What’s causing my dizziness or vertigo while chewing?
Temporomandibular joint (TMJ) disorders are common, affecting almost twelve million people in the U.S. These disorders involve the jaw joint and the muscles that control the jaw movement.
Some of the common TMJ disorder symptoms include:
- Jaw muscle pain during chewing or upon palpation
- Pain in the TMJ itself
- Difficulty in chewing
- Teeth feel tender while chewing.
- Headaches
A less frequently discussed symptom with TMJ disorders is vertigo or dizziness while chewing.
Anatomically, the TMJ is adjacent to the ear canal. The TMJ can be easily palpated by placing the pinky finger in the ear and applying slight pressure forward while the jaw opens and closes. Also, muscles and ligaments from the jaw attach to the skull near the ear canal and middle ear. These jaw structures can impact the middle ear and cause dizziness or vertigo.
- Swelling in the TMJ could lead to distortion of the ear canal and with it the fluids of the inner ear.
- TMJ swelling could displace the position of the tendons or ligaments that are near the middle ear causing impinging on the membrane.
- The jaw muscles near to the middle ear membrane can swell with use and place pressure on this membrane.
These physical changes during movement of the jawbone and the muscles while chewing can lead to benign paroxysmal positional vertigo (BPPV).
Benign paroxysmal positional vertigo is the most common inner ear problem and cause of vertigo.
BPPV is a specific diagnosis, and each word describes the condition:
Benign: It is not life-threatening, even though the symptoms can be very intense and upsetting.
Paroxysmal: Comes in sudden, short spells.
Positional: Certain head positions or movements can trigger a spell.
Vertigo: Feeling like you are spinning or the world around you is spinning.
We have crystals of calcium carbonate in our inner ear that help us with our balance and body motion. These tiny rocklike crystals, or ‘‘otoconia’’ are settled in the center ‘‘pouch’’ of our inner ear. BPPV is caused by the crystals becoming ‘‘unglued’’ from their normal place. As they float around, they can get stuck on sensors in the wrong part or wrong canal of the inner ear. BPPV symptoms are caused by the crystals being out of position.
The most intense part of BPPV symptoms relate to how long it takes the crystals or sensors to settle down. As the crystals move and settle in your inner ear, your brain is getting these powerful (false) messages telling you that you are violently spinning when all you may have done is chew food during a meal.
Avoiding or at least trying to minimize the jaw movements that trigger BPPV would be the best preventative measure.
- If it occurs while chewing, avoid foods or snacks that are difficult to chew, in particular gum.
- Eat slowly and take small bites to minimize jaw movements that might dislodge the crystals.
- Clenching or grinding (bruxism) habits can be treated by various methods.
- TMJ swelling can be treated by ice, anti-inflammatory medications and rest.