From the Guidelines
The primary causes of Temporomandibular Joint (TMJ) dysfunction in female adolescents are multifactorial, including stress and anxiety, hormonal changes, poor posture, orthodontic treatment, joint hypermobility, trauma, and malocclusion, with up to 30% of acute cases becoming chronic 1. When considering the management of TMJ dysfunction, it is essential to address the underlying causes to prevent long-term complications and chronic pain.
Key Factors Contributing to TMJ Dysfunction
- Stress and anxiety: Leading to teeth grinding (bruxism) and jaw clenching, which puts excessive pressure on the TMJ 1.
- Hormonal changes: Fluctuations in estrogen levels during puberty may affect joint laxity and pain perception.
- Poor posture: Especially with increased use of smartphones and computers, leading to forward head posture and jaw misalignment.
- Orthodontic treatment: Braces or other dental work can temporarily affect bite alignment.
- Joint hypermobility: More common in females, this can lead to instability in the TMJ.
- Trauma: Direct injury to the jaw or whiplash-type injuries.
- Malocclusion: Misalignment of teeth or jaw can put uneven pressure on the TMJ.
Management Approach
To address these issues, a multifaceted approach is often necessary, including:
- Stress management techniques (e.g., mindfulness, relaxation exercises)
- Proper posture education and ergonomic adjustments
- Custom-fitted night guards to prevent teeth grinding
- Physical therapy exercises to strengthen jaw muscles
- Orthodontic evaluation and treatment if necessary
- Pain management with NSAIDs like ibuprofen (400-600mg every 6-8 hours as needed)
- Application of heat or cold packs to the affected area It is crucial for adolescents experiencing TMJ symptoms to consult with a dentist or orthodontist for a proper diagnosis and personalized treatment plan, as early intervention can prevent long-term complications and chronic pain 1.
From the Research
Causes of Temporomandibular Joint (TMJ) Dysfunction in Female Adolescents
- The etiological factors of musculo-articular dysfunction of the TMJ in adolescence can be dental anomalies, bad habits, disproportions in the growth of the bone and muscular skeleton, and hypokinetic states caused by psychophysiological responses to chronic stress 2.
- Factors predisposing to the disease include the presence of various bad habits, family history, trauma of the lower jaw and TMJ, and errors in orthodontic treatment 2.
- Oral parafunctions, such as nail-biting, grinding, and clenching of teeth, are commonly reported in adolescents with TMJ dysfunction 3.
- Morphologic malocclusion, unilateral contact, lateral shift, and mediotrusion interferences are also related to TMJ dysfunction 3.
- The presence of emotional stress is a significant factor, with 39.4% of patients reporting emotional stress 2.
- Clenching and grinding of teeth are related to frequency but not to intensity of headache, which is a common symptom of TMJ dysfunction 3.
- The prevalence of symptoms of mandibular dysfunction is higher in girls than in boys, with 20% of girls reporting symptoms each year 3.
- Increasing age, general health factors, and oral parafunctions are associated with TMD symptoms and signs in 10- and 15-year-olds 4.
- Stress response is an indirect contributing factor that usually works through the medium of clenching, and occlusal disharmonies increase noxious input to the neuromuscular system, causing increased muscle activity and spasm-pain 5.