Pain and clicking in the jaw? Don’t be surprised if your doctor prescribes a vacation rather than medicines. Because an aching jaw could be the symptom of stress, anger and anxiety. Working professionals are increasingly heading to the dentist or ENT specialists complaining of pain in the jaw or in front of the ears. It’s the result of people controlling their anger by gritting their teeth during stressful situations.

The jaw ends up absorbing the pressure, leading to a phenomenon called temporo mandibular joint (TMJ). And such patients usually benefit from counselling sessions and psychiatric treatment. “In the UK,” said Dr Anand Krishna, “all patients who come in with TMJ are given anti-depressants.
 
These medicines act as mood lifters and help in reducing stress and anxiety, thereby reducing the problem. I have even asked some of my patients to first go on a holiday and then come and see me.

There is usually a noticeable improvement after their vacation.” It’s not just professionals who complain of the problem. Even those going through an emotionally trying time can be susceptible. When 26-yearold Rashmi Menon hit a rough patch in her marriage, she had another kind of pain to contend with, apart from the emotional one: Pain in her jaws and inexplicable headaches.

After many visits to the general physician and the ENT specialist, Rashmi visited a dentist to find that the meniscus (disc between the jaw joints) had suffered severe wear and tear. “Women seem to be more susceptible to TMJ.

One of the reasons could be that they are better at multitasking and hence are under more pressure and stress than men,” said Dr Krishna. While Rashmi used to clench her teeth, others who don’t still get affected.
 
The reason being that the orofacial – face and mouth – region is the most sensitive part of the body and even a little stress can cause muscles in this region to go into spasms, resulting in pain while chewing, dislocation of the jaw and earlymorning stiffness in the jaw followed by headaches. Other symptoms include ear pain, toothaches, dizziness and ringing in the ears (tinnitis).
 
Many patients go to the ear specialist quite convinced their pain is due to an ear infection. But when that is ruled out, the doctor considers the possibility that the pain is caused by TMJ. “Proper diagnosis of TMJ begins with a detailed history and physical examination, including careful assessment of the teeth occlusion and function of the jaw joints and muscles,” said Dr Anuradha.
 
“Patients often get referred from the ENT specialist. I have had patients as young as 13 who have come with TMJ problems. We counsel them and teach them various kinds of exercises that could give them some relief,” she said.

Though TMJ can cause great discomfort, the treatment is usually conservative, ie non surgical. “Only in very advanced stages do we opt for surgery. Otherwise, we use an oral splint to align the muscles.

The patient has to wear the splint anywhere between six and eight weeks. Once the splint is removed and the muscles are back in place, there is usually a change in bite. Regular visits to the doc and a few exercises can help,” she said.

Two such exercises are placing a hand below the jaw for support and opening it and closing or moving it from side to side. Both these exercises should be done two or three times a day to a count of five. “However, these exercises should not be done advanced cases,” she added.

►   Women seem to be more susceptible to TMJ. One one of the reasons could be that they are better at multitasking and hence are under more pressure

-  Dr  Krishna