Temporomandibular Joint Disorders (TMD) – Ask Your Dentist

Temporomandibular Joint Disorders (TMD)

*TMJ is short for the Temporomandibular Joint but is often incorrectly used to apply to the disorders

The TMJ  is a hinge which connects your jaw to the temporal bones of the skull, in front of each ear. Allowing you to speak, chew and yawn. When this joint is injured or damaged, it can lead to temporomandibular joint disorders (TMD).

Your dentist can help diagnose and create a treatment plan and refer you to other professionals as necessary.

Causes of TMD

Exact causes are not always clear and could arise from problems with either the muscles or the joints. E.g.

  • Injury to the area from a heavy blow or whiplash
  • Clenching or grinding of teeth
  • Movement of the soft disc or cushion between the ball and socket of the joint
  • Arthritis causing stiffness in the joint
  • Stress related tightening of facial and jaw muscles

Common Symptoms

  • Pain or tenderness in your face, jaw joint area, neck and shoulders, and also in or around the ear when you open your mouth wide, chew or speak
  • Jaws can get "stuck" or "locked" in the open-mouth or closed-mouth positions
  • Clicking, popping, or grating sounds in the jaw joint when opening or closing your mouth or chewing. There may or may not be pain accompanying the noise.
  • Face has a tired feeling
  • Trouble chewing or the bite suddenly feels uncomfortable -- as if the upper and lower teeth are not fitting together properly
  • Swelling on the side of your face
  • Toothaches, headaches, neck aches, dizziness, earaches, hearing problems, upper shoulder pain, or ringing in the ears (tinnitus)

Diagnosis

Similar symptoms can be caused by other conditions, e.g. tooth decay, sinus issues, arthritis or gum disease.

Your dentist will:

  • Check jaw joints for pain or tenderness plus listen for clicks, pops, or grating sounds when you move them
  • Make sure your jaw works like it should and doesn’t lock when you open or close your mouth
  • Test your bite and check for problems with your facial muscles
  • Take full face X-rays if necessary in order to view your jaws, TMJ's, and teeth to rule out other problems
  • Schedule or refer you for other tests, e.g. MRI or to other specialists, e.g. oral surgeon

Treatments

Self-Care

Symptoms may be acute rather than chronic. Simple home treatments may suffice and are recommended as a first line.

  • Over-the-counter medications - such as Nonsteroidal anti-inflammatory drugs NSAIDs to reduce muscle pain and swelling
  • Moist heat or cold packs - e.g. ice pack for 10m, warm cloth for 5
  • Eat soft foods - to reduce joint strain
  • Gentle jaw movements - avoid yawning (if you can!) and chewing gum
  • Good posture, low pressure - don't rest your chin on your hand, maintain correct poise of head and neck
  • Teeth slightly apart - relieves pressure on the jaw from clenching
  • Relaxation techniques - physical therapy or massage can help

Medical Treatments

If symptoms persist then further treatments can be applied

  • Medications - higher doses of NSAIDs or muscle relaxer to reduce grinding and clenching teeth
  • Splint or Night Guard - help reduce the effects of grinding or clenching by use of a mouthpiece on upper and lower teeth
  • Dental Work - if problems are caused by incorrect bite then replacing missing teeth or use of crowns, bridges or braces can help balance the biting surfaces

Other Treatments

May include TENS, Ultrasound, Trigger-point Injections, Radio wave therapy, low-level laser therapy


Please don't hesitate to discuss with your dentist if you are experiencing possible symptoms in order to refine and adjust your dental treatment plan accordingly

Read more in this article from the Canadian Dental Association.

 

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