Temporomandibular disorders (TMD)

TMJ-img3 Temporomandibular disorders (TMD) are a common subgroup of orofacial pain disorders, often incorrectly referred to as “TMJ”. TMJ is the abbreviation used for temporomandibular joint or jaw joint. Patients may experience pain in or around the ear, jaw joint, muscle of the jaw, face, temple, head, neck, and shoulders. The pain may arise suddenly or progress over months to years with intermittent frequently and intensity. Clicking, popping, grating (crepitus), locking, limited or deviant jaw opening, and chewing difficulties are also associated with TMD.

TMD Type

TMJ-imgThere are two basic types of TMD: Myogenous TMD (muscle generated pain) and Arthrogenous TMD (jaw join generated pain).

The temporomandibular joint or TMJ is a “loose-fitting” rotating aid sliding joint with a fibrocartilage covered football shaped ball (condyle), fibrous pad (disc), fibrocartilage lined socket (fossa) ligament, tendons, blood vessels and nerves. The disc functions as a moving shock absorber and stabilizer between the condyle and fossa. As the jaw opens, normally the condyle first rotates and then slides forward within the fossa with the disc between the condyle and the fossa. Myogenous (muscle related) TMD usually results from overwork, fatigue or tension of the jaw and supporting muscles resulting in jaw ache headaches and sometimes neck ache. Artherogenous (joint related) TMD usually results from inflammation, disease, or degeneration of the hard or soft tissues within the TMJ. Capsulitis and synovitis (inflammation), disc dislocation (also called internal derangement) and degenerative arthoritis are the most common arthrogenous disorders of the TMJ.

TMD Causes 

TMJ-img2Causes for TMD are unclear as TMD usually involves more than a single symptom and rarely has a single cause. TMD is believed to result from several factors acting together including jaw injuries (trauma) and joint disease (arthritis). Tooth clenching and grinding (bruxism), and head and neck muscle tension, while not scientifically proven to be causes of TMD, may perpetuate TMD symptoms. It is important for the TMD patient to understand that the disorder can be chronic in nature and highly dependent upon multiple factors including emotional stability.

TMD SYMPTOMS

  • Headache
  • Earache
  • Jaw Pain
  • Neck Pain
  • TMJ Noise (clicking, popping, and grating)
  • Abnormal Jaw Opening (catching, locking, limitation, deviation)

FACTORS ASSOCIATED WITH TMD

  • Trauma
  • Abnormal Habits
  • Occlusion
  • Psychological Factors
  • Diseases of TM Joints
  • Other Factors

TMD Treatment options

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  • Occlusal Orthotic

Sometimes it is recommended that you wear an orthotic (also known as a splint, night guard, bite guard) that fits over either your upper or lower teeth.

  • Stress Management

Another treatment approach for your TMD problem is to learn to manage your daily stress including bio-feedback, relaxation breathing, guided imagery and sometimes referral to a therapist

  • Physical Therapy

Physical therapists are trained professionals who help rehabilitate off types of physical injuries including jaw exercise, postural and ergonomic training, ultrasound, electrical stimulation and mobilization.

  • Occlusal Correction

Occlusal Correction is sometimes necessary to improve the way your teeth fit together.

  • Orthodontics

This is involves using braces to move your teeth so they fit together better.

  • Bite Reconstruction

This is accomplished through extensive dental work like crowns, bridges, and if inditcated, implants.

  • Surgery

In some cases surgery is required to repair or reconstruct the TMjoints when more conservative treatments have failed to improve comfort and function.

Source: The American Academy of Orofacial Pain TMD Patient Brochure