Episode Transcript
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Speaker 1 (00:00):
Brought to you by the reinvented two thousand twelve Camray.
It's ready. Are you welcome to stump Mom Never told you?
From house top works dot com. Hello, and welcome to
the podcast. This is Molly and I'm Kristen. Kristen. I
(00:20):
wanted to do a podcast on t MRE a k
A temporal mandibular joint and muscle disorders because I feel
like every woman in my life has this except for you,
and I hope to give it to you by the
time we're done. I don't think that t m J
is contagious, but go ahead. I think I'm causing enough
stress in your life that I could trigger it. Well,
(00:41):
let's keep that off the podcast. But t m J,
as as we found out when we were researching this,
it does affect women much more than men asterisk unless
women are just the ones seeking help for it more often.
But you know, we've talked about on the Pain podcast
about how women are more sensitive of to pain, so
(01:01):
maybe they do go the doctor for it, or maybe
there's a reason why our jaws cause us so much grief,
And that's what we're going to dive into right now.
So in case you aren't familiar with t m J.
The National Institute of Dental and Craniofacial Research defines t
MJ as a group of conditions that cause pain and
(01:23):
dysfunction in the jaw, joint and the muscles that control
jaw movement. Pretty general definition, and it affects over ten
million Americans, but possibly as many as thirty million Americans.
Because the symptoms of t m J are so wide
ranging and are associated with other illnesses that a lot
(01:45):
of times it goes undiagnosed, So you might have t
MJ and not even know it. And then there are
those people who would say, but it's overdiagnosed. So you know,
if you have it, you really don't have it, right.
Because tm J first came into the limelight in the eighties,
it was sort of the the hot new, the hot
new disorder that everybody had, especially Burt Reynolds. So I
(02:08):
think was the Hollywood face of t MJ. Yeah, I
think it was fun fact, fun fact we found out. Uh.
And so there was concerned, especially in the late eighties
that a lot of people were just you know, they
would come to the doctors so they had a headache
and loan behold, they had t m J and then
they were undergoing all of this invasive jaw surgery, which
today is very much frowned on because when it comes
(02:31):
to t m J, actually the best remedy might be
no remedy at all. But I'm getting ahead of myself.
But I also think that one of the reasons why
people think that it's you know, overdiagnosed or maybe not
even real acquiring to some researchers, it's because women are
the majority of the people complaining of it, and because
stress is one of the factors. Uh. You know, there
was one essay by a woman in the New York
(02:52):
Times who was like, you know, doctors just tell you
not to stress out, and that just stresses you out
more because your jaw is not opening. And so I
think that also the hoop law around t m J
kind of is interesting in terms of how we treat
diseases that do affect women more than men. But first
I think we need to talk about the joint in question,
(03:13):
the jaw joint, the tempero mandibular joint, which I don't
want to go out on a limb, but could it
be my favorite name for a bone in the body,
maybe tempo temporal mandibular. I think it just rolls off
the tongue. Maybe I'm saying it wrong. I don't know
temporal mandibular. It's not rolling off my tongue. But that's okay. Well,
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if it's a lot of work to say, it's because
that joint does a lot of work. It does so
many things. May I provide a delightful description of what
this jaw, this this jaw bone does. I would love
it if you did. Okay. This is from Susan Ferraro
from the New York Times. This is not my own
verbal brilliance, unfortunately. So this is what she says, the
(03:58):
temporal mandibular joint wise, but me the lower jaw or
the mandible and the skull. It's wildly mobile, a hula
dancing hinge that goes side to side, backward, forward, up
and down. It can exert six hundred and fifty two
a thousand pounds of force per square inch. It is
so strong that, yes, folks, you can buy it off
(04:19):
your own finger. Don't try that at home, though. So, yes,
that is a really amazing description by Ferraro of this
of this crazy little little joint that does so much
in our mouths. I mean think about all I mean,
like all the movement that your jaw can do, chewing,
yawning exactly. I mean it's moving around right now as
I talk to you, Molly, I know our dairy movement,
(04:40):
our jaws are are going today. Um and when we
open our mouths, the low the rounded end of the
lower jaw, that's called a con dial and it glides
along the joint of that temporal bone. And basically this
is why, uh, this joint is different than like a
knee joint or a hip joint is because not only
is there the uh you know, the sort of the
(05:01):
opening and closing of it, there's also sliding and that
there's this disc that lies between um, the condyle and
the bone like a pillow, right, a pillow, and just
like a pillow, you know, absorbs your head as you
go to sleep every night, this little disk absorbs all
the shock that you're that that joint is enduring from talking,
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from yawning, from a really bad habit that I have,
which is sitting at my desk with my chin on
my hand. I learned while researching this podcast that this
is this is really bad. You can lead to T MJ.
Don't don't put your chin on your fist or your hand.
But that's how I ponder. How else will I sit
and ponder? Mom? I know that's how I ponder too.
And we are putting ourselves at risk of t MJ.
