Ear-popping pain stems from TMJ

Dear Dr. Roach: I have seen several doctors for my TMJ: my primary doctor and dentist, an ear nose and throat doctor, the dental hygienist and also “ask Google.”

I am a 73-year-old female and have had this problem on the left side of my face for at least a couple of years. It started with pain in my left ear that can last for 10 minutes or all day. Now, for months, when I eat almost anything, my left jaw makes a popping sound. The only thing I do is press my check with my hand to make it stop and continue with a meal. The popping does not hurt, but the ear aching does.

My ENT said the jaw is a joint, like your knee or elbow, and it can pop and also have arthritis in it. He suggested I ask my dentist for help. I did, and he knew of nothing that would help me. Please tell me what I can do for relief or even possibly some sort of physical therapy.

V.C.

Answer: Your ENT specialist is quite correct that the temporomandibular joint, like any joint, may develop problems. However, the movement of the lower jaw on the upper jaw is unlike any other joint, so the TMJ may develop unique problems.

Years ago, TMJ expert Dr. Carol Cunningham wrote this to me:

“I instruct patients to sleep on the edge of the pillow, and to make sure that the pillow ends even with their ear. They should have nothing touching (no pressure) on their face past the point of their ear. The facial muscles want to be neutral and relaxed during sleep. If pressure is exerted on the muscles by a pillow, hand or arm, then the muscle will try to get back to a neutral position. Most often this is done by clenching and grinding. Pressure can be exerted on the muscles and joint, and this results in pain. We see a lot of TMJ problems in people who are stomach sleepers, as this results in the jaw being torqued throughout the night from lateral pressure on the face. I also tell patients to be aware of what they are doing with their teeth during the day. The only time teeth should touch is when you eat (and very briefly during certain words).”

If this advice doesn’t give adequate help, find a local TMJ expert.