Jaw Disorder Can Be Helped


January 7, 1993|By Dr. Paul Donohue

Dear Dr. Donohue: Suddenly, I developed this awful aching when I ate anything. It was not a tooth problem. My dentist settled that for me. He said it had all the earmarks of temporomandibular joint disorder. I know you wrote on the subject awhile back, but frankly, I skipped the item. I am not interested in a full rundown. What I want to know chiefly is whether it is curable by surgery or non-surgical treatments. -- Mrs. V.K.

Dear Mrs. V.K.: The temporomandibular joint is the jaw`s hinge, so it gets lots of work in a lifetime. You activate that joint even when you open your mouth slightly. It has a sliding kind of movement, one part of it slipping over the other.

Pain in that joint usually means some slight disorientation. The fact that the area is richly endowed with nerves causes the wide array of symptoms. Often, parts distant from the joint become focuses of pain, such as the ears, neck, eyes, teeth and throat. Muscular spasms are part of the pain picture.

One early sign of problems is a kind of clicking noise with jaw movement. X-rays and magnetic imaging may be required for evaluation.

Treatment runs the gamut from dental repair to muscle relaxant medicines. Special jaw splinting and corrective prostheses are available. Only rarely, in about one in 20 patients, is surgery to reposition the joint necessary.

Ask your dentist to help you, or to refer you to a specialist.

Dear Dr. Donohue: We have a hot tub. My husband and I are planning to start a family. A friend tells me I should stay out of the hot tub when I get pregnant. Does that make sense, or is it just another of the scare stories? -- A.H.

Dear A.H.: It`s true. The heat of a hot tub or a sauna can create serious temperature problems for the fetus, especially in the first three months. If you use one later in pregnancy, you should not stay in longer than 10 minutes.

For L.E.: No study I know of indicates any danger to the mother or baby from ultrasound. One concern voiced early on was of possible effect on mental ability. The British magazine Lancet reports on one study involving a group of 2,000 babies. The researchers studied subsequent school performance, at age 9, and no difference was found in performance between those who had been exposed to ultrasound and those who had not.


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