Jennifer Stacey was 13 when she first noticed the clicking sound on the left side of her jaw whenever she ate. Twenty-four years later, it's still clicking. "My jaw gets tired and sore if I eat something that requires a lot of chewing," she says. "It feels like an overworked muscle, a dull ache."
Stacey, an airport security badging coordinator who lives in Vancouver, Washington, suffers from temporomandibular joint and muscle disorder, known as TMD (also often called TMJ), which impairs the jaw joint and the muscles that control it, causing pain as well as embarrassment. It can affect one or both sides of the jaw.
It's rarely serious, but it can be debilitating if it becomes chronic, as it is with Stacey. "When I open wide - for example, at the dentist - it can be quite painful," she says.
Her father had it, too. The clicking "was so loud when he would eat that I would sometimes have to leave the room because it irritated me so much," she says. After she developed it, "I'd actually make excuses to not eat in front of people."
The temporomandibular joint connects the lower jaw (or mandible) to the temporal bone at the side of the head. The jaw joint's position and movement are controlled by muscles that surround it. Opening the mouth causes the rounded ends of the lower jaw (known as condyles) to glide along the joint socket of the temporal bone. They slide back when we close our mouths.
Why the click? A soft cartilage disk cushions the two bone surfaces. In people with TMD, the disk often is out of its normal position. When the mouth is opened, the disk snaps back into its normal location, causing a click; when the mouth is closed, it becomes displaced again, causing another click.
Estimates suggest that more than 10 million Americans have experienced TMD. For most people, this usually means a single episode or a few isolated bouts.
"It's one of the most common pain disorders, after low back pain and headache," says John Kusiak, acting deputy director of the National Institute of Dental and Craniofacial Research. "Fortunately, most first-onset cases of TMD will resolve with either no treatment or minimal care."
About 10 percent of people with TMD go on to develop long-term symptoms that affect the quality of their daily lives, Kusiak says. Experts usually define chronic TMD as consistent pain in the jaw area that lasts beyond three months, he says.
"The jaw is very important for a number of things, including how we eat, for smiling, for talking, for singing and for kissing," Kusiak says. "People may have difficulty talking, and smiling, difficulty interacting with others. As a result, they may develop emotional and psychological problems that can lead to the inability to work or communicate."
Scientists don't know what causes it, although trauma to the jaw or temporomandibular joint is a clear risk factor. Most of the time, TMD develops for no obvious reason.
Because the condition is more common in women, scientists are exploring its possible connection to female hormones. They also are studying possible genetic links, a relationship that would not surprise Stacey. "With my father having it, I'm assuming that's why I developed it, too," she says.
Research suggests that TMD risk factors also might include teeth grinding, which can aggravate the joint, smoking and sleep dysfunction - insomnia or sleep apnea, "anything that disturbs the normal cycle of sleep," Kusiak says - but there is no evidence that "a bite that is off, or constant chewing on one side" causes TMD.
While there is no cure, recommendations to treat symptoms include eating soft foods, applying ice packs to ease pain or swelling, and avoiding extreme jaw movements such as wide yawning, loud singing and gum chewing.
Sometimes, learning relaxation and stress-reduction techniques can help. Short-term use of over-the-counter or prescription pain medications also may provide some relief. There is no evidence that splints or night guards work as a first-line treatment, Kusiak says.
Experts advise against having surgery or other treatments that result in permanent changes in the bite or the jaw, among them crown and bridge work to balance the bite, orthodontics to change the bite, grinding down teeth to bring the bite into balance (occlusal adjustment) and repositioning splints, which permanently change the bite. Total or partial joint replacement can be especially risky, Kusiak says.
"In some cases, it can make the joint worse, and pain and discomfort worse, in that it can induce inflammation that can lead to a lot of serious problems," he says. Also, "in a minority of cases, it can lead to more-serious complications and multiple surgeries."
