Tmj and Vertigo

The Temporomandibular joint is the joint where your jaw attaches to your skull. If this joint becomes inflamed, it can cause a variety of symptoms, some of them not even related to each other. One of these symptoms is vertigo or dizziness.

Temporomandibular disorder (TMD) and vertigo are related due to the proximity of temporomandibular joint to the ear. Vertigo can cause balance issues, which can lead to falls or serious injuries.

TMD usually resolves on its own, but sometimes you may require visiting a medical professional to manage the symptoms.

Let’s continue to know more about temporomandibular disorders and how it is related to vertigo.

What is a temporomandibular disorder?

Temporomandibular disorder or TMJ syndrome is a pain in the jaw joint and can cause head and neck pain, facial pain, ear pain, headaches, a jaw that is locked in position or difficult to open, problems with biting, and jaw clicking or popping sounds when you chew.

What is vertigo?

Vertigo is a sensation of spinning dizziness. It can refer to any temporary or ongoing spells of dizziness caused by problems in the inner ear or brain.

A poorly aligned jaw can put pressure on the balance organs in your inner ear, reducing their ability to function and causing vertigo or dizziness.

What causes TMD?

TMD can be caused by:

  • Trauma- bruxism, clenching
  • Osteoarthritis
  • Rheumatoid arthritis
  • Infection in the jaw
  • Cancer
  • Any bone deformity that occurs at birth

Signs and symptoms of TMD

  • Pain in the facial muscles and jaw joints which may radiate to neck or shoulders. The pain may happen with talking, chewing, or yawning and lead to headaches, dizziness, and even symptoms of migraines.
  • TMD may cause ear pain, ringing in the ear (tinnitus), and hearing loss. (1)
  • The joints may produce clicking, grating, or popping sounds while moving.
  • The face and mouth may swell on the affected side.
  • The jaw may lock in a wide-open position, or it may not open fully at all.
  • Muscle spasms that may cause difficulty in swallowing
  • TMD can also lead to headaches or dizziness, nausea, and vomiting. (2)

How TMD causes vertigo and dizziness?

The vestibular system of your inner ear is located in your temporal bone, which is also where your jawbone attaches to the skull.

When your jaw is out of balance, it can put excessive force on this bone and lead to a misalignment of the vestibular system.

This will cause it to give false, conflicting signals to the brain about your balance, leading to dizziness or feelings of vertigo. (3)

People with TMD experience a variety of ear-related problems, including – (4)

  • Earaches
  • Fullness in the ear
  • Ear ringing (tinnitus)
  • Amplified sounds in the ear
  • Dizziness
  • Vertigo (spinning sensation)
  • Balance issues
  • Falls

Other conditions that can mimic TMJ disorders and dizziness mostly include infections. Whether the infection is in the ear, mouth, or salivary glands, it also can cause inflammation, pain, swelling, and dizziness simultaneously.

Diagnosis of TMD

The exact causes of TMD are often challenging to pinpoint unless you have an evident injury or trauma to the jaw. Your medical practitioner will examine your jaw, the joint and surrounding muscles to identify pain and listen for sounds during movement of the joint.

X-rays are not usually needed unless the doctor suspects an underlying issue such as arthritis, which could be affecting your jaw.

Treatment for TMD and vertigo

Temporomandibular disorder is self-limiting, and most of the symptoms disappear in two weeks once the jaw is rested. TMD can be treated with home remedies, and if it lasts for more than two weeks, then professional intervention is required.

Home remedies

Some of the home remedies for treating TMD are:

  • Anti-inflammatory and pain medications such as aspirin or acetaminophen or ibuprofen may provide relief.
  • Eat a diet of soft foods.
  • Avoid chewing gum and eating hard candy or chewy foods. Your doctor may show you how to perform gentle muscle stretching and relaxation exercises.
  • Stress-reduction techniques may help you manage stress and relax your jaw along with the rest of your body.
  • Apply warm compression on the area of pain. Home therapy includes lower jaw movements such as opening and closing the jaw from side to side. It should be repeated three to five times a day, five minutes continuously each time, for about two to four weeks.

Professional intervention

In case the symptoms of TMD do not resolve on its own, you may require a team approach. This includes a dentist, ENT surgeon, pain specialist, physiotherapist, and a primary care physician.

Medications that may be used to relieve pain may include tricyclic antidepressants, muscle relaxants, and prescription-strength painkillers. Botulinum toxin can be used alone or in combination with other treatments to ease muscle spasm and pain.

The doctor may fit you with a splint or bite plate. This is a plastic guard that fits over your upper or lower teeth. The splint can help reduce clenching and teeth grinding, especially if worn at night.

Surgery is never the first choice of treatment for TMD. Arthroscopy surgery is done when there is suspicion of an internal problem with the temporomandibular joint. It does require anesthesia and has a high success rate in resolving pain. (5)

Anyone with recurrent or chronic TMJ syndrome is referred for physical therapy. The therapist will restore joint mobility, increase muscle strength, and relieve pain.

A variety of other treatments are also available that include friction massage, transcutaneous nerve stimulation (TENS), and cognitive behavior therapy.

Take away message

TMD causes a variety of symptoms, many of which are unexpected. Dizziness is a sign of TMD that may leave you concerned that a severe condition may cause it.

Many people deal with ear problems or vertigo for months or even years before they are finally given a TMD diagnosis. Most people do well with conservative therapy, such as resting the jaw or using a mouth splint.

The success of treatment depends on how severe the symptoms are and how well you comply with the procedure.