The temporomandibular joint (TMJ) facilitates movement in the lower jaw with the help of the articular disc. Lockjaw is a symptom of a dysfunctional TMJ, making it difficult to open or close your lower jaw.
What is Lockjaw?
Lockjaw is a condition in which the lower jaw gets stuck in an open or closed position.
Closed lock: Most commonly identified when a person is experiencing difficulty opening their mouth. The mouth is unable to open to the standard 2-inch distance between the upper and lower teeth, typically limited to around one inch.
Open lock: People experiencing an open lock are unable to close their jaw to bring their teeth together.
How Does a Closed Lockjaw Happen?
The articular disc is an elastic piece of cartilage wedged between two elements in the TMJ. It enables smooth, flexible movement of the lower jaw and is held in place by ligaments. TMJ disorders, periodontal infections, or previous injuries can damage the ligaments, increasing the chances of an articular disc displacement. Hearing clicks or pops upon movement of the jaw often indicates that the articular disc isn’t functioning correctly.
Lockjaw occurs when the articular disc isn’t pulled back into place, resulting in the lower jaw getting stuck. While relatively uncommon, closed locks can be treated.
What Can I Do to Unlock My Locked Jaw?
You can do a few things at home to unlock your jaw, but it’s critical to see a TMJ specialist if they don’t work. Some closed locks won’t resolve on their own, meaning time is of the essence for treatment.
Try to Stay Calm
Your jaw is less likely to unlock if the muscles are clenched from stress. Try to stay calm to avoid adding more tension to the joint.
Apply a Warm Compress
Apply heat to your jaw for 10-15 minutes to help ease tension and reduce muscle spasms. A warm compress should always be applied before you attempt to massage or unlock your jaw. You can do this multiple times a day to help manage your locked jaw.
Massage Your Jaw
A gentle massage can improve blood flow and reduce tension in the lower jaw. Place 2-3 fingers just below your cheekbone and knead in circular motions for a few minutes. Afterward, gently try to move your jaw from side to side.
Treating a Closed Lock Jaw
The best chance for unlocking occurs within the first few days, so contacting a TMJ doctor as soon as the lock occurs is crucial. 30-day treatment with custom orthotics and closed lock procedures will help reduce inflammation, and in some cases, the normal range of motion may be restored. Over 30 days decrease the chances of being unlocked secondary to disc changes.
It’s important to understand that once unlocked, you may develop a clicking or popping sound on the side that was locked. Below is a list of treatment recommendations for a closed lock:
If you’re experiencing pain or discomfort from TMJ dysfunction, consider visiting a dentist trained in TMJ disorders. Visit Dr. Tracy Davidian to learn more and find an appropriate treatment plan for you.
You’re probably familiar with Botox and its cosmetic uses, but most don’t consider its other applications for medical treatment. Medical botox can help to treat a variety of medical problems related to mouth, jaw and head pain.
What Exactly is Botox?
Botox is derived from the botulinum toxin (BoNT) that’s produced by the Clostridium botulinum bacterium. The botulinum toxin has many medical uses and was originally used to treat strabismus, also known as crossed eyes. Over time, these patients reported fewer headaches in conjunction with their treatment, opening an opportunity for Botox to be used in other applications.
How Does Botox Work?
Once injected, Botox blocks chemical signals that often tell our muscles to move or send pain transmissions. By temporarily blocking these signals, the muscle will be paralyzed for a short period of time—alleviating pain and tension.
TMJ Botox Treatments
Although Botox can be applied in multiple areas of the body, Carolina TMJ focuses on Botox treatments for medical issues that include:
Chronic migraines and headaches
TMJ
Jaw pain
Bruxism
Are Medical Botox Treatments Right for Me?
It’s important to consult a professional about your options to know if medical Botox is the right choice for you. Botox should only be administered by licensed professionals who will assess your needs and perform the procedure safely and correctly.
Alleviate Your Pain with Carolina TMJ
Suffering from TMJ or jaw pain? Contact us today to learn more about Botox and how treatments with Carolina TMJ can help.
This is a very common question that we get at Carolina TMJ. Sometimes new patients come in with no jaw pain or limitation in opening before a dental procedure or extraction, begin experiencing pain or limitation after a procedure. While you may think this is because your dentist did something wrong, the vast majority of the time, that’s not the case.
