TMJ and TMD Symptoms and Treatment Overview
Do you ever experience a clicking or popping sound when opening or closing your mouth? Have you been suffering from headaches or migraines and no one seems to be able to help you? Have you been taking pain medicine for years and would like to get off of it? Do you feel any clogging or congestion in one or both of your ears? These are just a few of many symptoms that might be associated with TMD, or Temporomandibular Dysfunction, a common condition affecting the jaw joint or Temporomandibular Joint (TMJ).
TMJ dysfunction, often referred to as TMD, is a disharmony between the way the jaw joint works in an unstrained position and the way the teeth and bite work during those movements. Possible causes of this disharmony include tooth loss, accidents (like whiplash), mal-positioned and/or underdeveloped cranial or jawbones, and perhaps habits like clenching or teeth grinding. Many people go through life suffering from headaches and a variety of facial and neck pains without knowing the ultimate cause, which in many cases is TMJ disorder.
Define TMJ and TMD
They are the two joints which connect the lower jaw to the temporal bone at the side of the head. If you place your fingers just in front of your ears and open your mouth, you can feel the joint on each side of the head. Because these joints are flexible, the jaw can move smoothly up and down and side to side, enabling us to talk, chew and yawn. When the TMJ is not functioning normally and it is not within its physiological limits, it creates a condition called TMD, or Temporomandibular Dysfunction.
TMD is a group of conditions resulting from not having a normal function or "comfortable" positioning of the TMJ, and will present as a cycle of pain, muscle spasms and jaw problems. When teeth are missing, out of alignment, crowded or misshaped, chewing and biting cannot be achieved in a balanced way, so the TMJ and the muscles of chewing try to compensate for this unbalanced movement which results in symptoms that will confirm the presence of TMD.
Temporomandibular Joint Disorder (TMD) is not just a disorder, but a group of conditions, often painful, that affect the jaw joint or Temporomandibular Joint (TMJ) and the muscles that control chewing.
- Myofascial pain, the most common form of TMD, which is discomfort or pain in the muscles that control jaw functions and the neck and shoulder muscles.
- Internal derangement of the joint meaning a dislocated or displaced disc or injury to the condyle (the rounded part at the end of the jaw bone).
- Degenerative joint disease such as Osteoarthritis or Rheumatoid Arthritis in the jaw joint. Causes of TMJ/TMD
- Unbalanced occlusion or "Bad Bite"
- Stress (emotional or work/school related)
- Injury or trauma (this could have been an injury as obvious as a blow to the jaw with a fist or something as subtle as a whiplash injury with direct trauma to the head or jaw.
- Teeth grinding or Bruxism
- Missing teeth
- Crowded or "crooked" teeth
- Worn down teeth
- Old crowns and bridges
- Unbalanced dentures
When teeth are missing, or out of alignment, it causes the jaw to shift positions and the muscles to work harder to chew, swallow, bite...etc and eventually will cause: muscle spasms, tension and pain.
Muscle tension and misplaced TMJ could cause the TMJ disc to be pulled out of place which will result in pain, clicking and popping in the TMJ.
If the disc is displaced for a long time, the bones will start rubbing against each other and some damage will happen to the bone, this is called Osteoorthrosis.
If there is inflammation in other joints or bones of the body, it is called Osteoarthritis (Arthritis) which may involve the jaw bone and the TMJ. Some damage to the bone may be evident on the x-rays.
- Headaches, Migraines or tension headaches
- Worn or loose teeth
- Painful muscles in the neck and shoulders (muscle spasms)
- Pain behind the eyes.
- Clicking and popping of the jaw joint (TMJ)
- Locked jaw or restriction in opening or closing the mouth
- Earaches or a clogging feeling in the ears
- Tingling or numbness in the hands and the fingertips
While recognizing TMJ problems is within the ability of most physicians and dentists, not all practitioners are qualified to diagnose it properly and treat it right. It is imperative that a trained practitioner in craniofacial pain or Neuromuscular Dentistry give the final and definitive diagnosis and suggest the most suitable treatment plan.
There is a lot of skepticism about TMJ treatment in the medical society and that is simply due to the fact that physicians didn't receive the dental training and didn't acquire the knowledge required for such complicated diagnosis and treatment. Furthermore, many dentists rush into treating TMJ thinking that they can cure these problems, only to find that they lack the skill and experience to get the job done.
