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The Scenario:
Today's mystery is that of a young woman who just recently moved into a new city to start her first job after college. She felt a little over her head, but by working hard, seemed to be doing pretty well. However, she gradually began to notice that she was waking up in the morning with a headache. It seemed to be located on the right side of her head, and gradually went away as the day wore on. She also noticed that her right ear began to hurt, almost like an ear ache, and if she yawned the pain became very intense. She had had migraine headaches in the past, but they did not feel like this.
One morning, while biting on an apple, she had intense pain on the right side of her face, and a popping sensation from her jaw. She complained to her boyfriend who told her he had noticed that she sometimes made a terrible grinding sound with her teeth at night. She later saw a doctor who actually recommended she get some counseling.
Questions:
Answer:
This woman's problem is well known to many of you. It is sometimes misdiagnosed as an earache, a headache, or an infected tooth. However, her symptoms are typical for TMJ (which stands for "temporomandibular joint") syndrome.
The temporomandibular joint is the one just in front of your ears, where your jaw attaches to your head. There are a number of reasons why someone may get TMJ syndrome. For example, very often a person will unconsciously clench their jaw and teeth at night while sleeping. One's bed mate may actually hear you grind your teeth -- an unnerving sound. What that means is that in the morning you may wake up with a very painful jaw, stiff muscles, and the popping and clicking of the jaw joint as occurred in this case.
The clenching is often associated with stress, hence the doctors recommendation for counseling. However, stress reduction is apt to take some time, and in the meantime the jaw is painful, and perhaps even the teeth are getting worn down. A dentist or oral surgeon can fit her with a mouth guard to wear at night which helps relieve the discomfort. Also, anti-inflammatory agents such as ibuprofen may be helpful. Needless to say, it is important to avoid chewing hard foods in order to rest the jaw.
Check out Ask the Doctor for more information on TMJ.
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