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Temporomandibular Joint (TMJ) Dysfunction
and
Emotional Stress
Introduction
Emotional stress often plays an integral role in the development of TMJ dysfunction (TMD). Stress increases both the severity and duration of bruxism (clenching of the teeth) while asleep.
Also, many will subconsciously clench or grind their teeth more while awake during times of stress. The other way stress contributes to TMD is that during times of stress your pain sensitivity and susceptibility to inflammation will increase. As a result you are more likely to experience symptoms of TMJ or other pains that already exist. That is why the relaxation and stress management is a major component in the treatment of TMJ.
This article will explore in many details the connection between emotional stress and various manifestations of TMJ dysfunction.
Due to disparate descriptions of emotions in literature, it is needed for the purpose of this paper to find a base line definition of emotion and emotional stress.
While some authors define emotions in terms of their biochemical composition (Pert, 1997), others describe emotions and emotional stress as a subjective experience of the person which is elicited by a stressor that is specific for the individual and can be objectively measured as a physiological response (Ohrbach, Blascovich, Gale, McCall, & Dworkin, 1998). Another approach is of eastern origin when the emotions are viewed as a reflection of current body sensations based on previous experiences. The article “The Experience of Emotion” provides a good overview of the current outlook on emotions (Barrett, Mesquita, Ochsner, & Gross, 2007).
Defining emotion is clearly outside of the scope of this paper, so for the purpose of this work I will use the approach that measures emotional stress in terms of biological changes that can be objectively measured by independent observer through various technological means.
In general, it has been noted by many clinicians that temporomandibular joint dysfunctions (TMD) can be often observed in patients with high levels of emotional stress. In my own practice I commonly find TMD in patients with active emotional issues caused by life events such as separation, previous abuse or study overload.
There are studies that experimentally prove that emotional states can be a good predictor of jaw pain levels. (Glaros, Williams, & Lausten, 2005) Anxiety, depression, stressful life events are highly correlated to TMD. It is recognised that emotional stress may be an etiological factor in some dysfunctions; in other cases, however, anxiety or depression may result from a TMD.(Rugh, Woods, & Dahlstrom, 1993)
This paper will provide an overview of the connection between the emotional stress and temporomandibular joint (TMJ) from the osteopathic perspective.
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