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Temporomandibular Joint (TMJ) Dysfunction
and
Emotional Stress
Physiological effects of emotional stress on the body and its effects on the TMJ
Effects on the visceral system
Reflex muscular contraction is present in tensor tympani and tensor veli palatini muscles in rhythmic opening and closing of the Eustachian tube. It is suggested that these muscles can exhibit tonic spasm due to the cranial nerves V and VII irritation in TMD. This muscular behaviour may correspond to a reflex pattern due to constant fatigue of these muscles during increased emotional tension and stress.(Klockhoff, Lindholm, & Westerberg, 1971)
Sustained contraction of these muscles in TMD may alter inner ear perilymphatic and endolymphatic pressure through changes transmitted from the oval window toward the walls of the labyrinth and semicircular canals. This may lead to vestibular and cochlear impulse imbalance and symptoms such as: vertigo, hearing loss, tinnitus, and ear ache. (Ramirez, Ballesteros, & Sandoval, 2007)
It can be postulated that the above symptoms can further exacerbate the emotional stress of the patient.
Natural killer cells were shown to decrease their activity in the peripheral structures during stress.(Pike et al., 1997) This explains the altered immune response and can point to altered states of inflammation in peripheral structures pertaining to TMJ.
Rhythmic jaw movements during sleep could contribute to the release of saliva to protect, through a lubricating action, the integrity of oro-esophageal structures.(Lavigne et al., 2003)
Lack of salivation (dry mouth) is a well known effect of emotional stress. And this example clearly demonstrates how sleep bruxism can be an essential adaptation to the lack of salivation caused by stress.
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