Is your teen complaining of jaw pain, chronic headaches, or facial pain? Like adults, teens can suffer from pain in the face, jaw, and in the ear. Perhaps your teen has debilitating headaches that are impacting school and other activities. Issues with jaw movement can result in difficulty chewing, difficulty yawning, and painful “clicking.”

Sometimes, these problems are attributable to trauma. Teenagers are constantly on the move, engaging in all types of physical activities from morning till night. They are subject to all kinds of accidents, sports injuries and falls. Teens are also heavy users of smartphones and other technologies. When texting away or surfing social media with these devices, their heads and necks are often in awkward forward head positions that cause neck muscle tension and strain.

Your teen’s facial or jaw pain can be related to a variety of conditions. One possible condition that should be considered in these circumstances is a temporomandibular joint disorder (TMD). According to the American Academy of Pediatric Dentistry, TMD is a common, often overlooked, problem in the teenage population. TMD happens more often in women than in men. Also, TMDs can mimic other conditions such as sinus pain, rheumatoid arthritis, allergies, muscle pain and ear pain.

CAUSES OF TMD/TMJ 

TMD problem involve a complex group of facial muscles that perform many functions including movement of the temporomandibular joint (often abbreviated as TMJ), the human skull’s sole joint. This essential hinge joint connects the jaw to the temporal bones of your skull, which are in front of each ear. This all-important joint allows us to move our jaw up and down and side to side, so that we can talk, chew, and yawn.

Studies of temporomandibular disorders indicate that they are caused by several factors acting together. Those with TMD often have some jaw injury. There may have been some macro-trauma from an accident that caused

hyperflexion/hyperextension (“whiplash”) , injuries, or micro-traumas that we are often unaware of, such as clenching and grinding (bruxism). TMD can also be caused by a joint disease, such as arthritis. Other factors can exacerbate TMD, such as gum chewing, stress, and head and neck muscle tension caused by unnatural postural and resting positions. According to the American Academy of Orofacial Pain, these factors can have a surprisingly large contribution to TMD symptoms and need to be controlled to reduce and manage TMD.

Finally, stress and anxiety can cause or aggravate TMD.

If your teen is dealing with pain in the jaw or they hear noises when moving their jaw, it is imperative that he or she sees a TMJ specialist for a formal evaluation.

TMD/TMJ SYMPTOMS

Some of the more common symptoms are headaches, especially in the morning, jaw or facial pain, and jaw popping or clicking. Additionally, many sufferers experience dizziness, difficulty eating or swallowing. In severe cases, the jaw can become locked or dislocated.

Other signs and symptoms may occur in other areas of the body besides the joint. Those suffering from TMD may experience toothaches, eye pain, blurred vision, earaches or ringing, loss of hearing, and or neck/back stiffness.

TMD/TMJ SYMPTOMS AND TREATMENT

The goals of TMD management include decreasing pain, decreasing pressure in the jaw joints and restoration of jaw function.

For some patients, a dentist may determine that clenching or grinding of the teeth is putting and excessive amount of strain on the joint and that a customized oral appliance therapy or a nightguard is the best course of action. Others may benefit from simple physical therapy techniques such as moist heat, massage, and or other muscle manipulation modalities.

Because TMD is often caused or agitated by stress and anxiety, in many cases, certain muscle relaxers, antidepressants, or anti-anxiety medications can be used as an adjunct therapy to help reduce stress and ease tension. Trigger point injections and Botox are also utilized to decrease muscle hyperactivity.

If conservative management does not reduce pain, then surgical options may be necessary. Typically, the proper management of TMD involves a combination of more than one of these therapies. As such, it is critical to have a proper diagnosis before committing to a specific treatment option. 

Both Dr. Melinda Wagner and Dr. Michele Schultz are formally trained in the management of TMDs and Orofacial Pain. As TMD specialists, they offer comprehensive examinations for diagnosing and treating their patients with care and empathy.

Sources:

  1. Michigan Head and Neck Institute
  2. The presence of altered cranio-cervical posture and mobility in smartphone-addicted teenagers with temporomandibular disorders, Kee et al, Journal of Physical Therapy Science 28:339-347, 2016
  3. AAOP