Temporomandibular Disorders

TMD – Temporomandibular Disorders

Do you have frequent headaches, earaches, tender jaw muscles or a dull, aching facial pain? Does your jaw lock or stray to one side when you open your mouth? These aches and pains may be related to the jaw joint, called the temporomandibular joint or “TMJ,” and the muscles that work to move the joint. These painful conditions are often called “TMD” for temporomandibular disorders.

Temporomandibular joint (TMJ)

Signs and symptoms

A TMD is a condition, not a specific disease. Temporomandibular disorders can have many different signs and symptoms, from mild to severe. Some patients may have symptoms but are still able to function fully. TMDs appear to be more common in women. Specific symptoms may include:
• pain in or around the ear
• tender jaw muscles
• clicking or popping noises in the jaw
• difficulty opening or closing the mouth
• pain when yawning or chewing
• jaw joints that feel as if they are “locked,” “stuck” or they “go out”
• headaches

What causes TMD?

Several conditions may be linked with TMD. This often makes it difficult to pinpoint the cause of a particular case of TMD. Related conditions may include:
• jaw or head injuries
• diseases that affect the muscles or joints, such as arthritis
• tooth grinding
• stress
To determine how best to treat your condition, a complete evaluation is recommended. Your dentist may check the joints and muscles for tenderness, clicking, popping or difficulty moving. Your complete medical history may be reviewed, so it is important to keep your dental office record up-to-date. Your dentist may take X-rays and may make a model of your teeth to see how your bite fits together. Your dentist may also request specialized X-rays of the TM joints.

How the jaw joints and muscles work

The joints and muscles on each side of your jaw help open and close the mouth. These joints move in many different directions. They allow you to chew, talk and swallow.
The two temporomandibular joints are among the most complex joints in the body. They work together in a delicate balance with muscles, ligaments, cartilage and your jaw bones. When a problem prevents these parts from working together properly, pain may result.

Close-up of TMJ

Treatment Options

For some patients, the disorders may disappear by themselves; for others, they may come and go, or may worsen over time. TMD disorders are often managed, rather than cured. Your general dentist may recommend treatment, or he or she may refer you to a physician or dental specialist.
There are several ways TMD may be managed. The success of the treatment often depends upon you and your dentist working together to find what works to relieve your symptoms.
Treatment may involve a series of steps. The step-by-step plan allows you to try simple treatment before moving on to more involved treatment. Experts generally recommend a “less is often best” approach to treating TMJ disorders.
The following self-care practices may be recommended:
• eating softer foods or avoiding foods that cause symptoms
• minimize extreme jaw movements, such as yawning, yelling or singing
• avoid chewing gum
• modifying the pain with heat or ice packs
• practicing relaxation techniques to control jaw tension, such as meditation
If necessary, your dentist may recommend the following to relieve your symptoms:
• exercises to strengthen jaw muscles
• medicines to reduce pain or inflammation, or to help you relax
• a night guard or bite plate to decrease clenching or grinding of teeth
In some cases, your dentist may recommend fixing an uneven bite by adjusting or reshaping some teeth. Orthodontic treatment may also be recommended.

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