Allied Medical Temporomandibular TMJ Disorder TMD

What is the Temporomandibular Joint?
The temporomandibular joint (TMJ) is also known as your jaw bone socket. Your TM joints are where your upper jaw and lower jaw meet just in front of the ears. The joints are moving parts that allow the lower jaw to move. This lets you open and close your mouth for talking, biting and chewing. The joints are a complex, made of muscles and jawbones. Each part plays a role in keeping your TMJs working smoothly. When the muscles are relaxed and balanced and both jaw joints open and close comfortably, you are able to talk, chew or yawn with no pain. Because your muscles and joints work together, a problem with either one can lead to uncomfortable results such as stiffness, headaches, pain, bite problems, clicking sounds or lock jaw.

Temporomandibular Disorder (TMD) may occur when the jaw twists during opening, closing or side-motion movements. These movements affect the jaw joint and the muscles that control chewing.

TMD describes a variety of conditions that affect jaw muscles, temporomandibular joints, and nerves. TMD can be associated with chronic facial pain. Symptoms may occur on one or both sides of the face, head or jaw, or develop after an injury. TMD affects more than twice as many women than men and is the most common non-dental related chronic orofacial pain.

What causes TMD?
Normal function for this muscle group includes chewing, swallowing, speech and communication. Most experts suggest that certain tasks, either mental or physical, cause or aggravate TMD, such as strenuous physical tasks or stressful situations. Most discomfort is caused from overuse of the muscles, specifically clenching or grinding teeth (bruxism).

These excessive habits tire the jaw muscles and lead to discomfort, such as headaches or neck pain. Additionally, abnormal function can lead to worn or sensitive teeth, traumatized soft tissues, muscle soreness, jaw discomfort when eating, and temporal (side) headaches.

What TMD symptoms can I experience?

An earache without an infection
Jaw pain or soreness more prevalent in the morning or late afternoon
Jaw pain when you chew, bite or yawn
Clicking when opening and closing your mouth
Difficulty opening and closing your mouth
Locked or stiff jaw when you talk, yawn or eat
Sensitive teeth when no dental problems can be found

What can I do to treat TMD?
The majority of cases can be treated by resting the joint, taking a pain reliever such as acetaminophen (Tylenol) or nonsteroidal anti-inflammatory medications (Motrin, Alleve, etc...),and practicing stress management and relaxation techniques.

It's important to break bad habits to ease the symptoms. Most treatment for TMD is simple, often can be done at home, and does not need surgery. For example, control clenching or grinding during the day by sticking your tongue between your teeth. If you still experience pain, you may be grinding or clenching your teeth at night. So see your dentist for a nighttime mouthguard.

Most people will experience relief with minor treatment. More severe cases may be treated with physical therapy, ice and hot packs, posture training and orthopedic appliance therapy (splint). Eating soft foods and avoiding chewing gum also help relax the muscles.

The various options available are:

Self care: includes resting your jaw. Rest relaxes your jaw muscles and takes the pressure off your joint. Practicing good posture, eating soft foods and reducing stress will also relax tense muscles and help give your jaw a break. Applying ice and heat alternately, and exercising your jaw also helps to relieve symptoms.
Medications: If your pain is severe and the self-care measures do not help, your doctor may prescribe an anti-inflammatory to help reduce pain and swelling, or a muscle relaxant.
Stress Management: Stress, teeth clenching and poor posture cause your muscles to tighten up. This tightening pulls your upper and lower jaws closer together, putting pressure on TMJ and sometimes wearing down your teeth. Managing daily stress is one of the best ways to restore harmony between your muscles and joints.
Physical Therapy: A variety of physiotherapy techniques such as jaw exercises, postural training and mobilization help you regain the harmony of your jaw joints and muscles. Physical therapy is often used when your disk, ligaments or other joint tissues are injured. It promotes healing and reduces pain and swelling. It also aids muscle relaxation and increases your jaw's range of motion.
Occlusal Splint: is a clear plastic appliance that fits over your top or bottom teeth and maybe recommended by your doctor to establish harmony between your muscles and joints. It works by keeping your upper and lower teeth slightly apart, thus relaxing the muscles and reducing the attendant pain. A splint can also change jaw posture, enough to stabilize some bite problems and reduce pressure in your joints. It may not be easy to get used to wearing and caring for your splint, but it is an important treatment that may last for 3 months or more.
Bite Correction: If your TMJ disorder has caused problems with how your teeth fit together, you may need treatment to correct your bite, although this is seldom necessary. Bite problems may be corrected either by orthodontic wiring, or by placing a crown or filling onto your teeth.
Ultrasound: Painless sound waves reduce pain and swelling in your joints and muscles, and improve circulation.
Electrical Stimulation: An electrical impulse sent through your skin relaxes muscles, aids circulation and relieves pain.
Surgery: can help restore your jaw joint and eliminate the pain and other symptoms of TMJ disorders. It is rarely needed, except in very severe cases, that is if the joint has become so badly damaged that it cannot be corrected by other means.

You may need a combination of treatments, depending on the severity of your case as decided by your dentist. From biting and talking to chewing and yawning, your TM joints always come into play. So when something goes wrong with your jaw joints, it can cause you much discomfort.

Is TMD permanent?
The condition is often cyclical and may recur during times of stress, good or bad. As the patient, you should be active in your treatment, by being aware of the causes of your jaw problems after seeing a dentist for a diagnosis regime.