chemistry at the Johns Hopkins School of Medicine and associate dean for faculty affairs at the school.

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