TMJ and Stress

1. TMJ and Stress Dr Shwetha S Hegde Consultant Oral Medicine and Radiology Australian Dental Board Certified Dr Shwetha S Hegde

2. What is stress? • Anything that poses a challenge or a threat to our well-being is a stress. • Stress is the body’s reaction to any stimuli that disturb its equilibrium. • a stressor is an agent or stimulus that causes stress. Dr Shwetha S Hegde

3. How does stress affect head and neck region? • fight or flight response- release of adrenalin • increase in heart rate, respiration, blood pressure, metabolism and muscle tension. • overuse of jaw muscles, specifically clenching or grinding teeth Dr Shwetha S Hegde

4. Conditions related to stress are: • Oral lichen planus • Apthous ulcers, herpes labialis • Burning mouth syndrome • TMJ Disorders like MPDS ( Myofascial Pain Dysfunction Syndrome) • Bruxism, clenching and other parafunctional habits • Periodontal disease or worsening of existing periodontal disease related to poor oral hygiene and unhealthy eating habits Dr Shwetha S Hegde

5. Effects of stress on TMJ • tenderness of the jaw or jaw muscles • jaw pain or soreness that is more prevalent in the morning or late afternoon • jaw pain when chewing, biting or yawning • difficulty opening and closing the mouth • clicking or popping noises when opening the mouth • sensitive teeth when no other dental problems can be found Dr Shwetha S Hegde

6. Less frequently… • Vertigo • Tinnitus, lancing pain in one or both ears, diminished auditory acuity, stuffiness in one or both ears • Light sensitivity in the eyes • Ulcer-like pains in the stomach • Pain in the neck, shoulder, lower back pain • Headaches including migraine, tension headache Dr Shwetha S Hegde

7. Signs and symptoms of TMD Threeclassically described, cardinal signs and symptoms of TMD are: • Pain and tenderness on palpation in the muscles of mastication, or of the joint itself • Limited range of mandibular movement which may cause difficulty eating or even talking. There may be locking of the jaw, or stiffness in the jaw muscles and the joints, especially present upon waking. There may also be incoordination, asymmetry or deviation of mandibular movement. • Noises from the joint during mandibular movement, which may be intermittent. Joint noises may be described as clicking, popping, or crepitus (grating). Dr Shwetha S Hegde

8. Why is TMJ a unique joint? • 2 joints function as one • Another structure( teeth) dictates its function • It has a fibro cartilaginous disc within it between the condyle and the glenoid fossa Dr Shwetha S Hegde

9. Dr Shwetha S Hegde

10. Treatment options broadly include • Relaxation therapy include yoga, meditation, deep breathing exercises etc • Physical therapy include postural training, occlusal equilibration and occlusal splints • Medications such as muscle relaxants and anti depressants • Palliative therapy includes massage, hot and cold fomentation , TENS, soft LASERS Dr Shwetha S Hegde

11. It is important to.. • Identify warning signs • Identify triggers • Establish routines • Spend time with people who care • Look after your health • Notice your ‘self-talk’ • Practice relaxation Dr Shwetha S Hegde

12. Role of a Oral Medicine Specialist in TMD.. • Diagnosis is an important step before treatment. However, because the exact causes and symptoms of TMD are not clear, a correct diagnosis is job half done. • Management of such patient involves a multipronged approach that takes care of patients’ mental and physical well being • Usually the treatment is protracted and therefore its important to keep the patient motivated. Dr Shwetha S Hegde

13. Thank you Dr Shwetha S Hegde