TMD is not just one
disorder, but a group of conditions, often painful, that affect the jaw joint or
temporomandibular joint or TMJ and the muscles that control chewing.
Women are twice as
likely to have it than men.
Usually, discomfort from
TMD/TMJ is occasional and temporary, often occurring in cycles,
In most people, discomfort
from TMD/TMJ will eventually go away whether treated or not.
What is TMD?
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
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.
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Temporomandibular disorders fall into
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
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TMD Is Caused
Severe injury to the jaw or temporomandibular
Arthritis in the jaw joint.
Bad bite (malocclusion), this theory is in
Orthodontic treatment (braces) however
studies now show that this is unlikely.
Displaced disc, disc is not in a normal
position, however if there is no pain or problems with jaw movement, no
treatment is needed.
Stress causing clenching or grinding of teeth
at night can tire the jaw muscles and lead to pain.
Jaw clicking, however if there is not other
symptoms like pain or the jaw locking than jaw clicking alone may not need
Avoid, if at all possible,
treatments that cause permanent changes in the bite or jaw.
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Pain in the chewing muscles and/or jaw joint.
Limited movement or locking of the jaw
Radiating pain in the face, neck or shoulders
Painful clicking, popping or grating sounds
in the jaw joint when opening or closing the mouth.
Sudden, major change in the way the upper and
lower teeth fit together.
It is important to keep
in mind, however, that occasional discomfort in the jaw joint or chewing
muscles is quite common and is generally not a cause for concern.
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Locked known as "acute
If your jaw
becomes locked open it mean NTI.
Also do not open your mouth greater then the thickness of
your thumb for at least 4 weeks with some
NSAIDS and Ice
........NO heat. Your dentist may have to manipulate the
mandible back into position if the jaw is locked open from
spray and stretch
packs (10 min on, 10 min off, 10 min on) over the joint
muscle relaxants ****
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NIDCR Launches Study on TMJDs
The National Institute of Dental and
Craniofacial Research (NIDCR), part of the National Institutes
of Health, has launched a 7-year clinical study that could
accelerate research on better pain-controlling treatments for a
jaw condition called temporomandibular joint and muscle
disorders. Called Orofacial Pain: Prospective Evaluation and
Risk Assessment (OPPERA), the $19.1 million project is the
first-ever large, prospective clinical study to identify risk
factors that contribute to developing a TMJ disorder. Scientists
will track 3,200 health volunteers from 3-5 years to see how
many develop the disorder. Then Dr. William Maixner, the study’s
principal investigator and scientist at the University of North
Carolina in Chapel Hill, said that for those who develop TMJ
problems, the study will “open a window on the early stages of
the disorder, pointing at genes and other biologic factors that
might contribute to pain sensitivity.” TMJ disorders occur in
5-15% of Americans.
Routine dental care
more difficult for patients with TMD, they report that their
discomfort creates more difficulty with daily oral health care
as compared with the general dentistry patient population, The
results also indicated that TMD patients felt their discomfort
had created more difficulty performing basic daily oral care,
such as brushing their teeth, because of the presence of pain
and the limited ability to open their mouths. Flossing also
presented problems for the TMD patients. This study confirmed
what clinicians hear frequently from patients who have TMD pain
with or without limited opening: the limitations of this
disorder make it difficult for patients to continue with daily
oral health care at home and make it difficult to continue with
routine professional care.
Journal of Orofacial Pain, Vol. 16, No. 2.The
study, conducted at the Orofacial Pain Center at the University
of Kentucky College of Dentistry
Estrogen replacement therapy
does NOT place women at increased risk for developing TMDs.
JADA, Vol 132, March 2001 pg 319-326.
Academy of Otolarynology.
***trigger point injections of the
lateral pterygoid on the affected side of plain lido or
carbocaine with no vasoconstrictor
More on TMJ
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February 06, 2008
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