Bruxism: A Runners Guide to Jaw Pain
Bruxism, are there any runners out there who compete and find that the stress of competition affects your body in ways such as tightening of the jaw, or grinding of the teeth? This may even have further knock on effects such as headaches due to the tightness in your jaw. This article to give you some ideas on what to look out for and what measures you would need to take if these issues began affecting you adversely.
In this article, we are going to focus on the jaw area, more specifically jaw pain. Once we have looked at the structure of the mouth and jaw and looked at jaw pain in general we will the look into dislocation of the jaw, dislocated jaw and bruxism a little deeper. Before we go any further with these however, we need to understand a bit about dislocations in general and how the jaw area works and is designed.
So, let’s start with the structure of the mouth and jaw area. The mouth also called the oral cavity is composed of several parts, which include the teeth, gums (gingiva), tongue, palate, cheeks, lips and the bottom of the mouth also called the floor. The whole of the mouth apart for the teeth is lined by mucous membranes and the teeth are covered by enamel to protect them. The teeth are held in by the jaw bones and have many functions one of which is allowing you to chew. They help with creating facial shape and appearance and allow you to speak properly and clearly. You also have the gums (gingiva) which cover the jaw bone and surround the teeth which protects the teeth and jaw by creating a barrier. Then you have the tongue, a muscular organ in the mouth which has functions such as taste, chewing, speaking.
There is also the palate of which there is two, a soft and hard palate. The hard palate is attached to the teeth and gums, forming an arch at the top of your mouth, creating the roof of your mouth and is solid and immovable. The soft part of the palate is located behind the hard palate more towards the back of the throat and this is where the gag reflex occurs. The cheeks also form part of the mouth and start from the sides and continue along the front of the face to the lips. They are responsible for smiling, swallowing and keeping food inside the mouth for chewing and digestion. The lips connect the front of the cheeks and are made of soft pliable fleshy tissue. The outside of the lips is covered by skin and the inside is attached to the gums. The blood vessels which are close to the surface of the lips are what give them their color. The lips are the most mobile part of the body and help with speech and keeping food inside the mouth, they are also very sensitive to the temperature and textures of foods.
Finally, we have the floor of the mouth which consists of the tongue mainly. It is made mainly of mucous membranes extending from both sides of the lower jaw bone inwards and from the tongue to the gum line, this also forms a crescent shape just as the roof of the mouth does. The floor of the mouth contains glands, nerves and parts of the tongue muscle. The jaw is made up of a pair of bones forming the framework of the mouth. The lower jaw bone (mandible) is movable and the upper (maxilla) is fixed. It functions by moving in opposite directions to each other for the purposes of biting and chewing. There is a part of the jaw that is vertical and it is this section that forms movable hinges for the joint on either side of the head also connecting with the temporal bones of the skull.
Structure of the Mouth and Jaw
So now that we have an idea of the structure of the mouth and jaw let’s have a closer look at what jaw pain is. Jaw pain is pain associated with the mandible (lower jaw) and temporal bone joint and is called temporomandibular joint disorder or TMJ/TMD for short and it happens due to issues with the jaw, the joint and the surrounding facial muscles. It is the facial muscles which control the movement of the jaw when chewing, yawning or talking. If you have ever had TMJ you will have noticed that the pain due to this is directly in front of the ear and can be either on one side or both sides of the face. As well as being called TMJ/TMD it can also be referred to as TMJ syndrome or dysfunction and it is technically a repetitive strain injury although this is not always the case. Due to the jaw being able to move up and down as well as side to side it is the muscles surrounding and attached to the jaw that control the position and movement of the jaw.
It is not clear what the cause of TMJ disorders is, however dentists think the problems could be with the jaw muscles or the joint itself. Any injury from a heavy blow or whiplash to the muscles of the head, neck, temporomandibular joint or the jaw could be the cause of TMJ disorders as well as grinding or clenching the teeth which puts great pressure on the TMJ joint, if the discs between the joints have been dislocated, if there is any signs of osteoarthritis or rheumatoid arthritis in the joint or mental or emotional stress or trauma which can cause the person to tighten their facial or jaw muscles, this could also cause TMJ disorders.
