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 TMD
What is TMD?
The temporomandibular joint connects the lower jaw, called the mandible, 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 your 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. Muscles attached to and surrounding the jaw joint control its position and movement.
When we open our mouths, the rounded ends of the lower jaw, called condyles, glide along the joint socket of the temporal bone. The condyles slide back to their original position when we close our mouths. To keep this motion smooth, a soft disc lies between the condyle and the temporal bone. This disc absorbs shocks to the TMJ from chewing and other movements.
TMD stands for temporomandibular disorder, and is defined as a disorder affecting the temporomandibular joint (TMJ) which connects the lower jaw (mandible) to the temporal bone in the skull. The motion of this joint can be felt by placing your fingers just in front of your ears and opening your mouth. This motion is controlled by muscles surrounding the joint, allowing you to talk, yawn, and chew. During any of these activities, the rounded ends of the lower jaw bone (condyles) slide along the joint socket of the temporal bone. This motion is kept smooth by a soft disc located between the condyle and the temporal bone that absorbs shocks to the TMJ.
Temporomandibular disorders fall into three main categories:
- Myofascial pain, the most common form of TMD, which is discomfort or pain in the muscles that control jaw function and the neck and shoulder muscles;
- Internal derangement of the joint, meaning a dislocated jaw or displaced disc, or injury to the condyle;
- Degenerative joint disease, such as osteoarthritis or rheumatoid arthritis in the jaw joint. (A person may have one or more of these conditions at the same time.)
When disruptions in this motion of the TMJ occur, they are categorized in one of three ways:
- Myofascial pain. This is the result of strain on the muscles controlling the jaw, neck, and shoulders. Symptoms are discomfort or pain in the joint and muscles. This is the most common type of TMD
- Internal derangement of the joint. This type of TMD occurs when the jaw is dislocated or the disc between the condyle and the temporal bone is displaced or injured.
- Degenerative joind diseas. This occurs when the patient has osteoarthritis or rheumatoid arthritis in the TMJ.
Symptoms of TMD:
- Isolated pain in muscles of the jaw or in the jaw joint.
- Limited mobility of the jaw or locking of the TMJ
- Dull, aching pain throughout the jaw, neck, or shoulder muscles
- Clicking, popping, or grinding sounds as a result of normal jaw motion
- Abrupt, substantial difference in the way the upper and lower teeth fit together.
Diagnosis:
Due to the wide range of symptoms and causes of TMD, there is currently no standard test to correctly identify TMD. In most cases, however, the patient's description of symptoms and a physical examination by a dentist can provide enough information for an accurate diagnosis.
Treatment:
- Your dentist may suggest an oral splint or biteplate, which is a plastic guard that fits over the upper or lower teeth that helps reduce clenching or grinding. The purpose of the splint is to reduce muscle tension and alleviate pain.
- Surgical treatments are available to treat TMD if all other nonsurgical options have been exhausted. Surgical replacement of jaw joints with artificial implants have been used to treat extreme forms of TMD in the past, but are not recommended as a common solution for this disorder.
- Self care techniques, in addition to an oral splint or biteplate, are usually enough to relieve the pain of TMD. Ask your dentist about the treatment methods they offer and which one may be right for you.
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