What are TMJ Disorders (TMD)?
The temporomandibular joint, the joint that connects your jaw to your skull in front of your ears, is one of the most complex joints in the body. In addition to moving your jaw up and down, this joint moves forward and back and side to side, all controlled by a network of chewing muscles, ligaments and an articular disc. When this delicately balanced system is not working together correctly, symptoms can occur such as the joint locking, popping or clicking, as well as muscles cramping or going into spasm. If left untreated, TMD can cause tissue damage, chronic pain, muscle tenderness and lead to the inability to function and chew.
It is important to understand that TMJ disorders develop for many reasons and often not one treatment modality can cure it completely.
At our office the treatment begins by taking a detailed history and performing a thorough examination of your TMJ. Treatment recommendations are then discussed and patients are guided as to what may correct the problem in the best possible fashion.
What are the symptoms of TMD?
TMD symptoms include pain, popping, clicking or locking of the jaw causing muscles to go into spasm. This then may not allow your jaw to open or close properly to chew. Pain and tenderness can also be located in the neck, shoulders, face and head.
Below is a checklist of symptoms that may apply to you:
- Do your jaws that lock or get stuck?
- Do you have popping or clicking of the jaw when you open your mouth?
- Do you wake up with headaches?
- Do you wake up with stiff or sore muscles around your jaw?
- Do you have tenderness or pain in the jaw muscles, neck , shoulders or back?
- Do you have pain in or around the ear?
- Do you have difficulty in chewing or opening your mouth?
- Do you have ringing in your ears?
- Have you been told that you clench or grind your teeth while asleep?
- Are your teeth worn or do you have gum recession?
What causes TMD?
The cause of TMJ pain can be for many different reasons, but arise from problems of either the muscles of the jaw, the joint itself, or the disc or surrounding cartilage. The most common reasons are listed below.
- Injury to the joint or muscles of the head and neck such as from a heavy blow or whiplash.
- Grinding or clenching of the teeth especially when stressed causing overworked tired muscles and perhaps muscle spasms.
- Dislocation or slipping of the disc in the joint.
- Misaligned bite.
- Genetic patterns and other triggering diseases such as arthritis and Ehlers-Danlos Syndrome.
- Medications that have side affects that cause an increase in clenching and grinding.
- Sleep Apnea.
Treatment
Treatment begins with a complete history and a thorough examination of your teeth, jaw, head and neck . Sometimes x-rays are needed of your teeth to determine that there are no other problems that are causing the TMD issue. Once evaluated and a diagnosis is made, the proper course of treatment will be recommended.
Some basic, conservative treatments are often recommended such as:
- Eating soft foods and avoid extreme jaw movement.
- Drink less caffeine.
- Resting the jaw by not speaking as much.
- Applying ice or heat to the painful muscles.
- Take anti-inflammatory medications, if you are able, such as Ibuprofen, Motrin, or Advil.
- Practice good posture to reduce neck, shoulder and back pain.
- Change medications based on your physicians choice that have side affects that cause increased clenching or grinding.
Most other TMD treatments include:
- Relaxation techniques or biofeedback therapy to help control muscle tension.
- Physical therapy to relieve muscles that are in spasm, re-program and with proper exercises to strengthen them.
- Bite adjustment to balance the teeth to a proper bite.
- Orthodontic treatment if proper adjustments cannot be made to the teeth themselves and tooth movement is needed instead.
- Corrective dental treatment such as restorative and tooth replacement dentistry to allow for a proper bite.
- Splint or night guard construction that fits over the teeth to lessen the effects of clenching and grinding. There are several different appliances that can be made to get the jaw into the correct position and to relax muscles.
The very last resort is joint surgery only if there is severe degeneration.