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Jaw joint (temporo-mandibular joints) pain and clicking |
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The jaw joints, technically called the temporo-mandibular joints, lie just in front of the ear and join the jaw to the skull, allowing the jaw to open and close and move in other directions during chewing, swallowing and talking.
The main muscles moving the jaw are the temporalis (a fan shaped muscle on the side of the skull), the masseter (that lies in the cheek), and two muscles inside the mouth called the pterygoids (one of which attaches to a disc inside the joint). Weaker muscles run from the jaw bone down the front of the neck.
Jaw movements - and jaw problems - are complicated, for several reasons. Because the left and right jaw joints are connected across the midline by the jaw bone, problems on one side can affect the other. When the jaw closes, misalignments of the teeth can affect the way the upper and lower teeth bite together (“malocclusion”). Alterations of the posture of the head and neck can also affect the jaw joint and its muscles. For example, if the head is carried forward, the muscles at the front of the neck will pull backward on the jaw, compressing the jaw joints. You can feel this effect yourself by jutting your head forward and then trying to close your mouth – you will feel the tightness at the front of your neck.
Symptoms of jaw joint problems can include pain in the jaw itself, clicking or locking of the joint, inability to fully open or close the mouth, neck pain, headaches, dizziness and tinnitus (though note that these last four can also have other causes).
Trouble with the jaw joints can arise from a direct blow to the jaw, whiplash, malocclusion, bruxism ( grinding the teeth), excessive clenching of the jaws, poor posture, and neck problems.
Osteopaths are trained to examine the jaw joints and their muscles, and to look for the factors which have caused the problem. Treatment can involve working on the joint and muscles themselves, but also addressing faults in the neck and the patient’s posture. If malocclusion is part of the problem, the osteopath may also send you to a dentist with experience in the field to see if you need, for example, a custom-made orthotic to correct the bite. Some osteopaths have a special interest in jaw joint problems.
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