What Is the Temporomandibular Joint (TMJ)?
The temporomandibular joint connects the lower jaw, called the mandible, to the temporal bone in front of the ear. In a normal situation this joint should move easily and pain free.
A small disc is positioned between the condyle and the temporal bone. This disc is to provide a cushion as the jaw moves so that the bones don’t slide against each other.
What Are Temporomandibular Disorders?
A disorder is diagnosed when the joints do not function as they should. The reasons for a dysfunction can many times to be traced to head or face trauma, increased life struggles, or sometimes seems to be onset for no apparent reason.
What Causes TMD?
We know that injury to the jaw or temporomandibular joint can cause TMD. Trauma to the face or jaw is many times the reason for pain in the temporomandibular area. In such cases, there may be damage to the disc that lies between the condyle and the temporal bone, the jaw bone itself, or the surrounding muscles.
Some experts suggest that stress may cause or aggravate TMD. People with TMD often clench or grind their teeth at night, which can tire the jaw muscles and lead to joint pain and or headaches.
TMD Signs and Symptoms
Occasionally the disc that lies between the condyle and the temporal bone may become displaced upon opening or closing of the jaw. As this disc is forced into an irregular pattern with the joint movement it causes a clicking sound. This can occur in either joint or in both. As long as the displaced disc causes no pain or problems with jaw movement, no treatment is typically needed.
A variety of symptoms may be linked to TMD. Pain, particularly in the chewing muscles and/or jaw joint, is the most common symptom. Other likely symptoms include:
- Limited movement or locking of the jaw,
- Radiating pain in the face, neck or shoulders,
- Clicking, popping or grating sounds in the jaw joint when opening or closing the mouth, this may or may not involve pain.
- Headaches
Diagnosis
The patient’s description of symptoms, combined with a simple physical examination of the face and jaw, provides information useful for diagnosing these disorders.
The examination includes feeling the jaw joints and chewing muscles for pain or tenderness; listening for clicking, popping or grating sounds during jaw movement; and examining for limited movement or locking of the jaw while opening or closing the mouth. Depending on the exam findings and symptoms Dr. Boggan will decide if treatment will be beneficial for the patient.
Treatment
In many cases treatment for TMD is achieved very quickly and easily. The objection of TMD treatment is to the have the patient’s jaw fully functioning and pain free, relieving headaches and/ or facial pain, as well as to provide protection to the anatomy of the teeth.
Because most TMD problems are temporary, simple treatment is all that is usually needed to relieve discomfort. Often times eating soft foods, applying heat or ice packs, and avoiding extreme jaw movements (such as wide yawning, loud singing and gum chewing) are useful in easing TMD symptoms.
The most common treatment we recommend for TMD dysfunction is an oral appliance, also called a NTI. This appliance fits comfortably over the top front teeth and is designed with a flat plane where the opposing lower teeth can touch. This appliance helps to take pressure off of the joints and jaw muscles by giving a stable place to bite. It can help reduce clenching or grinding, which eases muscle tension. Other types of oral appliances are also sometimes used.
In rare cases other types of TMD treatment are needed, such as surgery to the joint area. Surgical treatments are often irreversible and should be avoided where possible.