The link between the oral cavity and shoulder stiffness can seem distant.
And yet, numerous joint pains are a result of dental problems.


Temporo-mandibular joints play a part in speaking, chewing, yawing, and opening the mouth.
These joints link the lower jaw to the skull base. They are located in front of the ear, on both sides of the face.
If the temporo-mandibular joints do not function in synergy for lack of a proper dental occlusion, contracture of the masticatory muscles causing a blockage, arthrosis…, a muscular or joint disorder will develop.
This disorder is called TMD: Temporomandibular disorder.
20% of the population suffers from this disorder, whether it is young adults or the elderly.
But, women are more prone to this disorder as a result of a predisposition to ligament laxity.

Signs of TMD:
- A decrease in the range of the jaw movements.
- Acute or chronic pain.

This pain can radiate to the temple, neck, shoulders, causing spasms, muscle stiffness and headaches.


Causes of TMD:
- Trauma: Blow to the chin, an oversized tube used during intubation, an overextended dental extraction, resulting in the displacement of the disk of the temporo-mandibular joints.
- Use of a dental crown exceeding by even 1 millimeter the required size results in an imbalance of the dental occlusion.
- Arthrosis (affects people over 60 years old).
- Stress: clenching of the teeth, chronic nail-biting.



Solutions:
Usually, the TMD is difficult to diagnose. Patients end up wandering from rheumatologists to neurologists in vain.
- If the cause is an ill-fitting denture, it has to be replaced.
- Neuromuscular rehabilitation is necessary in case of severe tics (cheek or nail-biting).
- Kinesitherapy and an occlusal gutter worn during the night.
This gutter relaxes the joints, alleviates the pain,and restores the equilibrium.
- Grinding of the teeth to eliminate the interferences during the movement of the temporo-mandibular joint.
- Unreplaced teeth can alter the equilibrium of the lower jaw and the mastication, which can lead to neck and even scapular pain. These teeth have to be restored.
- Untreated or badly treated lesions of the dental roots are prospective infected sites and can lead to tendinitis. Proper treatment is primordial.
- In the case of limited or increased maximum mouth opening, surgery may be necessary.