Stacey has learned to live with the disorder. "I'd never been told it was treatable," she says. "Every time I go to a new dentist, it's usually the first thing they say to me when I open my mouth - 'Oh, you have TMJ.' I've learned how to hide it or minimize it while in social settings where food is involved. I chew very slowly and take small bites."
The Washington Post
Sat Jun 10 2017
The temporomandibular joint connects the lower jaw (or mandible) to the temporal bone at the side of the head.
Astro AWANI's revamped English news website, AWANI International, launches on Oct 21
Astro AWANI's revamped English platform delivers in-depth global news and expert analysis to keep you informed on key developments.
Israeli strikes kill 33 people in Jabalia refugee camp in Gaza, medics say
Residents of Jabalia said Israeli tanks had reached the heart of the camp after pushing through suburbs and residential districts.
Liam Payne's ex-partner calls for media restraint after 'painful' death
Cheryl Tweedy used her statement to urge the media to remember they had a seven-year-old son, Bear, who could read the reports.
Analysts: Indonesia's strong MoF leadership team to boost investor confidence
Sri Mulyani Indrawati as head of Indonesia's Ministry of Finance is expected to instil confidence among investors.
Biden offers both a carrot and a stick to Israel as his term nears an end
Israel has frequently resisted US advice and has caused political difficulties for the Biden administration.
Putin says BRICS will generate most of global economic growth
Russian President Vladimir Putin will host a summit of the group in the city of Kazan on Oct. 22-24.
ISIS Malaysia's perspective of Budget 2025
An excellent rakyat-centric budget under the overarching principle of a caring and humane economy.
Budget 2025: Record increase in STR, SARA aid initiatives
The government will provide a significant boost to the Sumbangan Tunai Rahmah (STR) and Sumbangan Asas Rahmah (SARA) initiatives next year.
Budget 2025: EPF contributions to be made mandatory for foreign workers – PM Anwar
The government plans to make it compulsory for all non-citizen workers to contribute to the Employees Provident Fund (EPF).
What policies to expect from Indonesia's new President Prabowo
Prabowo will be open to foreign investment, his aide has said, such as by offering investors management of airports and sea ports.
Budget 2025: Govt allocates RM470 mil to empower women's participation in PMKS
The Women's Leadership Apprenticeship Program will be intensified as an effort to produce more female corporate personalities.
Israel sends more troops into north Gaza, deepens raid
Residents of Jabalia in northern Gaza said Israeli tanks had reached the heart of the camp, using heavy air and ground fire.
Indonesia ramps up security ahead of Prabowo's inauguration
Prabowo Subianto will be sworn in as Indonesia's president on Sunday with Vice President-elect, Gibran Rakabuming Raka, also taking office.
Immediate allocation of RM150 mil for local authorities, DID to tackle flash floods
Datuk Seri Anwar Ibrahim said this allocation is intended to address the recent flash floods that hit the capital and several major towns.
Budget 2025: Sabah, Sarawak to continue receiving among highest allocations - PM
Sabah and Sarawak continues to be prioritised under Budget 2025, with allocations of RM6.7 billion and RM5.9 billion respectively.
NFOF will be operational in November 2024 with funding of RM1 bil
PM Anwar Ibrahim said NFOF will support venture capital fund managers to invest in startup companies with RM300 million set aside for 2025.
Minimum wage to increase to RM1,700 effective Feb 1, 2025
The Progressive Wage Policy would be fully enforced next year with an allocation of RM200 million, benefiting 50,000 workers.
Bursa Malaysia ends higher on Budget 2025 optimism
The benchmark index, which opened 1.85 points higher at 1,643.29, moved between 1,641.71 and 1,649.31 throughout the trading session.
Five important aspects relating to people’s lives in Budget 2025 - PM
The focus is on driving the MADANI Economy, speeding reforms, cutting red tape, raising wages, and tackling the cost of living.
Economic outlook: Govt plans to leverage, expand existing city transit system
The expansion aims to provide a more efficient and reliable public transportation network, reduce congestion, and improve accessibility.