Understanding TMJ

By Premier Dental of Ohio

What you need to know about TMJ

What to Know About TMJ

When it comes to the most poorly understood health conditions, TMJ tops the list. In fact, TMJ is not even the correct term, as we will explain later. Many people suffer from problems in the jaw joint or joints without understanding the nature of the issue. The more you understand, the better you are able to cope when problems arise.  Read this week’s blog to learn what you need to know about TMJ.

What is TMJ?

TMJ stands for TemporoMandibular Joint, and each person has two of these joints. This joint connects the temporal bone of the skull with the lower jaw, or mandible.  

It is the most complicated joint in the human body.  It is a ball-in-socket joint, like the shoulders and hips, but what makes it complicated is its motion. The TMJs are unlike the other ball-in-socket joints in the body in that the ball comes out of the socket during normal function.  

In order for the lower jaw to open the mouth, the “ball” of the jawbone rotates and glides out of the “socket” of the skull. This requires great cooperation by the bones, tendons, ligaments, discs and muscles involved in this complex joint system. And there are two of them that need to function in coordination with each other.  

TMJ describes a normal anatomical feature of the human body.  

What is TMD?

TMD stands for TemporoMandibular Disorder or Dysfunction, and this is the correct term to describe problems with the jaw joints. TMD is a very broad term, encompassing any issues with any part of the joint system. TMD can involve one or more aspects of these complex joints, including the muscles, the discs, the bones, or the ligaments and tendons.  

TMD can affect only one side of the jaw, or it can affect both at the same time. TMD can also be a “silent” problem causing no noticeable symptoms to the patient.

Some TMD patients have pain, and others have a limitation in function. This means that they may not be able to chew properly or open their mouth widely.

TMD is very common among American adults, and it can be difficult to treat. The reason it is tough to treat is that it can be difficult to diagnose without expensive imaging (three-dimensional CT scans and MRIs).

What are the Symptoms of TMD?

Because of the wide variety of problems involved in TMD, patients may experience a number of symptoms. As we stated earlier, some people can experience no symptoms at all. This is due to the potential for adaptation by the human body. Some people can continue to function without pain despite deterioration in the jaw joints. Dentists and oral surgeons typically identify this asymptomatic type of case as an incidental finding on images of the upper and lower jaws.  

For those with TMD who do experience symptoms may notice one or more of the following:

  • Pain in or near the ears during chewing, opening the mouth widely, or biting the teeth together
  • Pain in the cheeks and facial muscles
  • Headaches, especially in the temples
  • A limitation in the movement of the jaws, being unable to move to one side or unable to open widely
  • Sounds like clicking or popping in the jaw joints
  • Sounds like crunching or driving on gravel in the jaw joints
  • Ringing in the ears
  • Experiencing a “locked” jaw, either being open and unable to close or being closed and unable to open
  • A sudden, noticeable change in the way the upper and lower teeth fit together

What Causes TMD?

The causes of TMD can vary from person to person. There is not a single cause of TMD problems, but rather a variety of potential causes. In general, we can divide these potential causes into a few broad categories.

  1. Developmental Problems – Some people have a high risk for TMJ problems due to the growth and development of the upper and lower jaws. Dentists, surgeons, and scientists have a variety of opinions on what causes the growth problems.  Some suggest injuries during childhood, while others claim the airway is to blame. Another camp believes there are hormonal influences. This is a relatively hazy area that requires more research for better understanding. It is safe to say that those who have underdeveloped jaws have a much higher risk for TMJ problems throughout their lifetimes than those with normally developed jaws.
  2. Injuries/Trauma – A common cause of TMJ disorder is injury or trauma to the lower jaw. This can be a fall where one lands on the chin or a blow to the face.  Anything that creates a blunt, heavy force into the jaw joints will cause damage that can have lasting effects for decades. If an injury occurs during childhood, it often affects the growth of the jaw.  Injuries to the jaw joints in adult can accelerate arthritis and joint deterioration.
  3. Microtrauma/Wear and Tear – Microtrauma simply means small amounts of heavy forces accumulating over a long period. A more simple way to describe microtrauma is “wear and tear”. The human jaw joints can withstand normal chewing forces well. They cannot withstand the heavy forces of strong clenching and grinding during sleep.  Over time, those abnormally heavy forces can damage the jaw joints.

What are the Treatment Options for TMD?

The treatment for TMD also varies widely. First, an accurate diagnosis of the underlying problem is necessary. Otherwise, treatment may be ineffective. The next, important step is determining the goal of treatment. Some TMJ disorders are relatively simple to manage, but difficult to cure. Sometimes the goal is just pain management and the ability to chew. 

Dental Splints/Appliances

This is the most common treatment prescribed for patients suffering with TMD. Your dentist or surgeon can fabricate a dental appliance, which fits over the teeth and holds the jaws in a prescribed position. Not only does this protect the jaw joints; it also protects the teeth and their supporting structures from damage.

Physical Therapy

The goal of physical therapy is both pain management and improved joint function. Physical therapy typically cannot “fix” severe joint problems, but it can help a patient reach a stage of comfort. Physical therapy works best when performed in conjunction with splint therapy by your dentist.

Chiropractic Care

Chiropractic adjustments can decompress the jaw joints, reducing pressure and pain. They may also improve the ability to open and close the jaws. Chiropractors must have specific training in the jaw joints in order to perform these adjustments, so make sure you do your research!  Better yet, ask your dentist for a referral to a chiropractor with a reputation for successfully helping TMJ patients.

Prescription Medication

Prescription medications can be helpful in managing acute TMJ problems, but they are not a good option for long-term care. The most common types of medications prescribed for TMD are muscle relaxants. By reducing the force of the jaw muscles, they can relieve pain and aid in the work of physical therapy. Some doctors will also prescribe anti-inflammatory medications to alleviate pain in the joints.

Joint Surgery

Surgery is obviously the most invasive treatment option, and typically, doctors reserve it as a “last resort”. The types of TMJ surgery range from repositioning a displaced disc into the joint to completely replacing the entire joint with a prosthetic joint. TMJ surgery should not be entered into lightly, and we strongly recommend consulting with both your dentist and multiple surgeons prior to committing to this path of treatment.

Can I Prevent TMD?

In some cases, yes.

Unfortunately, we cannot prevent developmental problems and most injuries.  We can prevent some injuries during sports by wearing athletic mouthguards.  We can also prevent microtrauma by protecting our jaws against the effects of heavy clenching and/or grinding during sleep. This requires wearing a protective nightguard every night. This will separate the teeth, reducing the amount of force your jaw muscles can produce. It also decompresses the jaw joints, reducing the force they receive.

More Questions about TMJ/TMD?

Call your nearest Premier Dental of Ohio location to schedule a TMJ consultation with one of our compassionate dentists. We understand the pain and frustration of TMJ disorder and love helping our patients find relief.

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