What are the possible symptoms of a problem with the bite and the jaw muscles?

In the ear:

• Pain in the ears
• Sense of pressure and fullness in the ears
• Ringing in the ears (tinnitus)
• Dizziness
• Excessive ear wax
• Difficulty clearing the ears, especially on aeroplanes or at high altitudes

Ear pain which is related to a dental problem is often easy to recognise as it is usually felt in only one ear and can feel very 'deep'. The pain may also be felt in the neck, the temple, or the back of the head and it is often aggravated by movement of the jaw.

Other symptoms of a problem with the bite and jaw muscles:

• Sore and tender muscles around the jaw joints
• Clicking, popping or grating sound in the jaw joints
• Jaw shifting to right or left when open wide
• Difficulty opening and closing the mouth
• Migraine type headaches which do not respond to migraine drugs
• Tense and/or painful muscles in the neck and shoulders

Why does it happen?

The anatomy of the jaw and ears are closely related. In a developing embryo, the jaw and ear are initially one and the same. It is not until the embryo grows that the bones of the ear and jaw separate. When fully developed, the ear forms three parts: the external ear, the middle ear and the internal ear. The three small bones (ossicles) in the middle ear, the hammer (malleus), the anvil (incus), and the stirrup (stapes) are named appropriately after their respective shapes. Two muscles, the stapedius and the tensor tympani, attach to these small bones and control the vibrations of the ear drum and protect the internal ear from sudden loud sounds. As a result of the close relationship between the ear and the jaw during embryonic development, the same nerve (?the trigeminal nerve) controls both the tensor tympani and the chewing muscles. Consequently, signals which are sent through the ?trigeminal nerve can affect both the jaw and the ear muscles.

How a 'bad bite' can affect the ears

A 'bad bite' is the most common cause of dislocation of the jaw joints and tension in the chewing muscles. A bad bite means that the upper and lower teeth do not come together in a way which provides proper support to brace the jaw against the skull. On average during a 24 hour period the teeth come together over 2000 times when a person swallows. If the bite is unstable due to poorly aligned or missing teeth, the chewing muscles have to work much harder to bring the teeth together and eventually they tire out and become shortened and stiff. Eventually the chewing muscles may even start to spasm, which can be very painful and can cause the jaw joints to misalign.

What if I have these symptoms?

If you have any of the symptoms described above, you should contact your dentist who will examine your bite and the muscles of your jaw to determine whether they are causing the problems. Dental treatment by a dentist can involve adjusting the bite so that the chewing muscles can function without extra strain and tension.

However, the ear symptoms described here could be caused by a variety of ear-related problems. You should, therefore, also contact your GP so that he or she can, if appropriate, refer you to an ENT (Ear, Nose and Throat) consultant.

If you live in the Greenock area, or are willing to travel, you may wish to consider making an appointment with Stewart Wright who, in addition to offering the full range of standard dental treatments and cosmetic dentistry, has extensive experience of treating pain and other symptoms related to problems of dental origin. Stewart takes an holistic approach to the diagnosis and treatment of head, neck and facial pain and other related problems. He and his associates offer a range treatments and therapies. You may wish to read what some of Stewart's existing patients have to say about treatment by him.