Robert Hayden, DC, PhD, FICC
Not long ago a young lady came to see me with left jaw pain. That immediately gets my attention because frequently women present with jaw pain that is actually cardiac in origin. In this case, however, the jaw was actually sore to touch, and that will not happen if it is cardiac in origin. This could be just what appeared to be, maybe. It could be simply jaw pain. Of course, nothing is that simple.
Put your fingers at the angle of your jaw and then clench your teeth. The muscle you feel tightening is the masseter, a primary muscle for chewing. Sometimes when it is sore, someone has been chewing gum (or, gag, tobacco) excessively. That was not the case here. So I pressed on for more information.
Drawing from my own experience with jaw pain, I asked a few pointed questions. Yes, she did awaken in the mornings with her mouth feeling sore and swollen. Yes, it did hurt to fully open and extend the jaw. Yes, it was getting worse. The only positive aspect she saw was that her jaw pain was a mild deterrent to eating during the holiday.
So many times this story unfolds with a consistent pattern. Someone is stressed. That stress interferes with sleep and rest. Muscles stay active when they should be asleep, including those that operate the jaw. Grinding your teeth at night is called bruxism, and it is fairly common.
This particular young lady was not aware that she was grinding her teeth. Whatever happens in that twilight between sleep and wakefulness is not necessarily recorded in our conscious mind. For this reason, I believe most people who have bruxism at night are really unaware of it.
The cause? This young lady is married, has four children and two grandchildren (the word “young” is relative, you see?), four dogs, some fish in a tank, a sick and needy father, and a very elderly and fragile direct relative in another household for whom she provides direct care. She also works part-time approximately 20 hours per week. She is active in her church and engages in some volunteer activity in fundraisers for missions. Do you think she might be stressed? Does she feel the need to be in more places at one time than actually possible? She even feels guilt when she cannot perform all of these roles 100% every minute of every day.
From my standpoint, the treatment is fairly simple. She observed with some anxiety as I put on a glove and asked her to open her mouth. There is a muscle inside the jaw (medial pterygoid) that can be massaged in order to decrease jaw tension. It is not an activity you would classify as “fun,” but it yields great dividends in loosening the jaw.
I used a form of electrotherapy in which I put one electrode on her shoulder and the other on my left hand. I then placed my finger over her left masseter muscle with some ultrasound gel on it and turned on the electrotherapy unit so that the electrotherapy went through my fingers into her masseter muscle. This allows me to do trigger point therapy on that spastic muscle and electrotherapy at the same time, actually pinpointing the electrotherapy with my finger. I can control her comfort because I feel exactly what she does.
This actually relaxed her jaw so much that I did not need to go further. There are other treatment options available to us if we need them. We can carefully chiropractically adjust the temporomandibular joint (TMJ) to provide significant relief with jaw pain. We sometimes use a laser on the jaw to promote deep healing. We can also ultrasound this joint.
If she had a dentist, I would send her to have a bite block made that would keep the teeth from grinding on each other. It is worn at night and is quite comfortable. One alternative (if there is no dentist available) might be to visit a sporting goods store and buy a mouth guard that fits as snugly as possible. That is a fairly inexpensive way to protect your teeth while you are asleep, but it is not as good as the custom bite block you would get from your dentist.
A possible result of ignoring this problem, or staying unaware of it as I did, is that you will break your own teeth. During a particularly stressful time about 10 years ago, I was unaware of my own bruxism at night. I now have a crown and two dental implants to reinforce my learning.
Of course, this treats the immediate problem. Stress is causative. Much time is typically devoted to talking to patients about how to positively handle the rocks that life throws at us. The young lady in this story is faith-driven, and she personally knows her Creator-- the One who promised (in writing, like a guarantee) He would never lay on us more than we could handle with His help. She and I would agree that He has a lot of confidence in her. If I were God, I would be proud of her.
So if you have bitten off more than you can chew, so to speak, and you recognize any of this in yourself, give me a call. Let’s fix your jaw and then you can take it from there.