Temporomandibular Disorder

Millions of Americans suffer from chronic facial and neck pain as well as recurrent headaches. In some cases this pain is due to Temporomandibular Disorder, or TMD.

Your temporomandibular joints, or jaw joints, connect your lower jawbone to your skull. As you may imagine, these joints get quite a lot of use throughout the day as you speak, chew, swallow, and yawn. Pain in and around these joints can be unpleasant and may even restrict movement.

Symptoms of TMD include:

• Pain in the jaw area
• Pain, ringing, or stuffiness in the ears
• Frequent headaches or neck aches
• Clicking or popping sound when the jaw moves
• Swelling on the sides of the face
• Muscle spasms in the jaw area
• A change in the alignment of top and bottom teeth
• Locked jaw or limited opening of the mouth
• Excessive clenching and grinding of teeth

Should you notice any of these symptoms, let us know! We can help advise you as to whether they indicate the presence of TMD, and what sort of treatment is appropriate for you.

If you don't have any of these symptoms, let's keep it that way! There are some simple things you can do at home or work to prevent TMD from occurring in your jaw joints:

• Relax your face - remember the rule: "Lips together, teeth apart"
• Avoid grinding your teeth
• Avoid constant gum chewing
• Don't cradle the phone receiver between your head and shoulder - either use a headset or hold the receiver to your ear
• Chew food evenly on both sides of your mouth
• Do not sit with your chin rested on your hand
• Practice good posture - keep your head up, back straight, and shoulders squared

TMJ problems are generally classified into two basic categories: Muscular Problems and Internal Joint Damage.

Muscular Problems

Muscular problems are reversible because there has been no damage inside the joint itself. The chewing muscles are in spasm due to a poor bite forcing the lower jaw out of position on closure. This muscle tension is manifested as headaches, grinding of the teeth, ringing in the ears, or neck and shoulder pain. Because stress causes many people to clench their teeth, nervous tension can worsen these problems. Such problems are easily corrected by relaxing the muscles and ultimately correcting the bite problem. A bite splint can be used to separate the bite and relax the muscles. This can be followed with orthodontic treatment to ultimately correct the bite.

Internal Joint Damage

Internal joint damage is when damage has actually occurred inside the joint. Such problems are not as reversible as muscular problems. The following illustration depicts the normal joint function:

The following illustration depicts DISK DISPLACEMENT. The ligaments are compressed and stretched, causing them to degenerate from the pressure of the jaw pushing up on them as the jaw moves. Adjacent nerves and blood vessels are compressed, causing pain and headaches.

In the most severe cases, the back ligaments degenerate away completely. The patient now has bone-to-bone contact and the bone wears down and becomes arthritic. Joint function becomes further limited and the patient is able to open less and less.