Covid and Jaw Pain (TMJ or TMD)

As a dentist, one of my areas of responsibility is helping patients with jaw pain, commonly referred to as TMJ disorder. This is a common condition that afflicts many people, with varying degrees of severity. Causes of jaw pain can include trauma, malocclusions (poor bite alignments), chronic pain syndromes, postural issues, sleep issues, and psychological stress. These are just a few of the plethora of conditions that negatively affect many people’s quality of life.

To clarify a common misconception, TMJ is not actually a disease. TMJ is an abbreviation of temporomandibular joint. Everybody has 2 TMJ’s, which help connect their jaw to their skull. The actual condition (disease) is termed temporomandibular disease (TMD). Now that we have the terminology aligned, let’s take a look at a recent uptick in cases of TMD.

It is no secret that the Covid-19 pandemic has been stressful on a global scale. It would be a rarity to not have your day and routine affected by Covid in some way. For many people, Covid has flipped their worlds upside down. This has resulted in a high degree of stress. Stress is a complex response by the body that is often manifested in the muscles. Ancient Chinese medicine is known for saying that pain is the body’s way of telling the story of psychological stress. I believe this to be true. From back pain to neck pain to jaw pain, pain is the body’s way of telling a story, and that story is often one of psychological stress.

In our office, myself and the other doctors have had a very significant uptick in patients coming in with TMD. In addition, we have had an increase in cracked teeth, broken teeth, and a host of other urgent dental emergencies that have often required restorative dentistry solutions. It is clear something is different, and we are all in agreement that it’s likely the stress from Covid.

There is one more likely contributor to this situation: the wearing of masks. Not many of us enjoy wearing masks, and we all yearn for the day when they can be relegated to their conventional uses. In the meantime, we should know the risks these masks pose to our jaw health. Myself and my colleagues have concluded that the uptick in cases of TMD is a result of masks for 2 reasons.

The first assumption is that masks are forcing the lower jaw (mandible) to be forced up and backwards, a direction the jaw doesn’t necessarily like to be in. It prefers to be down and forward, such as the position it assumes when we bite into an apple. As the jaw goes up and backwards, the muscles fight this and attempt to brace the jaw down and forward. If you were asked to stand on one leg for long periods of time, that leg would hurt. Asking your jaw muscles to act “unnaturally” for long periods of time has indeed taken its toll.

The second assumption is that masks decrease our ability to breathe adequately. Breathing is one of the body’s most important functions. Without breathing, we don’t get oxygen. Without oxygen, there is no human life. As the body is theoretically getting less oxygen, for lengthy periods of time, there is a fallout. Without getting into the physiology of this fallout, suffice it to say that this might be contributing to the stress we are discussing here.

Well, this is all good and well, but what do we do? Good question. Much of this is up to a wide array of medical practitioners, such as your physician, psychologist, chiropractor, nutritionist, and exercise coach. TMD is a multi-disciplinary condition that is only in part treated by myself and my dental colleagues. For a comprehensive approach, I’d suggest you discuss this situation with the aforementioned clinicians.

In the meantime, I’ll share what I’m doing to deal with my TMD. Yes, even dentists can get TMD. I’m focusing on my mental health. I’m a huge proponent of spending 1 hour a day on my mental condition. Reading, meditating, breathing, yoga, walking, and other forms of physical exercise, puzzles, journaling and much more can help one relax, both mentally and physically. The brain yearns for these activities. The brain controls everything. Give the brain what it needs, and everything else seems to fall into place. This is especially true in times of psychological stress.

Don’t have time for this? Very few people do. To help you discover the time, may I suggest the book Morning Miracle by Hal Elrod. This very short book is an easy read, and it has changed my life, as well as the lives of many others. It is an approach to early mornings that gives you new found free time that you can use on one of these stress-reduction methods.

Covid has damaged many things, including people’s oral health. But we can fight back. Hopefully this awareness of the situation will give you and your jaw a fighting chance. If there’s anything we can do to help, don’t hesitate to contact Saco River Dentistry. Our office number is (207) 929-3900 and my email is [email protected]

Best of luck in your journey to health and well-being. Just know we are all on that journey with you!

In Good Health,

Nicholas K. Roy, D.M.D., M.A.G.D.

Master in the Academy of General Dentistry