Reasons For Jaw Pain
Typically, jaw pain after a dental procedure is the result of a chronic or underlying jaw condition. Here are the most common reasons for jaw pain and how we diagnose these conditions:
Trismus
This is the involuntary contraction of the jaw muscles, sometimes due to inflammation of those muscles. This inflammation will contribute to muscle irritation and spasm. Trismus is typically treated with muscle relaxers, NSAIDs, and jaw stretches. When this becomes chronic in nature, or the above treatments do not seem to do the trick, patients come to see me for relief.
Temporal Tendonitis
Temporal tendonitis is the inflammation of the temporal tendon which connects the temporal muscle on the side of the head to the mandible. Symptoms of temporal tendonitis can include:
Limitation in opening the mouth
Pain/pressure behind the eye
Temporal head pain that can radiate to the forehead
Ear pain/congestion
Pain/swelling in the cheek
Teeth sensitivity
Occlusal wear (loss of tooth structure) on a patient’s teeth, possible arthritis occurring in a patient’s joint, or a history of clenching can all contribute to temporal tendon inflammation. This condition is harder to treat through medication alone, and we have several ways that we treat this condition successfully in our practice every day. Proper diagnosing is crucial as a first step, as it allows us to create a more effective treatment plan.
Arthritic Joint
It is possible that you had an arthritic process already occurring in one or both of your temporomandibular joints, and the dental procedure aggravated both your joint and the soft tissue supporting your joint. Your temporomandibular joint is used more than any other joint in your body, and it can develop the same issues as your other joints, including arthritis.
We have a protocol we follow for most of our patients with arthritic joints. It can involve custom orthotic therapy, injection therapy, and/or medication, and there are instances that we will refer a patient for further x-rays or MRI.
Closed Locked
Although it is a rare occurrence, it is true that a patient can become locked after a dental procedure. The reason this happens is based upon how the patient’s joint relates to the articular disc prior to the dental appointment. Here is the ideal joint/disc relationship and a view of the anterior displaced disc/joint:
Many patients come in with a disc anteriorly positioned to the joint without actual joint pain. These are patients that have clicks or pops when opening/closing, chewing, etc, but have no pain with the click. It is usually inflammation or a change in the shape of the disc that causes a patient to lock closed (the joint not able to reduce or click onto the disc).
When this occurs, pain will follow along with a limitation of opening and movement of the jaw. Often these patients share that their jaw clicked prior to the dental procedure, but now no longer clicks and they are now very limited in opening and have moderate to severe discomfort when attempting to open.
Let Dr. Davidian Relieve Your Jaw Pain
As you can see, there are many reasons why your jaw may now feel discomfort after a dental procedure or extraction. If you have attempted to resolve this discomfort and have been unsuccessful, you are not alone. We’re here to help you find relief. You can contact our office and schedule your appointment by calling us at 919-782-9955 or requesting an appointment online. We look forward to meeting you and helping you become pain free.
Midtown Magazine featured Dr. Tracy Davidian of Carolina TMJ & Facial Pain Center in their 2021 Meet The Doctors series. This annual series highlights some of the most exceptional healthcare providers in the Triangle.
Averaging over 140,000 readers for each issue and nearly one million readers annually, Midtown Magazine is a respected voice in the Raleigh area. Dr. Davidian is honored to be included in 2021 Meet The Doctors. You can pick up the September/October 2021 issue with Dr. Davidian’s feature at over 500 local businesses, at Midtown and Cary Living events, or with a subscription to the magazine.
“My ear hurts but I have gone to the doctor several times begging for an antibiotic and he keeps telling me that my ear looks fine!”
This is more common than you may think. Many of my patients have complained about this. They present with severe ear pain and pressure, some eye pain or pressure, pain around the temple area, and sometimes sensitive upper teeth. How could this not be an infection of some sort….right? Well the truth is, you may be suffering from temporal tendonitis.
What is Temporal Tendonitis?
Temporal tendonitis is a craniofacial pain disorder which results in the inflammation of the temporal tendon which connects the temporalis muscle on the side of the head to the mandible, or lower jaw, on the coronoid process.
Temporalis Muscle attaches to the lower jaw (mandible) on the Coronoid Process by the Temporal Tendon
After our examination, I usually discover signs of occlusal wear on a patient’s teeth, possible arthritis occurring in a patients joint, or a history of clenching. All of these, and other predisposed conditions, can contribute to temporal tendon inflammation.
