TMJ/ TMD

What is the temporomandibular joint?

The temporomandibular joint (TMJ) is one of the most complex joints in the body, especially because there are two of them working together. The TMJ is a joint that rotates just in front of your ear, consisting of the temporal bone (side and base of the skull) and the mandible (lower jaw). Mastication (chewing) muscles connect the lower jaw to the skull, allowing you to open and close your mouth when you chew, speak and swallow.

The joint works properly when the lower jaw and its joint are synchronized during movement. 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. Each of these joints has a disc between the ball and socket. This disc cushions the load while enabling the jaw to open widely and to move in combinations of hinge and gliding movements. Any problem that prevents this complex system of muscles, ligaments, discs and bones from working together properly may result in a TM disorder.

What causes a temporomandibular joint disorder?

When muscles and joints do not work properly, the muscles will often go into a cramp. This cramp can become part of a cycle that results in tissue damage, pain, muscle tenderness and more cramping.

While some cases of TM disorders may have clear-cut causes such as trauma, arthritis, or severe stress, most are due to a combination of factors. Discs often slip forward in the joint leading to problems such as clicking, popping or even getting “stuck for a moment”. However, these are often minor problems, and in the absence of jaw pain they usually don’t require treatment.

Oral habits such as clenching or grinding the teeth (bruxism) may develop as a response to stress, or as part of a sleep disorder. You may not be aware of nighttime clenching or grinding, but you may be aware of it during the day. 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.

It is important to realize that while many of the above factors are believed to cause TM disorders, the exact causes of the disorders are unknown and sometimes it is not possible to determine the causes of the symptoms.

Signs and Symptoms of TM Disorders

TM disorders have many different signs and symptoms. Some of the most common ones include the following:

1. Pain in or around the ear without an infection, sometimes spreading to the face .
2. Jaw pain or soreness that is more prevalent in the morning or late afternoon.
3. Clicking or popping noise when you open and close your mouth.
4. Difficulty in opening and closing your mouth.
5. Jaw that gets locked or stiff when you talk, yawn, open too wide or eat.
6. Sensitive teeth when no dental problems can be found.
7. Certain types of headaches or neck aches.

Treatment for TM Disorders

Treatments for TM disorders vary, based on your individual diagnosis. 95% of those with a TM disorder can experience long-term relief. Often within 24 hours! The majority of cases can be treated by unloading (resting) the joint, to eliminate the muscle spasm and pain by applying moist heat or prescribing medication such as muscle relaxants, analgesics or anti-inflammatory drugs. Other cases may require the use of a bite plate to stabilize your bite relationship, thus taking the pressure off your joints. Most treatments for TMD are simple and do not require surgery. It is important to break bad habits to ease the symptoms. Eating soft foods and avoiding chewing gum also helps relax the muscles.

Are TM disorders 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 and aware of the causes of your jaw problems.