Causes and treatments for temporomandibular disorders

What is the Temporomandibular joint?

The temporomandibular joint (TMJ) is a joint that slides and rotates just in from of your ear, consisting of the temporal bone (side and base of the skull) and the mandible (lower jaw). Mastication (chewing) muscles connect the lower jaw to the skull, allowing you to move your jaw forward, sideways, and open and close.

The joint works properly when the lower jaw and its joint (both the right and left) are synchronized during movement. Temporo­mandibular Disorder (TMD) may occur when the jaw twists during opening, closing or side-motion movements. These movements affect the jaw joint and the muscles that control chewing.

What is Temporomandibular Disorder?

TMD describes a variety of conditions that affect jaw muscles, temporomandibular joints, and nerves associated with chronic facial pain. Symptoms may occur on one or both sides of the face, head or jaw, or develop after an injury. TMD affects more than twice as many women than men and is the most common non-dental related chronic orofacial pain.

What causes TMD?

Normal function for this muscle group includes chewing, swallowing, speech and communication. Most experts suggest that certain tasks, either mental or phys­ical, cause or aggravate TMD, such as strenuous physical tasks or stressful situations. Most discomfort is caused from overuse of the muscles, specifically clenching or grinding teeth (bruxism).

These excessive habits tire the jaw muscles and lead to discomfort, such as headaches or neck pain. Additionally, abnormal func­tion can lead to worn or sensi­tive teeth, traumatized soft tissues, muscle soreness, jaw discomfort when eating, and temporal (side) headaches.

What TMD symptoms can I experience?

• An earache without an infection

• Jaw pain or soreness that is more prevalent in the morning or late afternoon

• Jaw pain when you chew, bite or yawn

• Clicking when opening and closing your mouth

• Difficulty opening and closing your mouth

• Locked or stiff jaw when you talk, yawn or  eat

• Sensitive teeth when no  dental problems can be found

What can I do to treat TMD?

The majority of cases can be treated by unloading (resting) the joint, taking a non-aspirin pain reliever and practicing stress management and relax­ation techniques. It's impor­tant to break bad habits to ease the symptoms. Most treatment for TMD is simple, often can be done at home, and does not need surgery. For example, control clenching or grinding during the day by sticking your tongue between your teeth. If you still experience pain, you may be grinding or clenching your teeth at night. So see your dentist for a night­time mouth guard.

Is TMD permanent?

The condition is often cyclical and may recur during times of stress, good or bad. As the patient, you should be active in your treatment, by being aware of the causes of your jaw problems after seeing a dentist for a diagnosis regime. Make routine dental appointments, so your doctor can check TMD on a regular basis.

Updated July 7998

Sources: Giblisco, Joseph A. DDS, Charles McNeill, DDS, Harold T. Perry, DDS, Orofacial Pain; Understanding Temporomandibular (TMJJ Disorders. Quintessence Publishing Co., Inc" Carol Stream, Illinois 1994; E. Mac Edington DDS, MAGD, ABGD; NIDR, Temporomandibular Disorders, Bethesda, Maryland; Wilkinson, Tom, "New patterns or dental dis­ease; Management or temporo­mandibular disorders." Australian Dental Association News Bulletin, No, 246, July 1997.