About Temporomandibular TMJ Disorders
TMJ is the initialism for temporomandibular joint, which connects your lower jaw (the mandible) to your skull at the temporal bone. This joint controls many jaw functions, like chewing. If the chewing muscles or the joint itself are causing you pain you may have temporomandibular disorder, or TMD. TMD can be caused by stress, continual clenching of the jaw muscles, or teeth grinding.
Causes of TMD
As with any other joint, the TMJ can be subject to orthopedic problems including inflammation, sore muscles, strained tendons and ligaments, and disk problems. TMD is also influenced by genes, gender (women appear to be more prone to it), and age. Physical and psychological stress can also be a factor. In some cases, jaw pain may be related to a more widespread, pain-inducing medical condition such as fibromyalgia (“fibro” – connective tissues; “myo” – muscle; “algia” – pain).
Signs and Symptoms of TMD
Clicking Sounds — Some people with TMD hear a clicking, popping or grating sound coming from the TMJ when opening or closing the mouth. This is usually caused by a shifting of the disk inside the joint. Someone standing next to you might even be able to hear it. Clicking by itself is actually not a significant symptom because one third of all people have jaw joints that click, studies show. However, if the clicking is accompanied by pain or limited jaw function — the jaw getting “stuck” in an open or closed position, for example — this would indicate TMD.
Muscle Pain — This can be felt in the cheeks (masseter muscles) and temples (temporalis muscles), where the two big pairs of jaw-closing muscles are located. If you feel soreness and stiffness upon waking up in the morning, it's often related to habits such as clenching and/or grinding the teeth at night. If you have this type of nocturnal habit, a custom-made nightguard should be very helpful in decreasing the force applied to your teeth, which will in turn allow your muscles to relax and relieve pressure on your jaw joints. Other self-care remedies are discussed below (please see Relieving the Pain).
Joint Pain — Pain that's actually coming from one or both jaw joints technically would be described as arthritis (“arth” – joint; “itis” – inflammation) of the TMJ. Radiographs (x-ray pictures) show that some people have arthritic-looking TMJs but no symptoms of pain or dysfunction; others have significant symptoms of pain and dysfunction but their joints look normal on radiographs. There is no cure for arthritis anywhere in the body, but medication can sometimes help relieve arthritic symptoms.
Many of these symptoms can often be associated with other health problems, so only a medical professional can tell you if it is due to TMD. Teeth grinding is an especially problematic symptom because it can lead to further problems. Prolonged teeth grinding, or bruxism, can cause enamel to wear off teeth and expose dentin. This material is softer than enamel and more susceptible to decay. Sensitivity to hot and cold food or drink may also develop from excessive teeth grinding.
Relieving the Pain
Once you have been examined, a strategy for treating your condition and managing your pain can be developed. Sometimes a temporary change to a softer diet can reduce stress on the muscles and joints. Ice and/or moist heat can help relieve soreness and inflammation. Muscles in spasm can also be helped with gentle stretching exercises. Non-steroidal anti-inflammatory medications and muscle relaxants can also provide relief.
Other Treatment Options
Severe TMD cases may require more complex forms of treatment, which might include orthodontics, dental restorations like bridgework, or minor procedures inside the joint such as cortisone injections or lavage (flushing) of the joint. It's rare for major surgery ever to be necessary in a case of TMD. Again, it's important to try the wide range of conservative, reversible treatments available, and give them enough time to work as they almost always prove effective. The first step is an examination at the dental office.
If you suspect you may have TMD come in for a consultation. We can help diagnose you and provide relief for your symptoms. Pain relievers and hot/cold compresses are short term methods to provide relief for pain symptoms. A night guard can be used to help prevent or lessen the effects of teeth grinding at night. This can lead to a more permanent solution. In very severe cases of TMD surgery may be required, but behavioral treatments to change the way you use your jaw muscles are usually enough to provide relief.
Want to learn more about TMJ treatment from John P. O'Grady, DMD?
Then call our Danville, CA office at (925) 820-5585 to book an appointment today!