Signs and Symptoms
This disorder is experience by more females than males and it also generally affects people between 20 – 40 years of age. People that suffer with this disorder will experience severe pain and discomfort which can either last years or be temporary. There are some signs that you can look out for to help minimize the pain and discomfort of TMJ disorders. These are an aching jaw first thing in the morning, signs of grinding or clenching your teeth in the night, a new complaint of jaw pain, regular headaches especially when this is not usually the case and you may also notice that it feels like the jaw is displaced.
There are also some symptoms that you should look out for if you have missed the early signs as, this disorder is still reversible and if caught early it will be a lot easier and less painful in the long term to manage and treat. There may be noticeable pain or tenderness in the face especially around the ear area and maybe even in the ear which will be more noticeable when you do anything which involves moving your jaw such as chewing, speaking or opening your mouth wide. You may also notice pain in the TMJ, neck and shoulders, you may not be able to open your mouth very wide without it causing you pain and discomfort or your mouth may get locked in either the open or closed position, there may also be a noticeable clicking, popping or grating sound in the TMJ when opening or closing the mouth which might cause pain, it may also be difficult to chew or if the joint has moved out of place you may notice that your teeth do not fit properly when you close your mouth. There may also be some swelling on the side of your face or tiredness. You may also find that you have symptoms such as toothache, headache, neck ache, dizziness, ear ache, problems with your hearing, tinnitus or even neck and shoulder pain.
There are lots of other conditions that can cause the same or similar symptoms as TMJ disorders so it is best to go and see your dentist or doctor allow them to examine you and get a proper diagnosis and treatment plan. If there is any need for further treatment your dentist or doctor will then be able to refer you to the right specialist.
There are a variety of treatment available to alleviate TMJ disorders from self-help treatments to surgery depending on the severity of the disorder. It is best to start with the self-help treatments first before opting for injections or surgery as these treatments may be enough to rectify the issue, however, it is generally best to combine treatments to get the best possible results. Some of the basic treatments you can do for TMJ disorders are as follows.
Alternating between hot and cold on the face (remember not to put ice straight onto your skin but have a barrier to protect you from burns such as a plastic bag or a towel). When doing the hot and cold treatment you ideally want to start and finish on hot. The heat will dilate the blood vessels allowing the blood to rush through the injured area and flush it, while the cold will constrict the vessels restricting the blood flow and more importantly it will numb the pain. Once you have applied the heat you may feel comfortable enough to do some facial stretches that you have been advised to do by your doctor or dentist to help loosen the joint. After doing the exercises put some ice and then repeat the heat and cold cycle a few times finishing with heat at the end of each cycle of 10 minutes. Do this a few times throughout the day.
Avoid eating hard foods like carrots and pretzels that require a lot of chewing and eat soft foods instead such as mashed potatoes, cottage cheese, soup, scrambled eggs and yoghurt. It also might be a good idea to cut up large pieces of food that would mean you having to open your mouth really wide.
Wear a mouth guard at night, also known as a splint. A mouth guard will either cover the top, bottom or both sets of teeth and prevent your teeth from meeting which will in turn reduce the effects of clenching or grinding the teeth and help position the teeth back to their most correct and least traumatic position. There is a difference between splints and mouth guards however, a splint is worn all the time and a mouth guard is only worn at night. It is best to discuss which one will be best to wear with your dentist. Corrective treatment can also help so, anything that helps correct your bite will help to reduce or eliminate TMJ. Any movements that are extreme such as yelling or chewing gum. Another thing that is not a good idea to do is resting your chin on your hands or anything else that is going to promote bad posture as good posture will help you reduce any neck and facial pain, keeping a gap between your teeth will also help to relieve any pressure on your jaw, this can be done by placing your tongue between your teeth, which is best done during the day. Learning some relaxation techniques will also help you to control the level of tension in the muscles of the jaw, and you can get some guidance on the best way to approach this from your dentist.
When you have tried these treatments and they have not worked then you may have to try further treatments such as ultrasound or injections into the affected muscles to relieve the pain or surgery if any of the former options do not work. These specialised treatments would have to be performed by a specialist, however try the ones mentioned previously as they may be enough to get your jaw back to full health.
