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What is TMJ/TMD?

TMJ stands for Temporomandibular Joint, or the jaw joint. There are two TMJs and they are located on each side of the face near the ears where the lower jawbone (mandible) joins the temporal bone of your skull. These joints operate simultaneously and allow all the mobility necessary for biting, chewing, swallowing, speaking, making facial expressions and even breathing.

TMD (Temporomandibular Dysfunction) is not one disorder, but refers to a group of conditions, often painful, that affect the jaw joint and associated muscles when the joints do not work together correctly. The most common cause of jaw-related problems is a bad (misaligned) bite.

How serious is TMD? As many as 60 million people in North America are affected by TMD. And a recent study revealed that 53% of people with TMD suffer from some level of depression, while 22% have symptoms of fatigue and/or insomnia due to disrupted sleep patterns. If this state of stress and fatigue continues over a long period of time it can cause other body systems to break down. Untreated, TMD can have a demonstrative effect on your health and wellbeing.

What are the Symptoms of TMD?

While the most common symptom of TMD is noise in the joint, pain in the jaw muscles and in the temporomandibular joint (jaw joint) are also common symptoms of TMD. It is not uncommon for pain to also spread around your ears to your head, neck, shoulders and back. Common symptoms include:

  • Clicking, popping or grating sounds in the jaw joint
  • Being unable to open the mouth comfortably
  • The jaw locks when you attempt to open your mouth
  • A bite that feels uncomfortable or “off”
  • Chronic headaches
  • Dizziness and vision problems
  • Facial pain
  • Neck pain or stiffness
  • Ringing in the ears, ear pain or decreased hearing

How do you treat TMD?

When an occlusion problem or tissue damage to the head, neck and facial area is diagnosed, it is important to have an evaluation by a trained and qualified TMD dentist. Our office performs a full examination of the TM joints, head, neck and facial region, as well as X-rays and occasionally MRI evaluation. We are able to objectively determine the pathological nature and extent of joint sounds and injuries to the TM joint area to arrive at a realistic prognosis. Frequently, a custom-made orthotic (“splint”) is prescribed for orthopedic and musculoskeletal stabilization.

Patients benefit from the non-surgical, conservative treatment our office provides. Once pain is controlled and the jaw joint is stabilized, the bite is balanced so the teeth, muscles and joints all work together without strain or pain. Initially, treatment addresses the pain by reducing inflammation and addressing the primary source of pain. Secondly, function is restored through the use of orthotic appliances and various physical therapies. Thirdly, the patient is stabilized and we discuss what is necessary to maintain proper bite alignment. Very rarely, surgery is necessary to see improvement. Because problems associated with the jaw joints can be progressive, accurate and immediate diagnosis and treatment is crucial.

In addition, we are trained in the ALF (Advanced Light Force wire) technology in which the upper jaw and palate are allowed to expand and develop to their best potential over the course of time. The ALF has proven to be an extremely valuable tool for those patients who otherwise might have been told they need their upper or lower jaw surgically moved.

What Causes TMD?

Truth be known, while many factors are believed to contribute to TMD, the exact cause is unknown. And sometimes it is not possible to determine the exact cause of the symptoms. There is considerable evidence that the relationship between the upper and the lower teeth and the teeth to the TM joints, as well as supporting ligaments and muscles, is a significant factor. Other contributing factors may include:

  • Trauma: The joint is damaged by a blow or other direct and indirect impact. Strains, sprains and injuries can lead to both pain and dysfunction.
  • Improper Occlusion: When teeth do not fit together properly, it causes sustained microtrauma to other joints. If the condition is not addressed, over time, the body begins to compensate by involving muscles in other areas: the neck, throat and upper back.
  • Muscle Hyperactivity: This goes hand-in-hand with internal jaw joint problems. Any condition that prevents the complex system of muscles, bones and joints from working together in harmony can contribute to TMD. Various ways this system can be disrupted include trauma, connective tissue disorders, arthritis or skeletal malformation.
  • Posture: Poor posture places unnecessary wear and tear on all the joints including the jaw joints. Over time, consequences of postural neglect can be as damaging as an injury.
  • Stress: Increased physical and emotional stress is another factor that impacts patients with TMD. Some patients unconsciously clench or grind their teeth (bruxism) in response to increased stress. Chronic clenching and bruxing creates strain on the TM joints and muscles which can intensify TMD problems.

Additional Questions

Q. I have a general dentist, can he help me or do I need to see a specialist?

A. While both general dentists and orthodontists deal with the health of your teeth orthodontists are also concerned with your joints and jaw alignment. Your general dentists will most likely be able to screen for this type of dysfunction but it is recommended to see someone who practices TMJ disorder treatments.

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