TMJ - All About Temporomandibular Joint Disorder

TM disorder describes a variety of conditions affecting the temporomandibular joint - TMJ (the point where the jaw opens and closes) and nerves related to chronic facial pain. These problems are now more easily diagnosed and treated than in the past. Women are twice as likely to be affected than men.

How Is It Caused?

The exact cause of the disorder is unknown. Some factors are related to an improper bite or malocclusion, injury, arthritis, severe stress, or a combination of factors. Clenching or grinding teeth, a condition called bruxism, may develop from stress or as part of a sleep disorder. This can tire muscles and create painful spasms, causing even more pain. Repeated muscle problems may affect the joints, resulting in tissue damage, muscle tenderness, and more spasms, perpetuating a cycle of pain.

What Are Some of the Symptoms?

• Jaw pain or soreness, more noticeable in the morning or afternoon
• Jaw pain while chewing, biting, or yawning
• Earache without an infection, sometimes spreading into the face
• A clicking or grinding noise while opening and closing your mouth
• Difficulty opening and closing your mouth
• A stiff jaw when eating, talking, or yawning
• Sensitive teeth without any signs of dental problems
• Aching on the side of the head and neck pain
• "Locking" of jaw in an open or closed position

How Can This Condition Be Treated?

Proper diagnosis is critical to make sure you receive treatment for your particular condition. Your dentist will recommend treatment after conducting a thorough health history, clinical exam, taking appropriate X-rays, and perhaps confirming the condition through other diagnostic tests.

Your dentist may prescribe a multiple-phase treatment plan. Only minor corrective treatment may be needed. Treatment may be simple or require more steps for alleviating the condition, depending on the degree of severity. Some of these treatments include:

• Taking a non-aspirin pain reliever or prescription medications such as muscle relaxants, analgesics, or anti-inflammatory drugs
• Eating soft foods
• Avoiding chewing gum
• Applying moist heat or ice
• Physical therapy
• Teaching relaxation techniques to control muscle tension
• Stress management training techniques
• Posture training
• Wearing bite plates to eliminate the harmful effects of clenching or grinding the teeth, and a better positioning of the jaws
• Adjusting the bite, known as "occlusal equilibration" involving removing interferences when the teeth touch
• Replacement of defective restorations that prevent the jaws from meeting properly
• Orthodontics, to put the teeth in proper position
• Surgery

In most cases, the symptoms related to TM disorders can be successfully treated to reduce or eliminate your discomfort. Postponement of treatment usually results in more damage to the joint, muscles, or teeth. Be sure to discuss any questions you may have about TM symptoms and treatment plans with your dentist.

By Brian J. Gray, DDS, MAGD, FICO

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