Let’s now move on to what is dislocation. A basic description of a dislocation is an injury to a joint (where two or more bones come together). The injury occurs when the ends of your bones are forced from their normal positions and as well as this being a very painful injury it can immobilize and deform your joint temporarily. Sometime the immobilization is through the sheer pain when trying to move the joint therefore it is not wise to try and reset a dislocation yourself, however, it would be advisable to seek medical attention to have your bones reset back to their proper positions if a dislocation is suspected. As long as the dislocated joint has been set properly you should be able to use it normally again within a few weeks of rest and rehabilitation, however there is an increased risk of a dislocation happening again at some joints so it is a good idea to try and find some preventative measures to try and prevent or at least reduce the chances of this happening.
Dislocation of the Jaw and dislocated jaw
The jaw has two joint actions which are a sliding motion along with a hinge action. The movement of the jaw is generally kept smooth because the parts of the jaw bone that are involved in these movements are covered with cartilage. It is helped further by having small shock-absorbing disks which separate the bones enough to prevent grinding of the joint.
There are some signs and symptoms that you will notice if you have a dislocation of the jaw (temporomandibular joint). These are pain and tenderness of the jaw, pain in either side or both sides of the jaw at the joint and possibly in and around the ear, difficulty or pain while chewing, face may also be aching and finally you may experience the joint locking which will make it difficult to open and close your mouth. There are other temporomandibular joint disorders where you will notice there is a clicking sound or a grating feeling, however if you do not experience any pain or limited movement that you would if you had a dislocation then it is more likely to be one of the other disorders rather than a dislocation.
When you are suffering with a dislocation you may be able to visibly see the bone is out of place, the site is likely to be swollen or discolored, there will be intense pain and there is a high possibility that you will not want to move it at all. It is wise to go and see a doctor or specialist if the pain and tenderness in your jaw is persistent or if you are having difficulty opening and closing your jaw fully. Your doctor, dentist or specialist will be able to investigate to find out the root cause of the injury and discuss possible treatments for it.
Dislocation of the jaw can occur when playing contact sports such as rugby, American football, martial arts and hockey and when participating in sports such as downhill skiing, gymnastics and volleyball. It could be caused by a car accident if you struck your jaw, but also something as simple as yawning, sneezing or yelling can cause a dislocation. A weak or unstable joint can also cause a dislocation as well as teeth that are not aligned properly, are worn or missing can cause your jaw to not work properly which in turn can cause a dislocation. Participation is certain sports such as the ones mentioned above could increase your risk of dislocating your jaw along with a car accident. A dislocation of the jaw can also cause other complications such as tearing of the muscles, ligaments and tendons, damage nerves or blood vessels around the dislocation, the damage done here could possibly need surgery to repair the tissues depending on the severity of the damage.
Signs and symptoms
There are a few signs and symptoms that will help you to determine if you have a dislocation of the jaw these are the inability to open or close or move your mouth from side to side, if your teeth are lining up differently, you find you are drooling, if you are having difficulty with eating, drink or speaking, if both sides of your face are not equal and finally if you have a dimple in front or your ear or even pain and swelling.
There are a few things you can do if you have had a dislocation of the Jaw such as supporting your jaw for a few days after the incident especially when you are yawning as this could make your jaw dislocate again. The idea is not to open your mouth too widely so it may be advisable to wear a chin strap or a bandage to prevent it happening again and to support it while it is healing.
Using ice will also help as it will decrease the pain and swelling as well. Using an ice pack or ice in either a plastic bag or a towel the best way to do it, do not put ice straight onto your skin as it could stick to your skin and cause you further problems. Eating soft foods is another way to help to reduce the risk of you dislocating your jaw again and after an initial dislocation you may need to eat soft foods such as bananas, cottage cheese, eggs and yogurt for some time.
If however you have had a few dislocations it may be advisable to have some physical therapy to help you get the muscles in your jaw stronger so that you help to reduce your risk of further dislocations. There is also the option of surgery but I personally would not take that root as there could be further complications with this option. Surgery can increase your risk of injuries from jaw ligaments being stretched to the residual pain from the surgery, possible nerve problems, stiffness or bleeding in the joint or even after surgery your upper and lower teeth may still not line up. There is also still the possibility of dislocating your jaw again.
