TMD and TMJ

TMD and TMJ

TMJ Pain.If you experience ongoing pain in the area near your ear, your jaw or the muscles on the side of your face, possibly accompanied by a clicking or popping sound or restricted jaw movement, you may be suffering from TMD — an abbreviation for Temporomandibular disorders. Sometimes people incorrectly use the term TMJ to refer to these problems, when in fact TMJ is the abbreviation for the temporomandibular joint — or jaw joint — itself. So while you definitely have a TMJ (two of them in fact), you may or may not have TMD.

TMD, then, describes a group of conditions characterized by pain and dysfunction of the TMJ and/or the muscles surrounding it. It's not always so easy to figure out exactly what's causing these symptoms, but the good news is that most TMD cases resolve themselves with the help of conservative remedies that you can try at home. In fact, it's important to exhaust all such reversible remedies before moving on to anything irreversible, such as bridgework or surgery.

The two TMJs that connect your lower jaw, the mandible, to the temporal bone of the skull on either side, are actually very complex joints that allow movement in three dimensions. The lower jaw and temporal bone fit together as a ball and socket, with a cushioning disk in between. Large pairs of muscles in the cheeks and temples move the lower jaw. Any of these parts — the disk, the muscles or the joint itself — can become the source of a TMD problem. If you are in pain, or are having difficulty opening or closing your jaw, a thorough examination can help pinpoint the problem area; then an appropriate remedy can be recommended.

Causes of TMD

TMJ Joint.As with any other joint, the TMJ can be subject to orthopedic problems including inflammation, sore muscles, strained tendons and ligaments, and disk problems. TMD is also influenced by genes, gender (women appear to be more prone to it), and age. Physical and psychological stress can also be a factor. In some cases, jaw pain may be related to a more widespread, pain-inducing medical condition such as fibromyalgia (“fibro” – connective tissues; “myo” – muscle; “algia” – pain).

Your teeth and the way they fit together (occlusion) can have a huge impact on TMD.  Malocclusion, or a bad bite, can be a large contributing factor to TMD.  In many cases, we will fabricate an occlusal splint to relieve TMD symptoms.  This is a professionally made and adjusted mouth guard.  If you are having TMD symptoms, please do not go to purchase a generic mouth guard at the store.  This will make TMD symptoms worse because these kind of mouth guards cannot be adjusted and will cause you to clench more.  Habits such as clenching and grinding can cause you to to experience more pain.  Please remember that the only time your teeth should touch is when you eat.  All other times, your lips may be together, but your teeth should not touch.  

Sleep habits have a significant impact on TMD.  Sleeping on your abdomen will cause you to clench more.  The muscles of your head and neck like to be in a neutral position.  You do not want to put your face in the middle of the pillow when sleeping as this puts pressure on the facial muscles and jaw and can negatively impact the jaw joint.  If you sleep on your side, end the pillow even with your ear so that none of the pillow goes past your ear and pushes on your jaw.  Don't place a hand or arm under your pillow or on your face, as this will cause pressure on the joint and cause you to clench, grind, or have pain.  

Prolonged computer work can also impact TMD.  If you are constantly tipping your head up to look at a monitor, you may unconsciously position your jaw forward.  We can show you stretches to do that will relieve tension in the muscles of the head and neck as they relate to computer work.  

Signs and Symptoms of TMD

Clicking Sounds — Some people with TMD hear a clicking, popping or grating sound coming from the TMJ when opening or closing the mouth. This is usually caused by a shifting of the disk inside the joint. Someone standing next to you might even be able to hear it. Clicking by itself is actually not a significant symptom because studies show that one third of all people have jaw joints that click. However, if the clicking is accompanied by pain or limited jaw function — the jaw getting “stuck” in an open or closed position, for example — this would indicate TMD.

Kids mouth anatomy.

Muscle Pain — This can be felt in the cheeks (masseter muscles) and temples (temporalis muscles), where the two big pairs of jaw-closing muscles are located. If you feel soreness and stiffness upon waking up in the morning, it's often related to habits such as clenching and/or grinding the teeth at night. If you have this type of nocturnal habit, a custom-made nightguard should be very helpful in decreasing the force applied to your teeth, which will in turn allow your muscles to relax and relieve pressure on your jaw joints. Other self-care remedies are discussed below (please see Relieving the Pain).

Joint Pain — Pain that's actually coming from one or both jaw joints technically would be described as arthritis (“arth” – joint; “itis” – inflammation) of the TMJ. Radiographs (x-ray pictures) show that some people have arthritic-looking TMJs but no symptoms of pain or dysfunction; others have significant symptoms of pain and dysfunction but their joints look normal on radiographs. There is no cure for arthritis anywhere in the body, but medication can sometimes help relieve arthritic symptoms.

Relieving the Pain

Once you have been examined, a strategy for treating your condition and managing your pain can be developed. Sometimes a temporary change to a softer diet can reduce stress on the muscles and joints. Ice and/or moist heat can help relieve soreness and inflammation. Muscles in spasm can also be helped with gentle stretching exercises. Non-steroidal anti-inflammatory medications and muscle relaxants can also provide relief.

Other Treatment Options

Severe TMD cases may require more complex forms of treatment, which might include orthodontics, dental restorations like bridgework, or minor procedures inside the joint such as cortisone injections or lavage (flushing) of the joint. It's rare for major surgery ever to be necessary in a case of TMD. Again, it's important to try the wide range of conservative, reversible treatments available, and give them enough time to work as they almost always prove effective. The first step is an examination at the dental office. To learn more about available treatment options, view this Chart on TMD Therapy

Looking to get TMD and TMJ treatment from Gentle Art of Dentistry?
Call us at (217) 422-7448 for more information!

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