Flora Blathwayt used to be afraid of getting too tired, because she knew that if she yawned, it would cause a sharp pain in her right jaw. Other simple actions like chewing or brushing your teeth were also agony.
Like an estimated one in 15 Britons, Flora has a temporomandibular joint (or TMJ) disorder. It is the same condition, which affects jaw movement, that former Radio 2 presenter Zoe Ball recently revealed she has.
Writing on Instagram, Zoe said: “I have TMJ and wake up most days with terrible headaches due to tension and clenching my jaw.”
Other symptoms of the condition include clicking or grinding when moving the jaw, or difficulty opening the mouth fully.
Since she began experiencing the problem 18 months ago, Flora says she has “forgotten what it’s like to take normal facial movements for granted.”
“I could be, for example, at a networking event where canapes are handed out and, although they are small, trying to eat them would hurt like hell, so I don’t do it,” says the 38-year-old from London.
‘Routine activities like brushing my teeth became difficult. Also, I was holding my right jaw with my hand just to try and relieve the pain.’ His jaw also made a painful ‘click’.
TMD is the name given to a variety of conditions that affect the temporomandibular joint, which is located in front of the ears and connects the jaw to the skull.
Former Radio 2 presenter Zoe Ball recently revealed she suffers from the condition, which affects jaw movement.
The condition can also affect muscles, ligaments (bands of tissue that support joints and connect bone to bone), and surrounding nerves, hence the pain, explains Dr. Nyree Whitley, a dentist at Mydentist, a network of private practices. and the NHS.
The temporomandibular joint works like a hinge, albeit a complex one. “It’s the joint that allows you to move your jaw from side to side, up and down, forward and back,” says Dr. Whitley.
TMD occurs when the bones, ligaments and muscles of the jaw do not move together as they should, or due to overuse of the muscles and joints, which can be a result of poor posture, teeth grinding, biting nails, chewing gum or even habitually chewing the tip of a pen. All of this can put the jaw under strain.
TMD is common, but according to Luke Cascarini, consultant oral and maxillofacial surgeon at the TMJ Clinic in London, it is often overlooked or misunderstood.
He points out that even the terminology is inaccurate. Patients often say they have TMJ (that’s the joint) when they actually mean TMD, he says.
In fact, he estimates that 90 percent of the time, the condition comes not from the joint itself but from overloading the jaw muscles. Often, he explains, this is due to an involuntary “sucking” action of the tongue, similar to that of babies when feeding.
“The tongue is pushed forward, which causes the release of brain chemicals that overload the jaw muscles,” says Mr. Cascarini.
“We tend to call this movement bruxism, which is also confusing because it really just means clenching or grinding your teeth, and it’s much more than that.”
Flora is estimated to suffer from temporomandibular joint disorder or TMD, like one in 15 Britons.
It is not entirely understood why some adults start making this sucking movement: it is likely due to changes in the brain, and stress and anxiety also influence many. TMD is also associated with the neurodevelopmental disorder ADHD.
“Unlike a baby, an adult has teeth and a differently shaped jaw joint, so when adults do this, it can cause the shock-absorbing disc of cartilage (between the jaw and the skull) to crack. become displaced and damaged,” says Mr. Cascarini. .
“Over time, the activity can cause real damage to the joint itself, leading to arthritis and misalignment of the jaw.
“It can also fracture the teeth or wear them down and inflame the ligaments that support the teeth, which is very painful: the gums can recede and the jaw bone becomes thicker and bulging,” he adds.
“Jaw muscle pain is extremely unpleasant and can spread to the back of the head and down the neck to the shoulders.”
Other causes of TMD include Alzheimer’s disease, Parkinson’s disease, brain injury, or sleep apnea (a disorder that causes breathing to repeatedly stop temporarily while you sleep).
Drugs such as antidepressants can also exacerbate the problem of TMD. What links many of these factors together is that they alter brain activity, and this is what leads to poor jaw function (and tongue thrusting).
Consequently, TMD can also be caused by stressful or traumatic events. This is what happened to Flora, who witnessed a catastrophic and distressing event in June 2023, although she does not want to reveal the details.
Zoe Ball shared photos on Instagram before and after her treatment for the painful condition.
“Suffice it to say, it was shocking,” he says. ‘The next morning, my teeth started chattering and I couldn’t seem to stop. It wasn’t the cold, I wasn’t shivering. It was very strange: I had never had problems like this before.
“A doctor friend who came to stay with me shortly after said she could hear me clenching and grinding while I slept nearby,” he adds.
‘I also developed terrible pain when I tried to open my mouth fully. It felt like my jaw was completely closed.
“For two weeks I couldn’t chew and only subsisted on yogurt and liquids. I told myself it was because I was anxious after what had happened and that everything would go away, but it didn’t.
After a couple of weeks, Flora (who runs Washed Up Cards, a company that makes greetings cards from discarded plastic), saw her GP, who thought it was a result of anxiety and suggested she get counselling.
But because her symptoms were so pronounced, Flora wanted a specialist to examine her jaw.
So in August last year he went to see a maxillofacial surgeon privately and had an MRI, which revealed an anterior dislocation (on the right side), meaning the jaw bone was slipping out of the socket. articulate. There was also a lot of inflammation.
He was told surgery could correct it, but the specialist recommended more conservative therapies first.
These included the Bowen technique, a hands-on therapy that uses gentle pressure to treat the body’s soft tissues and nervous system, and deep breathing exercises.
“I tried many things, including pain relief and hot compresses on my jaw, and was prescribed baclofen, a muscle relaxant,” Flora says. “But the pain never completely went away and it was taking a toll on my mental health.”
Flora stopped going out and even stopped habitually swimming in cold water, “as my doctor told me it could worsen my condition,” she says.
This is because deep breathing in response to exposure to cold water can aggravate already inflamed jaw muscles.
“In fact, when I read that Zoe Ball was also a lover of cold water swimming, I thought there might be a link with her too,” says Flora.
Another option for TMDs may be Botox injections, explains Hazim Sadideen, consultant plastic surgeon at London’s Cadogan Clinic.
‘This is injected into the masseters (the large chewing muscles in the cheek) and often the temporalis muscles, which extend up to the skull and are needed to close the jaw.
“This temporarily relaxes these muscles, reducing tension and pain,” he says. The effects usually last three to six months.
Unable to afford more private treatment, Flora returned to see her GP and was put on the waiting list to see an NHS surgeon.
In September 2024, he underwent arthrocentesis, a ten to 30-minute procedure in which small needles are inserted into the joint so that sterile fluid can be flushed to remove debris and reduce inflammation.
However, while this may help with pain and movement in the short term, corrective surgery like this is only part of the answer, Cascarini explains.
‘The key to treating TMD is finding out why you have the disorder, that is, what happens in the brain to stimulate the jaw muscles.
“It’s not always possible to just turn it off, but different causes have different treatments. For example, in cases related to anxiety, medications that increase levels of GABA (a chemical messenger in the brain associated with relaxation) seem to be helpful, while if it is related to ADHD, some psychiatrists have used medications to block the increase in the stress hormone norepinephrine.’
Above all, Cascarini says, it’s about “treating your brain kindly to keep it from getting into trouble.”
He recommends improving sleep habits and avoiding alcohol and other stimulants, “which can disrupt sleep and alter the brain.”
Some supplements like magnesium can also help, he adds. One theory is that the mineral increases GABA levels.
As for Flora, after the successful operation she hopes to be on the road to full recovery.
“I still have pain, but not like before,” he says. ‘Having a positive attitude can really help. I’m trying really hard to imagine myself better and I hope so.’