OROFACIAL PAIN AND OCCLUSION

Orofacial Pain and Occlusion focuses on the assessment, diagnosis and management of pain and conditions affecting the face, jaws, chewing muscles and temporomandibular joints.

Orofacial pain can have several different causes. A careful clinical assessment is therefore important to distinguish a temporomandibular disorder from other possible dental, neurological, muscular or ear-related conditions.

What is a temporomandibular disorder?

A temporomandibular disorder, usually referred to as a TMD, is a general term for a group of conditions that can affect:

• The temporomandibular joints, which connect the lower jaw to the skull;
• The muscles responsible for chewing;
• Structures involved in jaw movement.

TMD can present in different ways, and not everyone experiences the same symptoms.

Common signs and symptoms include:

• Pain or discomfort in the face, jaw or area around the ear;
• Pain or fatigue in the chewing muscles;
• Difficulty or limited movement when opening or closing the mouth;
• A locking sensation in the jaw;
• Clicking, grating or other joint sounds;
• Discomfort while chewing;
• Headaches associated with the temple area or chewing muscles.

Some people also report earache, a blocked-ear sensation or tinnitus. However, these symptoms can have other causes and should be properly assessed. Joint sounds without pain or restricted movement do not always require treatment.

Bruxism and teeth clenching

Bruxism is an activity of the chewing muscles that can occur during sleep or while a person is awake. It may involve grinding the teeth, clenching them or repeatedly tightening the jaw muscles.

Bruxism is not necessarily a disorder and may not cause any symptoms. However, when frequent or intense, it may be associated with:

• Wear or fracture of teeth and dental restorations;
• Tooth sensitivity;
• Pain or fatigue in the jaw muscles;
• Headaches on waking;
• Discomfort around the temporomandibular joints.

Bruxism and TMD are separate conditions. They may occur together, but bruxism is not the only cause of TMD, and not everyone with bruxism develops pain or joint problems.

Assessment and management

The assessment may include a review of the symptoms and medical history, observation of jaw movements, examination of the chewing muscles and joints, and an evaluation of the teeth, bite and possible signs of dental wear.

Further examinations or referral to another healthcare professional may be considered when necessary.

Treatment depends on the diagnosis and should be adapted to each patient. It may include advice, habit changes, exercises, pain management or an occlusal splint when clinically appropriate. Conservative and reversible approaches are generally considered first.

If you experience jaw or facial pain, difficulty opening your mouth or signs of bruxism, book an assessment at Wave Dental in Coimbra, Juncal or Valado dos Frades, in the municipality of Nazaré.