TMJ - TMD - Temporomandibular Joint Disease
By Dr. Bruce
1. Do you have difficulty, pain or both when opening your mouth, for instance when yawning?
2. Does your jaw get stuck, or lock, or go out?
3. Do you have difficulty, pain, or both when chewing, talking, or using your jaw?
4. Are you aware of noises in the jaw joint?
5. Do your jaws regularly feel stiff, tired, or tight?
6. Do you have pain in or about the ears, temples, or cheeks?
7. Do you have frequent headaches, neckaches or unexplained toothaches?
8. Have you had a recent injury to your head, neck, or jaw?
9. Have you been aware of any recent changes in your bite?
10. Have you been previously treated for unexplained facial pain or a jaw joint problem?
If you have answered yes to any of these questions, you should get a comprehensive TMD exam to determine if any of the findings are clinically significant.
TMJ dysfunction is a term used to describe any disorder of the jaw joints or the muscles that control the joints. There are many terms used to describe these disorders. The popular term "TMJ" is actually an abbreviation for the name of the joint: Temporomandibular Joint. These are the two joints, one on either side of your head, which serve as the connection between your lower jaw, or mandible, and your skull. The mandible is not actually part of the skull, but rather a separate entity that is literally hung by muscles, tendons, and ligaments. When these joints suffer a dysfunction, they can cause many problems such as:
ü Clicking or popping of the jaw joints
ü Pain in or around the joints
ü Locking or limited opening of the mouth
The muscles that surround and support the joints and those that are used in eating can also affect, and be affected by, the joint itself. Pain in the joints, from any number causes, can cause the muscles to tighten as a sort of protective mechanism. Tight, taut muscles will limit the movement in the joint and hence reduce the possibility of pain. This is called, protective co-contraction. In addition, any habit such as clenching or biting on pencils, or parafunction, such as nighttime teeth grinding (bruxism) can cause the muscles to fatigue or spasm. Imaging lifting a weight hundreds of times each day with your biceps muscle. You can see how this muscle would hurt and after a while be unable to contract efficiently anymore. Furthermore, the constant upward movement of the heads of the mandible can cause inflammation and pain in the TMJs.
This muscular component of the TMJ syndrome can cause:
ü Pain behind the eyes
ü Earaches or ringing in the ears (tinnitus)
ü Neck, shoulder or back pain
The good news is that when properly diagnosed by a trained practitioner, most of these symptoms respond well to treatment. Often, but not always, a temporary device known as an orthotic is worn over the teeth to reduce muscle spasm and joint pain. This, in conjunction with physical therapy, can give relief. If it is determined that the joint itself is damaged in some way it must be specifically treated.
It is important to note that many of these symptoms have different causes and a wide range of severity. Immediate medical help should be sought for any head pain that leads to:
ü Weakness of an arm or leg
ü Loss of vision
ü Loss of consciousness