Sussex ENT: Ear, Nose and Throat Surgery
Brighton and Sussex University Hospitals Trust
Worthing and Southlands Hospital


Jaw Joint Malfunction and associated facial pain

The majority of jaw joint problems are mechanical in origin resulting from excessive use, for example, chewing very hard foods (tough meats, toffees, chewing gum), opening the mouth too wide (yawning, singing, shouting) and various tension habits associated with stress, tooth clenching and grinding.

As a result, the ligaments holding the joint together become stretched and the disc of the cartilage within becomes displaced. This produces a click or grating feeling when the jaw is moved and if the damage becomes worse then pain occurs in the joint (often interpreted as earache). Associated cramp or spasms of the jaw muscles may occur producing a dull ache or a sharp, stabbing pain in the side of the head, cheek and along the bottom of the jaw (and stiffness which prevents wide opening of the mouth). This is commonly worse at the end of the say when the muscles are tired or in the morning if there is a tooth-grinding habit during the night.

The majority of jaw joint malfunctions get better with sustained rest; exercise is not a solution. With time, the ligaments become stronger again and the cartilage repositions. However, the sufferer must live on a continuous soft diet and learn to chew in a way which is comfortable, with the minimum of clicking.

It is important to chew more carefully, take much smaller mouthfuls and take longer over eating. The worse thing to do is to open the mouth wide and bite into large, hard morsels of food, for example, apples or bread rolls. These must be sliced or broken into thin pieces. The jaw must be supported underneath while yawning, shouting and singing and playing certain wind instruments should be avoided. Avoid chewing gum, toffees and nail-biting. Any tooth clenching or grinding habit should be identified and eliminated. Many people clench and grind their teeth as a response to stress, which includes concentration on a particular task, keeping to unrealistic timetables and generally trying to do too much. This is similar to what is described as tension headaches, but affecting the muscles of the face rather than the neck and back of head.

If these measures are followed then the joint should repair after some months and normal joint function will be possible. It is rarely a sign of a more serious medical problem.

Avoid Helpful Measures
Opening the mouth too wide:- An adult needs to be able to place only two fingers between the front teeth
Slice all food thinly
Biting into apples Do not bite large pieces of food
Biting into large rolls  
Chewing tough meats Chew slowly and avoid clicking noises if possible
Chewing gum/toffee Take longer over eating
Nail biting  
Open mouth yawning Support chin during yawning
Unnecessary punctuality  
Trying to achieve unrealistic goals 8 hours sleep, 8 hours work 8 hours play – nothing else is good for your health

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