TMJ Disorder: Will it get worse with stress?

If you are experiencing jaw joint pain, possible TMJ disorder, stress is the most common contributing factors that seems to aggravate the condition.

The jaw joint is comprised of a very sophisticated network of muscles, cartilage, and ligaments. It is responsible for your ability to chew, speak, and even smile. The joint, known as the Temporomandibular Joint (TMJ), is also prone to various disorders or various levels of dysfunction. The symptoms of TMJ disorder can range from mildly uncomfortable to severely debilitating, and often requires the expertise of a TMJ specialist in order to find relief.

TMJ Disorder can sometimes be a mysterious condition since determining the exact cause can be complicated. However, there are certain contributing factors that seem to aggravate the condition, the most common being stress. 

There are certain contributing factors that seem to aggravate the condition, the most common being stress.

As a natural human response to stress, most of us tend to clench or grit the teeth when the level of intensity increases in our lives. Unfortunately, our bodies sometimes react to stress even without our knowledge or control. What’s more, the stress can come in all shapes or forms, from strong concentration at work to pushing the limits at the gym. It can even be emotional in nature, as something that lingers in your mind even as you sleep.

Since stress isn’t necessarily something that you can see or hold in your hand, you may not recognize how deeply it affects you until you are challenged by a worsening TMJ condition. The muscles of the face and jaw may begin to tighten, you may wake to find that you’ve been clenching or gritting your teeth all night, or you may be derailed by intense headaches. Some patients might notice that they are experiencing more chipped teeth, broken fillings, and sensitivity.

All of these symptoms can indicate that the stress in your life has manifested in your jaw joint. The joint is working overtime, taxing the muscles, the teeth, and even the gums. Managing the stress in your life may take some time, but there are ways to protect your joints, teeth, and muscles in the meantime.

If you have questions or would like to schedule an appointment, please contact Dr. Larry Wolford’s office using our online contact form or call 214-828-9115.

Condylar hyperplasia (CH) is a generic term describing enlargement of the condyle.  There are a number of different condylar pathologies that enlarge the mandibular condyle, with subsequent adverse effects on the morphology and function of the TMJ and mandible.  This may result in the development or worsening of a dentofacial deformity such as; mandibular prognathism (symmetric or asymmetric), and unilateral enlargement of the condyle, ramus, and body, facial asymmetry and malocclusion. 

Wolford has developed a simple, but encompassing classification that will allow the clinician to better understand the nature of the various CH pathologies, progression, and treatment options that have proven to eliminate the pathological process and provide optimal functional and esthetic outcomes.  The classification (Table 2 and Figure 29) also begins with the most common occurring form of CH and progresses to the least common occurring form.

CH Type 1:  This condition develops during puberty, is an accelerated and prolonged growth aberration of the normal condylar growth mechanism, is self-limiting but can grow into the 20’s, and can occur bilaterally (CH Type 1A) or unilaterally (CH Type 1B).

CH Type 2:  These condylar pathologies can develop at any age (although 2/3s develop in the 2nd decade), are unilateral condylar vertical and/or horizontal over-growth deformities, and are the most common occurring mandibular condylar tumors; osteochondroma (CH Type 2A) and less common osteoma (CH Type 2B).

CH Type 3:  These are other rare benign causing condylar enlargement. 

CH Type 4:  These are malignant conditions that can cause condylar enlargement.

The more common forms of CH (Types 1 and 2) will be presented relative to the clinical and radiographic findings, growth characteristics, effects on the jaws and facial structures, histology, and treatment considerations that are highly predictable in the elimination of the pathology and provide optimal treatment outcomes. 

FIGURE 29 Description

A-C) normal TMJ with balanced joint spaces.
D-F) CH Type 1 with relatively normal condylar shape, elongated condylar head and neck, and narrow joint space related to thin articular disc or displaced disc.  In the coronal view the condylar head is more rounded.
G-I) CH Type 2Av; an osteochondroma with a vertical growth vector without significant horizontal condylar enlargement or exophytic horizontal growth. This is a “young” osteochondroma with only about 3 years of growth.
J-L) CH Type 2Ah; an osteochondroma with horizontal (as well as vertical) enlargement of the condyle and exophytic outgrowth of the tumor. This tumor has been present for 6 years. Notice the significant increased vertical height of the mandibular body and ramus.

FIGURE 29