We have training and experience in the treatment of these problems with outstanding success rates. With highly advanced equipment and a high level of knowledge, we address your concerns and provide the best diagnosis for the optimal treatment.
Many patients who suffer from TMD symptoms, were never told that it is related to their TMJ problem and were not aware that treating their TMJ could easily relieve their suffering.
Headaches and Migraines
If you suffer from headaches or migraines, TMJ dysfunction could be the major and most likely cause of your suffering. Your doctors, including neurologists, have simply not received the dental training required to relate your migraine or headache pain to your TMJ problems. Once you rule out any brain tumors or aneurysms, TMJ should be checked and TMD should be treated to relieve the headaches and migraines.
Treating TMJ/TMD Caused by Dentures:
Many patients complain that when they received dentures, they noticed pain in the jaw, headaches, ear problems and other symptoms. Sometimes taking the dentures out will relieve those symptoms. If your dentures are not made to the correct bite, or vertical dimension, it will most likely cause these symptoms. Simple adjustments could get rid of these symptoms, but sometimes a whole new set of dentures need to be made according to the neuromuscular principles, to rid you of your headaches or jaw pain.
Orthotics or Bite Splints
An orthotic is an acrylic device that is worn on the lower teeth 24 hours a day. It is designed to reposition the jaw to the correct neuromuscular position.
An orthotic, sometimes called a Bite Splint, is a very effective method in relieving TMD symptoms. It provides an acrylic platform to bite against, sometimes moving the mandible to a new position that is more comfortable.
To help diagnose a TMJ disorder, you want to look for the following symptoms that are generally related to TMD.
- Jaw Pain
- Jaw Clicking
- Limited Mouth Opening
- Jaw Locking
- Face Pain
- Eye Pain
- Ear Pain
- Neck Pain
If you are experiencing any of these symptoms, please call our office at (301) 261-3800 and we'll be happy to discuss possible treatments that are available and would work best for you.
If you suffer from frequent head or facial pain, an incorrect bite may be the cause due to constant cranial muscle strain.
Headaches from dental stress are a type of muscle tension headache. A tension headache may be on one or both sides of your head and feels like a dull, non-throbbing ache that can usually be relieved by aspirin.
When you swallow, your upper and lower jaw muscles must hold your jaw firmly against the skull. Between swallowing over 2,000 times a day and a poorly aligned bite, the jaw muscles can overwork causing muscle strain which in turn leads to a headache.
People who suffer from migraine pain and chronic headaches clench their jaws in a balanced, centered position. This causes extremely intense muscular contraction, but little strain on the jaw.
Nighttime jaw clenching usually goes unnoticed but it sets the stage for migraine pain and chronic headache pain.
Posture and your bite are closely related. One affects the other involving muscles in the neck, back, pelvis, and legs.
Poor posture can place unnecessary wear and tear on your joints and cause your muscles to suffer. Your teeth are what determine how your bite goes together. Your bite then determines the position of your jaw, and in turn, the position of your head on your spine.
The teeth are part of your skeletal system and if/when improperly aligns, there is often a compensating effect on the rest of your body. The human body will adjust itself, involving the muscles in the neck, back, and even those of the pelvis, legs, and feet. Most postural problems can be improved at any age, yet the longer the problem exists, the more difficult it will be to correct.
Symptoms of a poorly postured bite include:
- Numbing or tingling sensation in the hand
- Pain in the jaw, head, neck, shoulders, back
- Difficulty clearing the ears
- One shoulder being higher than the other
- Breast bone muscles feel tender to the touch- Pant legs must be hemmed to different lengths
- Heels wear unevenly
The NTI-TSS System is a type of mouth guard that is placed on the patient's upper teeth. This lets the lower jaw rest in its proper place and causes the teeth to subside from being able to clench together.
If you experience chronic headaches, please ask your doctor because the NTI-TSS System could work for you.
Bite splints (plates) are effective in relieving TMD symptoms.
A bite splint provides an acrylic platform to bite against. Some bite plates move the mandible to a new position.
Generally, splints are worn part-time and for most people night time seems to be the best time to wear them.
The T-Scan is the only system available to measure dental occlusal forces and quantify how well-balanced a patient's occlusion is. It is as simple as having the patient bite down on the ultra-thin sensor while the computer analyzes and displays the data.