If a patient has an irritated temporal tendon prior to a dental procedure (or any of the other reasons listed above), it is more likely that they will develop a tendonitis after the procedure is completed (or after taxing the tendon through normal function: yawning, eating, etc).
What Causes Temporal Tendonitis?
You may develop temporal tendonitis from:
Trauma to the side of your face/head
Being opened really wide for a long period of time for a dental procedure
Yawning really wide
Eating very hard foods
Loss of vertical dimension of occlusion (the distance between your nose and chin is shorter than it was when you were younger – you are becoming over-closed)
Chronic parafunction (your bite is off and your teeth do not come together appropriately)
Hypertrophy of the coronoid process (your coronoid process, a part of your lower jaw, becomes larger than it once was)
Temporal Tendonitis Symptoms
If you have one or more of the causes of temporal tendonitis listed above and experience one or more of these symptoms, it’s time to give us a call:
TMJ pain
Eye pain
Ear pain and pressure or congestion
Limitation in opening the mouth
Pain/pressure behind the eye
Temporal head pain that can radiate to the forehead
Pain and/or swelling in the cheek
Sensitivity of the teeth, particularly the upper maxillary teeth
How Do You Treat Temporal Tendonitis?
Treatment of temporal tendonitis can involve multiple processes such as:
Anti-inflammatories like ibuprofen
Muscle relaxants
A soft diet
Splints/orthotics
Physical therapy
Biofeedback if clenching related
Injection therapy with a long lasting local anesthetic and a steroid, sarapin, or prolotherapy
Temporal tendonitis is harder to treat through medication alone. We have several ways that we treat this condition successfully in our practice every day. Proper diagnosing is crucial and allows us to create your ideal treatment plan.
If you believe that you may be suffering from Temporal Tendonitis, we can help you! Call us today for an evaluation and treatment and be done with that ear pain once and for all!
Dr. Tracy Davidian
Fellow of the American Academy of Craniofacial Pain
Fellow of the Las Vegas Institute of Neuromuscular Dentistry
One of the first questions patients ask me when they are at my office for their New Patient or Consult appointment is: “How can a Dental Appliance help my Headaches/Migraines go Away?” The simplest way to explain this is by having them imagine a Bucket. We each have our own Buckets that are filled with our daily intakes. For example, if you drink coffee every morning….that cup will go into your daily bucket. If you drink a glass of wine every night….it to will go into your bucket. Other things that get poured into our individual daily buckets are: stress, lack of sleep, food allergies, allergies in general, monthly hormonal changes, temporomandibular joint or facial muscle issues, etc… What happens when your bucket gets full of daily intake? For a lot of my patients, they develop headaches or migraines. These headaches/migraines can be debilitating for a lot of my patients. It, in fact, is what brought them to my office in the first place. So back to the question: How can a Dental Appliance Help My Headaches/Migraines go Away?….. It has been proven that by repositioning the lower jaw in a down and more forward position, that the muscles of the face begin to relax. They are no longer constricted and in spasm; thereby, reducing headaches/migraines. Now how does this relate to the bucket? It is a wonderful thing for my patients, and for others that suffer from headaches/migraines, that by repositioning and relaxing the muscles of the face…. a huge portion of the bucket is emptied. This is Fantastic! My patients have fewer, if any, headaches/migraines with this treatment. And, I’m referring to my Many patients who have had debilitating, in the corner, lights off Migraines for many years…….they are now gone or Greatly Reduced. Will you ever have another headache/migraine with this treatment? Well sadly, the answer is probably yes. Occasionally. However, you are Always in Control of what You put into Your Daily Bucket. If you are filling it with EVERY Trigger you have, then chances are you will get a headache…. The power is still in Your Hands. But isn’t it Fabulous to know that You are In Control? An Occlusal Appliance will Help to Give you that Control….and in turn, help to Give you Your Life Back. Call Now……Physiologic Aesthetics is Where the Pain Ends and Your New Life Begins! 919-366-PAIN
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Dr. Tracy Davidian is bringing revolutionary sleep treatments to the Triangle. Dr. Davidian uses state-of-the-art technology to treat snoring and sleep apnea.
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