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*Ouch! My ear hurts like crazy. I have been noticing my jaw popping occasionally. I hope I am not going to need another root canal. That last root canal really hurt twice. I am not sure which hurt worse: my mouth or my pocketbook. If I had a fever, I would swear I had an ear infection. I am going to the doctor and get a prescription of antibiotics. Maybe that will help.*

This patient has TMJ, temporomandibular joint syndrome. Antibiotics are only required if the patient has subsequent tooth abscess. I cannot begin to tell you how many patients I have seen who would demand antibiotics to treat this non-infectious condition. TMJ is extremely common in the migraine syndrome (explained below). The muscle tightness in the upper neck just below the mastoid process (part of skull behind the ear) also correlates well to the tightness in the temple and jaw muscle. I found it extremely rare for a patient to have TMJ and not have migraines. Usually a severe cross bite or other malformation of the mouth would be present if the patient did not have migraines.

This person falls into the migraine syndrome profile. Let me explain what I mean by the migraine syndrome. It is the outward expression of the body's sensitivity to light, sound, smell, food, and/or stress. Some people are more sensitive than others; therefore, their reactions to different stimuli are greater. This sensitivity can be manifested in the body as migraines, sinus headaches, neck aches, palpitations, irritable bowel syndrome, motion sickness or vertigo, reactive hypoglycemia, temporomandibular joint syndrome (TMJ), panic attacks, and/or fibromyalgia. Now that's a mouthful! Understanding what is going on with you is very important in the healing process. ENT surgeons, dentists, physical therapists, psychologists can all play a role in treatment of TMJ. A headache specialist that understands the role of migraine syndrome in TMJ or an enlightened primary care physician can make the difference in your outcome.