TMJ (Temporomandibular Joint
Dysfunction)
More than fifteen percent of
American adults suffer from
chronic facial pain. Some common
symptoms include pain in or
around the ear, tenderness of
the jaw, clicking or popping
noises when opening the mouth,
or even headaches and neck
aches.
Two joints and several jaw
muscles make it possible to open
and close the mouth. They work
together when you chew, speak,
and swallow. These structures
include muscles and ligaments,
as well as the jaw bone, the
mandible (lower jaw) with two
joints, the TMJ’s.
The TM joint is one of the most
complex joints in the body.
Located on each side of the
head, these joints work together
and can make many different
movements, including a
combination of rotating and
translocational (gliding)
action, used when chewing and
speaking.
Several muscles help open and
close the mouth. They control
the lower jaw (mandible) as it
moves forward, backward, and
side-to-side. Both TM joints are
involved in these movements.
Each TM joint has a disc between
the ball and socket (see
diagram). The disc cushions the
load while enabling the jaw to
open widely and perform rotating
and translocational movements.
Any problem that prevents this
complex system of muscles,
ligaments, discs and bones from
working together properly may
result in a painful TMJ
disorder.
Diagnosis & Treatment
A dentist can help identify the
source of the pain with a
thorough exam and appropriate
x-rays. Often, it's a sinus,
toothache or an early stage of
periodontal disease. But for
some pain, the cause is not so
easily diagnosed. The pain could
be related to the facial
muscles, the jaw or
temporomandibular joint, located
in the front of the ear.
Treatments for this pain may
include stress reducing
exercises, muscle relaxants, or
wearing a mouth protector to
prevent teeth grinding. They've
been successful for many and
your dentist can recommend which
is best for you.
Several conditions may be
related to TMJ, but they can be
quite varied, and they are often
difficult to pinpoint. TM
disorders can result when the
jaw muscles or jaw joints are
affected.
The joint, ligaments, and
muscles used for chewing and
grinding food may all be
involved. In some cases, it is
not possible to clearly
determine the causes. In some
complex cases, where more than
one doctor is involved, it may
be difficult to get a consensus
on treatment.
Some TM problems result from
arthritis, dislocation, and
injury. All of these conditions
can cause pain and dysfunction.
Muscles that move the joints are
also subject to injury and
disease. Injuries to the jaw,
head or neck, and diseases such
as arthritis, might result in
some TM problems. Other factors
that relate to the way the teeth
fit together—the bite—may cause
some types of TMJ. Stress is
thought to be a factor. TMJ
affects women of childbearing
age more than men, or older men
and women.
There are several ways the TMJ
disorders may be treated. Your
dentist will recommend what type
of treatment is needed for your
particular problem or recommend
that you be referred to a
specialist. Treatment may
involve a series of steps. The
step-by-step plan is in your
best interest because only
minor, relatively non-invasive
treatment may be needed.
Diagnosis is an important step
before treatment. Part of your
clinical examination includes
checking the joints and muscles
for tenderness, clicking,
popping or difficulty moving.
Your complete medical history
may be reviewed, so it is
important to keep your dental
office record up-to-date. Your
dentist may take x-rays and may
make a “cast” of your teeth to
see how your bite fits together.
Your dentist may also request
specialized x-rays for the TM
joints. Depending on your case,
the dentist may refer you to a
physician or another dentist.
