Temporomandibular Disorders (TMD)
TMD is a common subgroup of orofacial pain disorders, often incorrectly referred to as “TMJ”. TMJ is the abbreviation used for the temporomandibular joint or jaw joint.
View the video below from the American Dental Association about TMD.
Pain or discomfort in or around the ear, jaw joint, and/or muscles of the jaw, face, temples and neck on one or both sides. The pain may arise suddenly and progress with fluctuating frequency and intensity over months to years. Clicking, popping, grating (crepitus), locking, limited opening or deviating jaw movement, chewing difficulties, and headache are also associated with TMD.
Causes for TMD are unclear as TMD usually involves more than a single symptom and rarely has a single cause. TMD is believed to result from several factors acting together, including jaw injuries (trauma), and joint disease (arthritis). Tooth clenching and grinding (bruxism) and head and neck muscle tension, while not scientifically proven to be a cause of TMD, may perpetuate TMD symptoms and often need to be controlled to reduce and manage TMD. It is important for the TMD patient to understand that the disorder can be chronic in nature and highly dependent upon multiple factors including emotional stability. Because there is no “quick fix” or immediate cure for TMD, the most successful and scientifically supported treatments focus on self-management and control of the aggravating factors.
It may be recommended that you wear an orthotic (also known as a splint, night guard, bite guard) that fits over either your upper or lower teeth. Splints are used to temporarily provide an occlusal condition that allows the TMJs to assume the most orthopedically stable joint position while clenching. Since this is more intense while we sleep, we only recommend wearing the splint at night. During the day we advise patients to avoid clenching and be aware of oral habits.
- Occlusal stability while clenching
- Joint stability
- Muscle relaxation
- Teeth protection
One treatment approach for your TMD problem is to learn to manage your daily stress. Your doctor may recommend several techniques to help you do this. They may include biofeedback, relaxation breathing, guided imagery, and sometimes referral to a therapist.
Physical therapists are trained professionals who help rehabilitate all types of physical injuries. There are many different techniques that are helpful and the most common include jaw exercises, postural and ergonomic training, ultrasound, electrical stimulation, and mobilization. Your doctor and physical therapist will work together to formulate a plan for your treatment.
Sometimes it is necessary to improve the way your teeth fit together. This can be accomplished in different ways.
Orthodontics, usually with braces, can move your teeth so they fit together better. In some cases, if the jaws themselves are misaligned, the jaws are moved with a combination of orthodontics and oral surgery called orthognathic surgery.
Bite Reconstruction is accomplished through extensive dental work like crowns, bridges and, if indicated, implants. This is done to replace missing teeth or to change the size and shape of the teeth so they fit and function together in a more harmonious manner with the jaw joints and muscles.