Advanced Dental Care

TEMPOROMANDIBULAR DISORDER (TMD)

What are the temporomandibular joints (TMJ)?
Simply stated, the temporomandibular joints (TMJ) are the two joints that connect your jaw to your skull. More specifically, they are the joints that slide and rotate in front of each ear, and consist of the mandible (the lower jaw) and the temporal bone (the side and base of the skull). When the mandible and the joints are properly aligned, a smooth muscle action, such as chewing, can take place. When these components are not aligned, nor synchronized in movement, several problems may occur.

What is temporomandibular disorder (TMD)?
Temporomandibular disorders (TMD) are disorders of the jaw muscles, temporomandibular joints, and/or the nerves associated with chronic facial pain. Any problem that prevents the complex system of muscles, bones, and joints from working together in harmony may result in temporomandibular disorder.

What causes TMD?
Most oral health professionals will agree that the primary cause of this disorder is excessive strain on the muscle group that controls chewing, swallowing, and speech. This strain may be a result of bruxism (incessant clenching of the teeth), or from physical or mental stress. These factors may be the cause, in most cases, or may aggravate an existing condition of TMD.

What are the symptoms of TMD?
The following are the most common symptoms of TMD. However, each individual may experience symptoms differently. Symptoms may include:

jaw discomfort or soreness (often most prevalent in the morning or late afternoon)

headaches

pain radiating behind the eyes, in the face, shoulder, neck, and/or back

earaches or ringing in the ears (not caused by an infection of the inner ear canal)

clicking or popping of the jaw

locking of the jaw

mouth motions are limited
clenching or grinding of the teeth
dizziness
sensitivity of the teeth without the presence of an oral health disease

numbness or tingling sensation in the fingers

The symptoms of TMD may resemble other conditions or medical problems. Consult a physician for diagnosis.

Treatment for TMD
Specific treatment for TMD will be determined by your physician or dentist based on:

	your age, overall health, and medical history
	extent of the disease
	your tolerance for specific medications, procedures, or therapies
	expectations for the course of the disease
	your opinion or preference

Treatment may include:

	resting the temporomandibular joint (TMJ)
	medication and/or pain relievers
	relaxation techniques and stress management
	behavior modification (to reduce or eliminate the clenching of the teeth)
	physical therapy
	an orthopaedic appliance or mouthguard worn in the mouth - to reduce bruxism
	posture training
	diet modification (to rest the jaw muscles)
	ice and hot packs
	surgery
	Categories of Temporomandibular Disorders The National Institute of Dental Research, part of the National Institutes of Health, classify the categories of TMD by the following criteria:
	*myofascial pain* - the most common form of TMD, which is discomfort or pain in the muscles that control jaw function and the neck and shoulder muscles.
	*internal derangement of the joint* - meaning a dislocated jaw or displaced disc, or injury to the condyle (the rounded edges of the jaw).
	*degenerative joint disease* - such as osteoporosis or rheumatoid arthritis in the jaw joint. A person can have one or more of these conditions at the same time.