TMJ Nerve Pain

The temporomandibular joint (TMJ) and the trigeminal nerve combine to produce a collection of poorly understood conditions. Problematic symptoms include pain in the jaw and surrounding tissues as well as limited jaw movement. Conditions that affect other joints in the body will also affect this joint.

The trigeminal nerve is critical to brain and facial interaction. In the broader sense of understanding, it is important to note that only 20 percent of sensation messages to the brain originate from the spinal column. The remaining 80 percent comes from the lower neck up to the top of the head.

Functions

• The human jaw has two temporomandibular joints, each joint being just forward of the ears. The joint connects the skull and the upper end of the bottom jawbone. TMJ allows the lower jaw to move up and down, forward, back and side-to-side. Jaw mobility is vital for nutrition and emotion.

  Biting, chewing and swallowing food is a nutritional necessity. Other important needs include speaking, breathing and the emotional facial expressions. Pain in the area of the TMJ can be fleeting and unanticipated. The best treatment is no treatment, even if the discomfort is persistent. When this joint hurts it is usually not an indication of any serious situation.

Trigeminal Nerve

• Woven into this mix is the nerve that makes it all happen. There are twelve sets of cranial nerves controlling 80 percent of messages to the brain. These nerves govern the function of five senses, body balance by inner ear mechanism and automatic function of organs and blood vessels.

  The trigeminal nerve provides more than half of the message input to the brain. Among responsibilities of the trigeminal nerve are teeth, periodontal ligaments, jaw muscles, eardrum tension muscle, muscle to both eustacian tubes, sinus linings, the jaw TMJs and blood flow to most of the rear brain area. Pain emanating from these areas warrants a visit to a medical or dental professional.

  The dentist is the first line of defense in the treatment of this pain. A complete evaluation could identify the medical or dental professional who could best treat this pain. It could require a visit to a neuromuscular dental professional or any of a number of medical professionals.

Identification

• This is one of those medical conditions diagnosed by a rule out of other medical conditions using an array of tests and procedures. It is difficult and often confusing to attempt a diagnosis of painful TMJ dysfunction. The facial pain can be a link to other conditions. Topping the list of suspect conditions are sinus or ear infections, facial neuralgia (nerve-related facial pain), headaches or decayed/abscessed teeth.

  No widely accepted or standardized test exists to properly identify the TMJ condition. Diagnosis depends largely on a detailed medical history, complete evaluation, patient description of symptoms followed by a physical examination of the head, neck, face and jaw. Eliminating other possible conditions leaves the diagnosis of TMJ dysfunction and/or trigeminal nerve involvement as the plausible explanation.

Vulnerable Population

• Women are in the majority of treatment seekers. However, both men and women experience problems with trigeminal nerve pain and/or TMJ. The childbearing years appear to be the time women are most susceptible. There is no plausible explanation for this.

  Although more than 35 million Americans suffer with TMJ problems, the causes remain elusive. Current speculation focuses on genetics, hormones, injuries to the jaw area, various forms of arthritis, dental procedures, low level infections, autoimmune diseases, clenching or grinding the teeth (usually during sleep) and the jaw stretching that's required to insert a breathing tube before surgery.

Considerations

• Numerous healthcare providers could help diagnose and treat the TMJ patient. The list includes family care physicians, dental specialists, neurologists, otolaryngologists, sleep laboratory analysts, endocrinologists, chiropractors, rheumatologists and pain specialists.

  Never rule out a second opinion. This is especially important when you have the recommendation for any highly expensive tests or invasive procedures. This opinion should come from your choice of an independent medical professional. Obtain this opinion from a physician who is not an associate of your current provider.