27Aug

TMJ in Children

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TMJ disorders are medical problems related to the temporomandibular joint (TMJ), the joint that connects the lower jaw to the skull. The TMJ is the most complex joint in the human body, consisting of three major parts : the lower jawbone, the pit of the temporal bone, and the associated connective tissue. The TMJ connects the lower jaw to the bone on the side of the head. The muscles and ligaments surrounding the joint work together to allow it to move. The health of those surrounding muscles and ligaments — and the health and position of your child’s teeth —all contribute to the proper alignment and functioning of the TMJ.

It is estimated that one in every six children have a TMJ disorder which can arise because of over-exertion of your child’s TMJ. Some examples of conditions that can cause this over-exertion are high levels of stress or anxiety, grinding or clenching of the teeth, or trauma to the jaw. When these muscles are over-exerted; chewing, smiling, and even breathing can become difficult. When children and teenagers have symptoms like these, they are likely to have developed a TMJ disorder, which may require treatment.

About TMJ Disorders

TMJ disorders can cause pain in the head, neck, jaw or face; including headaches. It can also cause issues with jaw alignment that includes:

chewing or biting
popping or clicking sounds when opening and closing the mouth
jaw that can be locked open or locked shut

TMJ disorders can affect kids of any age, but are much more prevalent in teenagers, and occurs more frequently in girls than boys. According to the American Academy of Pediatric Dentistry (AAPD), there is a rising concern about TMJ disorders and teenagers.

Causes

There are multiple factors that lead to the development of TMJ disorders. Children and teenagers are more likely to develop TMJ as a result of trauma to the jaw; for instance, impact injuries to the chin as a result of a fall. Stress can also influence TMJ, causing kids to grind their teeth, clench their jaws or tighten their jaw muscles. Bruxism (jaw clenching or grinding) over works the TMJ, leading to the disc in the joint wearing down or moving out of place. It can also cause a change in the alignment of the teeth, which affects chewing.

Additional TMJ factors:

teeth clenching or grinding
stress or anxiety
trauma to the jaw or the joint
muscle spasms
misalignment of the jaw (malocclusion)
Arthritis
Open bite
Extended overjet
Crossbite
Missing teeth
Hyper-extention
Postural and resting positions

Signs and Symptoms

If your child is suffering with any of these symptoms, you may want to consult your doctor or a sleep specialist. Some of the most common are:

difficulty opening or closing the mouth
pain in the facial muscles, jaw joints, or around the ear, and sometimes in the neck and shoulders. Some people have pain when they talk, chew, or yawn; a few might notice muscle spasms
popping, clicking, or grating sounds when opening or closing the mouth difficulty chewing or biting
headaches, dizziness, ear pain, hearing loss, and ringing in the ears
jaw locking; either open or shut
asymmetrical jaw opening, uneven vertical or lateral movements of the jaw

Signs and symptoms of TMJ may range from mild to severe, and some completely disappear over time. Fortunately, in most cases, individuals tend to be able to function fully. Age impacts the prevalence of most of these signs and symptoms, usually increasing with age.

Here are some helpful questions to ask your doctor or sleep specilaist about your child's TMJ disorder.

What is causing my child’s TMD?
Are there any tests we should do to confirm the diagnosis?
What can we do at home to help relieve the pain?
Will my child have to have surgery?
Do the medications you’re prescribing have any significant side effects?
Will the symptoms of TMD go away? What is my child’s long-term outlook?

Treatment

TMJ disorders are often generally managed rather than cured. For some children with more mild TMJ disorders, simply resting the jaw for a few days can provide relief. Applying ice packs or heat to the sides of the face may also help your child feel more comfortable.

Work on changing any habits that aggravate the joint or the muscles of the face. This includes avoiding chewing gum, hard foods, clenching or grinding the teeth, or opening the mouth extra-wide while yawning. Offer your child or teenager soft foods that cause less tension on the jaw.

Depending on the severity of a TMJ disorder diagnosis, further treatments might be necessary. A child whose jaw is locked will need to have the jaw manipulated until it can be opened or closed. Sometimes this is done under sedation.

If the TMJ pain is caused by bruxism (clenching the jaw or grinding the teeth), your child may need to be fit with a bite-plate to wear at night. Medicine also can be prescribed to help relieve the pain or relax the muscles.

If the child does not respond to the treatments, they might need surgery to repair damaged tissue in the joint. This is very rare in treatment for TMJ disorders.