On the other hand, not getting the correct treatment can also lead to further problems as the pain could increase along with trouble eating and talking. It can open you up to issues such as nerve problems, loss of hearing and possible injuries to your skull from the dislocated bone so it is advisable to at least have the injury looked at even if you do not have surgery. Some of the other less invasive treatments may be enough to set your jaw back so keep your options open and do what is best for your health.
So, we have looked at dislocation of the jaw and the mechanics of how this happens and we have also gone through the cause, symptoms and treatment of dislocation of the jaw and now we are going to follow on from that and look at what a dislocated jaw is.
We are going to look at bruxism which is a condition where you either grind, clench or gnash your teeth unconsciously while awake or in your sleep. If you mainly suffer from this condition while sleeping it is considered to be a sleep related movement disorder which is more than likely to mean that there are other sleep disorders at play such as snoring and sleep apnea.
If you have mild bruxism then you may not even notice it and it may not require you to get treatment however for some it may be severe and frequent leading to headaches which can become very severe, damage to the teeth and other jaw disorders.
Having sleep bruxism can mean you are unaware of it until you have developed complications so it’s important that you know the causes, signs and symptoms and it is also a good idea to get regular dental check-ups.
It is not completely understood by doctors what the cause of bruxism is, however it may be due to physical, psychological and genetic factors or a combination of some or all of these factors. When you are awake, it may be due to negative emotions such as stress, anger or frustration and when you are asleep it may be due to chewing activities linked to arousal while sleeping.
There are some risk factors that can increase your risk of bruxism such as stress including anger and frustration. Age is another factor and generally bruxism is common in young children but can go away by adulthood. Your personality type can also increase your risk of bruxism if you have a personality that is aggressive, competitive or hyperactive. Having family members with bruxism can also increase the possibility of you having it. There are other disorders such as Parkinson’s disease, dementia, ADHD and epilepsy which are associated with this condition as well.
Fortunately, there are no serious complications but severe bruxism can lead to damaged teeth or jaw, headaches similar to that of a tension headache, face or jaw pain that can be severe or TMJ disorders which will sound like clicking when opening and closing the mouth. If you go to the dentist regularly they will be able to notice any signs of bruxism when they check your teeth and mouth, then over the next few visits determine if you need treatment or not. If your dentist thinks there is a possibility of you having bruxism they will try and found out what is causing it by asking you questions about any medications you may be taking, your sleep habits, daily routines and your dental health. Your dentist may check for jaw tenderness, broken or missing teeth, grinding down of your teeth, any further underlying problems with your cheeks and the jaw bone. If there is any cause for concern and further treatment is needed the dentist may then refer you to a specialist.
Signs and symptoms
Some of the signs and symptoms of bruxism are grinding and clenching of the teeth, flattened, fractured, chipped or loose teeth, worn tooth enamel, there may be increased pain or sensitivity of the teeth, tight jaw muscles, locked jaw that will not open or close fully, either pain or soreness in the jaw, neck or face, or a headache that starts at the temples. If you have any concerns about your teeth or jaw then do not put of going to see your dentist.
In most cases treatment is not needed, however if the problem is severe there are therapies, medications and dental treatments that can help to ease jaw pain or discomfort and reduce further damage to your teeth. It is best to talk to and find out from your dentist which options will work best for you. Some of the preventative options available are splints or mouth guards or corrective procedures to reshape the surface of the teeth. If you grind your teeth due to stress techniques that encourage relaxation such as meditation will help, changing your jaw and mouth positioning and if that is difficult then you can use biofeedback which will help by teaching you how to control the activity of the muscles in your jaw.
There are also ways you can manage the effects of bruxism at home by doing things that you enjoy and also help you to stay relaxed such as listening to music, exercising or taking a warm bath, getting a good nights sleep and avoiding coffee, tea and alcohol in the evening before bed.
Remember if you are ever unsure of what the issue is it is always best to get professional help and advice before the issue gets really bad and to a point where you are forced to look at the option of surgery. Listen to your bodies and when you notice something is not quite right pay attention and get it resolved as soon as possible. The health and well-being of you and your mouth and jaw depend on you being proactive if you notice anything out of the ordinary.
You do not have to stop running or competing because of the stresses associated with competition you just need to incorporate things such as meditation that will help you reduce your stress levels and in turn this will reduce the jaw pain and tightening of the jaw associated with stress.
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