(05:43):
And and we've got to be really careful of this,
of this delicate hula hoop jah. And since that hula
hoop is going around back and forth, up, down and sideways,
since it is doing so much and is so strong,
that's one reason why it can have such a diverse
range of side effects if something goes wrong in that
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hula hoop dance, that's right. There are a few different
ways that t MJ can manifest itself. The most common
way is just sort of pain in that area or
immobility in that area, like your jaw won't open. Uh,
the clicking and popping that some people here. While that
isn't enough to say that you have t MJ, that
can be a part of that that face pain you
(06:24):
get in that area. People can also have internal derangement
of the joint. That's when the disc gets displaced, your
jog gets dislocated um and then you can also have
arthritis in that area. When that area becomes inflamed. Interesting
fact though, that I learned Molly. A lot of times
people will associate grinding your teeth with TMJ, especially people
(06:47):
who grind their teeth while they sleep. It might they
might be worried that that they're on the road to
t m J. Actually not as strong an association as
we think it is. A lot of times people who
grind their teeth do not have team J, and people
with t m J don't grind their teeth because it
would be far too painful. Yeah, it would hurt too
much to have your job clenched like that. Now, tooth grinding,
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of course is not is not good for your teeth,
but and also caused by stress, and stress can be
a big factor in t MJ coming on. If you
suffer a trauma to the head and you know your
job gets knocked the wrong way, obviously that can do something.
They used to think along with grinding, that a bad
bite or um braces would lead to t MJ. Now
that's really not a factor, just like the grinding thing
(07:29):
um and now they kind of don't know what causes
it because you know, let's say someone had a bad bite.
They would do these like Kristen said, the beginning these
invasive surgeries and nothing would get better. And so that's
why the recommendation, as we'll see, is to do nothing.
A lot of times experts today will say that a
little bit of self care and time will take care
(07:50):
of the symptoms. So certain self care practices doctors might
recommend for Team j would include eating soft foods, bagels,
no beagles, more beagles they're they're chewing, applying ice packs
to the did a jaw, avoiding extreme jaw movements, so
probably no, no shouting at sporting events, no gum I
(08:13):
do love? Do you love some gum? And then reducing
your stress level, learning how to relax your body, perhaps
doing some yoga, some meditation, some breathing exercises. But you know, Kristen,
having a lot of women in my life who I've
seen have this, it can be really frustrating to be told, hey,
just relax and don't you gum and this will be
(08:34):
fine when your jaw walp And I mean, how are
you supposed to reduce your stress when you can't rush
your teeth or you can't eat. So a lot of
people then do start to investigate these more what the
what the researchers you're calling invasive methods, something like botox,
which has not been proven to improved t MJ. But
some people think that if you just you know, stabilizing stuff,
(08:55):
stabilize that area, it'll work. A lot of people. Uh,
get a splint, which is actually proven to be somewhat
helpful and oral, you know, appliance that will bike guard
that will just fit over your teeth and kind of
hold your your biden place, but don't get anything permanently rearranged.
The doctors are saying, so in terms of treating t MJ,
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we know that it's incredibly hard to diagnose, but it's
happening in a ton of people. We know that we
shouldn't get these invasive surgeries and it might go away
on its own, but it might not, and you should avoid,
you know, eat soft foods and things like that. But
the biggest question, Molly, is how can you prevent it
in the first place. Because a lot of the studies
(09:38):
that we've been looking over about t MJ, and especially
t m J um as it affects women, are incredibly
inconclusive because they are searching for some kind of hormonal
link with t MJ trying to figure that out, and
they're still coming up with nothing. Right, let's talk about
a little bit of that research that they're doing on
hormones and t MJ. One interesting thing that uh, some
(10:02):
researchers found out is that in female baboons, they're estrogen
receptors at the tempero mandibular joint complex. So they think, hey,
there's something about this this area of the face. There's
estrogen there. Estrogen might be doing something kind of funky,
might be raising the chance women will be affected by
pain in that area. But all of the studies they
(10:24):
do are really inconclusive. They'll do somewhere they'll have women
who are undergoing hormone replacement therapy and those women do
have a higher chance of having t MJ, but they
can't trace it to whether it's the hormones or not.
So it's pretty frustrating because they just can't get a
conclusion on what estrogen might be doing to the body.
They've looked at cortisol, which is affected in pain, and
(10:45):
they do notice that women who have t MJ have
slightly elevated cortisol levels at different types of the day
than people who don't have t MJ that could have
something to do with it. And then another hormonal factor
might be relaxing, which is a female hormone that causes
muscle relaxation during childbirth. And they're saying that maybe people
who have TMJ have have weirder levels of that relax
(11:08):
in h than women who were just uh not not
having pain in the job. But again it's a big
maybe they still haven't figured it out entirely, but but
they have figured out one predictor of t m J.
Chris and I think this is the weirdest thing we've
learned about and our entire time doing this podcast. Here
(11:29):
you go, folks, get ready for this. Clamidia. Clamidia has
been linked with t m J. Yeah, there was a
study this is from, so it is a little a
little dated. The doctors tested a tissue of thirty one
team J patients, not a huge sample study sample, but
(11:50):
still thirty one tm J patients and of the study,
patients who had t MJ came up. The tissue came
up positive for traces of chlamydia. Yes, the bacteria that
causes chlamydia is significantly more prevalent in patients with t MJ.
