1. Pain in the Head (Headaches), Neck, Shoulders

Often, unstimulated pain in the head, neck, and shoulders may be muscle dysfunction related to malaligned occlusion. This syndrome is described as temporomandibular dysfunction (TMD). Innumerable causes are related to head and neck pain, and patients are advised to contact their dentist as soon as possible before making any conclusions, to confirm that the pain they are experiencing may or may not be related to occlusion (bite).

Pain related to occlusion and jaws is most common in the following locations: sides of head (temples), sides of lower jaw (cheeks), lateral sides of neck, back of head, top of shoulders, and upper back. Pain in one or all of these locations may be present at the same time. Usually, head pain (headaches) is not related to the jaws if it is in the eyes, nose, forehead, or top of the head. If pain is present in these locations, you probably do not have a jaw problem. Numerous diagnostic methods may be necessary to confirm that the pain is related to the jaw. Although there are many sophisticated treatment methods for muscle pain (headache) related to occlusion (bite), the simple, more common treatments, listed below, are emphasized in this book.

2. Clicking or Popping Jaw Joints

On movement of your jaw, you may feel or hear a “click” or “pop” on opening, closing, or both. This sound may be loud enough to attract the attention of other people, but it may be slight enough that only you are aware of it. Pain may or may not be associated with the sound. You may stimulate the pop by various movements of your mouth, or by chewing in ways that place stress on your jaw. A click without pain may not be a problem, but a click with pain usually signals that some problem is present. The usual conservative therapy for jaw joint clicking includes one or more of the following treatments:

3. Grinding or Grating Sound in Jaw Joints (Crepitus)

After months to years of mild jaw dysfunction and/or presence of other conditions such as an accident or arthritis, a grinding (“gravel”) sound in the jaw joints may occur. This condition usually indicates some breakdown of the jaw joints that may or may not have been associated with the occlusion (bite). When this sound occurs, the possibility for successful, simple, conservative treatment is reduced. However, the sequence of therapy for grinding or grating jaw joints varies from relatively simple to complex. Any or all of the following treatments may be used:

4. Can’t Open Jaw Or Can’t Close Jaw

Occasionally the bones, ligaments, and muscles that make up the mechanism of the jaw joints become malaligned, and, as a result, the jaw locks open or closed. This can be painful as well as frustrating. Frequently, your dentist can assist the jaw to open with simple manipulations in the dental office, but more often other treatment is required. One or more of the following treatment methods will probably be used:

5. Teeth Visibly Worn From Bruxism or Clenching

At least one fourth to one third of the world population grinds their teeth excessively, thereby wearing tooth structure beyond normal expectations (Fig. 11.1). This activity is called bruxism or clenching. During the first years of life this wear usually goes undetected, but soon it is evident, and concern is expressed. In the later stages of this problem, pain or even tooth death is caused by the wear. If you brux or clench your teeth excessively, you have the following potential treatment options, directly related to the severity of the condition as observed by your dentist:

FIG. 11.1 Worn teeth caused by excessive tooth grinding, bruxism, or clenching.