TMJ and TMD

TMJ is an abbreviation for the temporomandibular joint which connects the mandibular, or your lower jaw, to the temporal bones of the skull. The TMJ is one of the more unique joints within your body as it allows you to move your jaw forward, backward, and side to side so that you can chew, talk, sing, yawn, and more. This joint can be found just in front of your ears on both sides of your head.

Any problem with the muscles, ligaments, discs, bones, or the joint itself are known as temporomandibular disorders or TMD and refers to the actual disorder, where the jaw joint is misaligned and causing problems such as pain, inflammation, and inability to move or operate the jaw. However, it is fairly common for these problems or conditions to be incorrectly called by the joint name of TMJ instead.

What are the causes of TMD?

There can be a variety of causes for TMD and can arise from problems with the jaw, the muscles near the jaw, or the joint itself. The most common causes for TMD may include:

• Arthritis or other inflammatory conditions
• Grinding or clenching your teeth
• Injury to the joint, jaw, or muscles along the neck and face
• A jaw or bite misalignment 
• Movement or dislocation of the disc between joint parts
• Previous injuries or surgeries to the jaw
• Stress or anxiety
• Whiplash

Signs & Symptoms

Patients with TMD often experience severe pain and discomfort that can be temporary or chronic. Symptoms depend on the severity of your condition and can show on one side or both. There are many signs and symptoms of TMD that can overlap with other conditions, which makes a diagnosis by your doctor all the more important. Common symptoms of TMD may include:

• Dislocation of the jaw
• Earaches 
• Jaw pain 
• Locked, stiff, or stuck jaw
• Migraines and headaches
• Neck pain
• Numbness in the arms, hands, and fingers
• Popping or clicking sound in the jaw
• Shoulder pain 
• Sinus pressure and congestion
• Swelling on the side of the face
• Tenderness of jaw muscles 
• Tired cheeks or jaw
• Tooth pain
• Upper back pain

Diagnosis

As stated above, many of the symptoms of TMD can overlap with other conditions such as tooth decay, gum disease, sinus problems, or arthritis. To determine the cause, your dentist will conduct a physical examination and medical history review. 

During your appointment, your jaw will be tested for pain or tenderness, and your doctor will examine how your jaw works when you open and close it while listening for clicks, pops, or sounds when you operate your jaw. Your bite and facial muscles will also be tested. It is not uncommon for x-rays, MRIs, and CT scans to be required to determine the cause as these images can provide insight into the joint, surrounding tissues, and structures of your jaw. 

Treatment Options

Several different treatment options are available depending on your condition and the severity of your symptoms. In most mild cases TMD can be treated with self-care practices at home. Home care methods include:

• Avoiding hard, crunchy, or chewy foods
• Eating soft foods or cutting your food into smaller pieces
• Limiting extreme jaw movements 
• Reducing stress levels
• stretching your jaw
• Taking over the counter medication to relieve pain and swelling
• Using heat and cold packs

If your symptoms do not improve with these home remedies or if your case is more complex, your doctor may prescribe pain medication, anti-inflammatory medicine, or muscle relaxants in combination with other conservative treatment options. Physical therapy has proven effective in many cases of TMD to help strengthen the jaw and regain full motion and function of the area without pain. 

Your doctor may also provide you with custom-made bite guards or splints to prevent clenching or grinding of your teeth. If misaligned teeth or bite is the cause, corrective dental treatment may be necessary, common dental options include bridges, crowns, braces, and retainers. 

Other treatment options may include low-level laser therapy, ultrasound therapy, or low-level electrical stimulation to provide muscle relief. In extreme cases, surgery can help to remove fluid or debris from the jaw or replace/realign the joint. Surgery is only considered once all other treatment options have been exhausted. 

Every case is unique, and a careful diagnosis and treatment plan will help to address your needs. For more information on TMD or your temporomandibular join or to schedule a consultation for treatment, contact our office today at (516) 506-0000.