A jaw that aches on waking. A partner who hears grinding at night. A dentist pointing out worn enamel. A lower face that has squared off without any change in weight.
These are usually one problem seen from different angles.
WHAT PEOPLE NOTICE
Tightness or ache through the angle of the jaw, worse in the morning. Headache through the temples. Teeth that feel tender. Difficulty opening wide, or a click from the jaw joint, the TMJ. A squarer lower face, or a visible bulge when the teeth are clenched. Some people notice the shape change first and the tension only when it is pointed out.
WHY THE MUSCLE CHANGES
The masseter is the muscle you can feel move at the angle of the jaw when you bite down. Like any muscle under repeated load it enlarges, and clenching and grinding, known medically as bruxism, load it heavily, often during sleep, often without the person knowing. Stress, sleep quality, airway problems and dental occlusion all feed into it, which is why the assessment covers more than the muscle itself.
WHAT THE CONSULTATION COVERS
Dr Ryan Shannan (MBBS, FRACGP) takes a history of the symptoms, their pattern through the day and night, and any dental history. He examines the jaw at rest and under clench, checks joint movement, and where it is relevant scans the area with ultrasound to assess muscle size and rule out other causes of a swelling at the angle of the jaw, which is not always muscle.
What is appropriate, and whether anything is appropriate at all, is determined at that consultation rather than before it. Where the picture points to the joint, the bite or sleep, you will be referred to the practitioner who should be handling that part.
WHEN WE REFER
To your dentist or a dental specialist where wear, occlusion or a splint is the priority. To a sleep physician where the history suggests disordered breathing. Referral is often part of the plan rather than an alternative to it.
Consultations are held at Shop 6, 111-139 Darlinghurst Road, Potts Point NSW 2011.
Please reach us at info@imagedomain.com.au if you cannot find an answer to your question.
No. You can book directly. If a dentist or another practitioner has referred you, bring any notes, images or splint details they have given you.
Bruxism is the medical term for clenching and grinding the teeth. It often happens during sleep, which is why many people first hear about it from a partner or a dentist rather than noticing it themselves.
Symptoms that are worst on waking usually point to something happening overnight rather than during the day. Sleep clenching, sleep quality and breathing during sleep are all covered in the history for that reason.
The masseter enlarges under repeated load, in the same way any muscle does, and that can square off the lower face. Whether the change you have noticed is muscle is what the examination and, where relevant, an ultrasound scan is used to work out. A swelling at the angle of the jaw is not always muscle.
Often, yes. Where tooth wear, the bite or a splint is the priority, that part belongs with a dentist or a dental specialist. Where the history suggests disordered breathing in sleep, a sleep physician is the right referral. This is usually part of the plan rather than an alternative to it.
Image Domain is at Shop 6, 111-139 Darlinghurst Road, Potts Point, in inner Sydney.
Image Domain · Shop 6, 111-139 Darlinghurst Road, Potts Point NSW 2011, Australia · Phone: 0481 820 755 · Email: info@imagedomain.com.au
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