Dysfunction then in the general population was the finding of
(12:12):
these doctors. And so what they're saying is that the
same bacteria that causes chlamydia can cause arthritis, perhaps particularly
at this point. And uh, it's just another I think
cautionary reason to get your annual perhaps mere get tested,
because if your chlamydia goes untreated right ten years later,
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they're they're hypothesizing you could have t MJ. Right because
there was another Johns Hopkins study that this article references,
where they were tracking sexually active teenage girls and found
that around of them tested positive for chlamydia, but a
lot of them had no idea. They were carrying it
around for years and they had no idea that it
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was that it was in their bodies. And I would like,
in this potential chlamydia t MJ a connection, you know,
this idea of chlamydia hang out in your body, untreated
and then lo and behold, you get t MJ ten
years later. It's like shingles, Molly, Like you get the
chicken pox, you know, and you think it goes away,
but no, it's just gonna come back in the form
of shingles, which is awful. And um, yeah, I mean,
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chicken pox a little a little easier to get rid
of than chlamydia. But again yet another reason to play
at safe people and get tested. And just because you
have chlamydia doesn't mean you're gonna get t MJ. Just
because you have t MJ yes, does not mean that
you have chlamydia. We're not saying that the ten million
Americans out there walking around with t m J are
also chlamydia carriers, and that would be a dangerous stigma.
(13:41):
It really caught on because you know, like you said,
t m J already had this sort of you know,
hip disease fallback position. Magic diagnosis got a lot sexier.
But you don't want people scared to go see their
doctor because people are gonna be like, oh gosh, she
had chlamydia. Right, So it's a dangerous. It's it's it's
(14:02):
just something neat, I guess, but it is dangerous to
be like t m J clivide or the exact same thing.
And because that's not going to help your stress level
if you're trying to reduce stress and to sum up
and yet not some up t MJ. How about this
recent New England Journal of Medicine tidbit okay on from
these Boston physicians who were writing on TMJ. They say
(14:23):
that the cause is now considered multi factorial, with biologic, behavioral, environmental, social, emotional,
and cognitive factors alone or in combination contributing to the
development of signs and symptoms of temporal mandibular disorders. Adders
are like, Hey, anything anything goes with your hula hoop joint? Yeah,
(14:44):
it's just a hula hoop uh luo in your mouth.
Who knows. So that's where we got to end it.
That's what's known about TMJ. Another disease that we've covered
that affects women that no one needs to know about.
What's known and more importantly not known. Uh. And we
would to hear from you guys if you have lived
with this way as you've found to manage it. Uh,
(15:05):
we'd love to know. And our email address is mom
stuff at how self works dot com. And let's read
a few list our mails before we close this one out,
because great, I have one here from Sarah and this
is a listener mail about listener mail. Sarah writes, I
was interested to hear the letters endorsing acutane to treat ACNE.
(15:26):
I myself took accutane on and off from the time
I was thirteen to seventeen. While it did rid me
of pesky acne, I was diagnosed this past year with
atable bowel syndrome. Given that you've provided the scoop on Ladypoop,
I won't hesitate to discuss this with you, But my
general practitioner diagnosed me. The first thing he asked was
whether I had taken accutane more than four years ago,
and told me there had recently been studies linking accutane
(15:48):
with IBS, and she attached one of the studies for us.
It was in nature and it's a pretty much rule disorder.
As we discussed, there's no cure, but it can be
control with diet. I want to inform your listeners before
they think accutane's a miracle cure, that it does have
permanent side effects, and to consider whether it's worth putting
up with a few years of acne and not potentially
risking a lifetime of discomfort. I've got an email here
(16:10):
from Nicole and this is in response to our podcast
on Home mec and she writes, I have always been
a feminist. I'm college educated and always imagine myself as
a career woman until I decided to become a stay
at home mom. I guess I suffer from a sort
of feminist guilt because of this decision, and because I
can say unequivocally that I enjoy being at home far
(16:31):
more than I enjoyed being in the workforce. I derive
a lot of pleasure from caring for my family by
making meals, taking care of our house during the grocery shopping, etcetera.
I've struggled with this because it sometimes feels so counter
to the image of female empowerment. While I'm all for
women pursuing careers and continuing to break the glass ceiling,
I would also like to witness the disappearance of what
I think is a stigma against women who decided to
(16:54):
stay at home. Since I've been home, I spent a
lot more time reading about nutrition, learning about the effects
of chemicals on a person's et cetera. I'm constantly applying
this knowledge to what meals I cook, which cleaning products
I use. I think these are aspects of taking care
of a home that are often overlooked, and I think
your podcast really highlighted the fact that we can have
the study of home economics to thank for our modern
(17:14):
understanding in areas like nutrition and child development. An excellent point, Nicole,
So if you have any thoughts to share again, our
email is mom Stuff at how stuff works dot com.
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(17:35):
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(17:56):
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