TMD – Temporomandibular Joint Dysfunction
TMD stands for Temporomandibular Dysfunction or Disorders. This is also called TMJ. Because problems with the jaw often involves more than just the joint, TMD refers more to the whole complex, comprised of muscles, the jaw, and other related structures in the head and neck.
What causes TMD?
Some of the most common causes of TMD include:
- Unconscious habits such as grinding or clenching the teeth
- Trauma related to an accident or fall
- Stress or Anxiety
- Arthritis or a degenerative process
What is the TMJ?
The TMJ is the Temporomandibular Joint, or jaw joint. It connects the lower jaw to the skull. It is the joint which allows your jaw to move while eating, speaking, swallowing and yawning. This joint works in conjunction with the muscles of the jaw, head and neck.
The TMJ is one of the most complex yet smallest joints in the body. This joint is positioned in front of the ear on each side of head and consists of the following:
The Condyle: which is part of the lower jaw and allows the jaw (mandible) to move.
The Disc: tissue that provides a gliding surface for joint movement.
The condyle and disc sit in a depression in the skull which provides a place for them to rest.
What are the symptoms of TMD?
Symptoms can involve the TM joint alone or more commonly are associated with other areas in the head, neck, jaw, and mostly the muscles in these areas.
Common symptoms might be:
- Pain in the TMJ and surrounding areas
- Unexplained headaches or facial pain
- Clicking, popping or grating noises in the TMJ’s
- Limited mouth opening or movement
- Difficulty or pain with chewing
- Pain in or around the ears or ear stuffiness
- Sinus or eye pain
- Neck and shoulder pain
What is orofacial pain?
Orofacial pain may be discomfort or pain in the face, head, jaw, neck or even the teeth which is of an abnormal nature. This can be a muscular or a neurologic type pain of the head and face or toothache like pain in an otherwise normal condition. Sometimes TMD may be more of an orofacial pain condition that requires specific attention and care.
What about headaches?
As a dentist I can help you with determining if your headaches are related to muscle pain, TMD, or orofacial pain. If the headaches are related to the head and neck area, often I can provide some degree of assistance in treating them. If they are more complex or require a team approach, I can help direct you to others who may also be helpful.
How is a diagnosis established?
To arrive at a diagnosis a complete history and a head and neck evaluation is performed. X-rays may also be necessary. Once all of the information is collected a diagnosis is made. Following the exam a consultation is done to review the findings and a treatment plan is established. Consultation with and/or referral to other health care providers may also be necessary or recommended.
Bruxism or grinding of the teeth is an action that occurs primarily during sleep, is related to rhythmic movement of the jaw and often times may be associated with snoring or sleep apnea. For the most part it is not related to bite problems or stress but is related to a lack of deep sleep.
Signs or Symptoms of Bruxism include:
- Tired jaw muscles upon awakening
- Witnessing audible sounds with grinding
- Morning headaches
- Excessive wear of the teeth, mainly at the biting or on the chewing surfaces
- Teeth that are sensitive
- Teeth that are broken or chipped
- Wear of teeth or notching at the gum line
- TMD symptoms
Children with TMD or who Snore
Children may also have TMD symptoms as well as problems with their sleep. Their symptoms can be different and are often related to Bruxism, a lack of adequate or poor sleep, enlarged tonsils and/or adenoids, or trauma.
Symptoms might include:
- Audible sounds of grinding during sleep
- Wear on the back teeth
- Mouth Breathing while sleeping
- Irritable or moody
- Poor school performance
- Bed wetting
- Frequent earaches or throat infections
- Lack of lower jaw growth or related bite problems
- If there is concern about your child, please ask for more information. A consultation can also be scheduled.
How are these Conditions Treated?
Each of the areas discussed are treated in a manner that is specific to that condition. Treatment will vary based on the specific diagnosis as well as the findings at the evaluation.
Treatment may consist of:
- Removable appliances that are worn in the mouth, usually while sleeping, designed to treat TMD or for Snoring and/or Sleep Apnea
- Physical Therapy for the head, neck, and jaw
- Referral to other Health Care providers
- Medications for pain and inflammation
- Biofeedback and/or stress management
- Diet Control
- Myofunctional or Speech Therapy Home Exercise Program
Orthodontics is done using both fixed braces and removable type appliances that enhance jaw growth. Each situation is diagnosed individually and the treatment is then customized. A consultation can be arranged to discuss specific concerns.