Temporomandibular Joint Disorder

There's another joint you have to take care of. (photo from http://www.pacificdentalbangkok.com/joint_pain_treatment.html)

Having a hard time biting that quarter pounder  you have been keeping your eye on? Or  do you occassionally experience painful clicking, popping, or grating in  your jaw?   How  about pain in the jaw, neck, or face? Then you might  be suffering from temporomandibular joint disorder  or  TMD.

What is the temporomandibular joint?

The temporomandibular joint (TMJ) is the area directly in front of the ear on either side of the head where the upper jaw (maxilla) and lower jaw (mandible) meet. Within the TMJ are moving parts that allow the upper jaw to close on the lower jaw.  It is one of the most frequently used joints of the body as  we use our TMJ to move our  jaw everyday in biting, chewing, talking, and yawning. To locate the TMJ,  put a finger on the triangular structure in front of your ear. Move your finger  just slightly forward and pressed firmly while opening the jaw. The motion felt is from the TMJ. We can also feel the joint motion if we put a little finger against the inside front part of the ear canal.

There’s another joint you have to take care of. (photo from http://www.pacificdentalbangkok.com/joint_pain_treatment.html)



Other  symptoms of TMJ disorder include:

  • Stiff jaw muscles
  • A jaw that locks or has limited movement
  • Changes in the fit between upper and lower teeth

In the  US,  more than 10 million Americans have been  affected by Temporomandibular Joint disorder   or TMD (according to National Institutes of Health) with women more affected than men.

What can cause Temporomandibular Joint disorder?

  • Habitual gum chewing or fingernail biting
  • Dental problems and misalignment of the teeth  (malocclusion).
  • Chewing on only one side of the jaw
  • Trauma to the jaws  like previous fractures in the jaw or facial bones can lead to TMJ disorders.
  • Stress  can  lead to unreleased nervous energy.  People under stress  commonly release this nervous energy by either consciously or unconsciously grinding  or clenching their teeth.
  • Occupational tasks or habits such as holding the telephone between the head and shoulder may contribute to TMJ disorders.

If you think  you have  TMD,  who should you consult?

Normally, the dentist is the first health professional to consult. Your dentist will ask about symptoms, take a medical and dental history, and examine your head, neck, face, teeth, and jaw.

What treatments  are recommended for TMD?

Experts agree that nonsurgical treatments should be tried first — unless there’s a compelling reason for immediate surgery (such as a tumor in the jaw joint)  as majority of temporomandibular disorders stem from jaw muscle spasm problems, causing  the pain and tightness

Use a bite guard or splint.This involves using a plastic guard that fits over the upper or lower teeth, allowing the teeth to slide smoothly against each other, which lets the jaw muscles relax, worn most of the time, only during the  evenings. Only in  severe cases should  the splint be worn 24 hours a day, except when eating.

Undergo physical therapy. This involves muscle relaxation and increasing the range of motion in the joint, where methods may include stretching exercises, or ultrasound treatments. Applying warm compresses to the side of the face during exercises may also help.  Known therapeutic exercises such as Yoga, meditation, acupuncture can also help ease symptoms. Stress  management can also  be done because stress, though it doesn’t cause TMD, can make it worse.

Anti-inflammatory medications and  prescription muscle relaxants can relieve pain.

In extreme cases, TMJ disorders can lead to problems within the jaw joint itself such as disk that moves out of proper position, strained ligaments, osteoarthritis, and other joint-related conditions. In such cases, the patient is recommended to undergo through MRI or a CAT scan of the joint. Extreme cases  can also  be managed  thru non-surgical treatments.  It is  very rare that surgical treatments are  recommended because  surgical treatments can bring  about surgical complicationssuch as  nerve damage, bleeding, infection, and scarring of the joint.  Consider getting second opinion if you are immediately advised to undergo surgical treaments.


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