TMJ Disorders
Temporomandibular joint and muscle
disorders, commonly called “TMJ” or TMD are a group of conditions that cause
pain and dysfunction in the jaw joint and the muscles that control jaw
movement.
For most people, pain in the area of the
jaw joint or muscles does not signal a serious problem. Generally, discomfort
from these conditions is occasional and temporary, often occurring in cycles.
The pain eventually goes away with little or no treatment. Some people,
however, develop significant, longterm symptoms.
What are the signs and symptoms?
- Radiating pain in the face, jaw or neck
- Jaw muscle stiffness
- Limited movement or locking of the jaw
- Painful clicking, popping or grating in the jaw joint when opening or closing the mouth
- A change in the way the upper and lower teeth fit together.
What is the Temporomandibular Joint?
The temporomandibular joint connects the
lower jaw (the mandible) with its condyle, to the bone at the side of the
head—the temporal bone. If you place your fingers just in front of your ears
and open your mouth, you can feel the joints.
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.
To keep this motion smooth, a soft disc
lies between the mandibular condyle and the temporal bone.
This disc absorbs shocks to the jaw joint
from chewing and other movements.
What are TMJ Disorders?
TMJ disorders fall into three main
categories:
- Myofascial pain, the most common temporo- mandibular disorder, involves discomfort or pain in the muscles that control jaw function.
- Internal derangement of the joint involves a displaced disc, dislocated jaw, or injury to the condyle.
- Arthritis refers to a group of degenerative or inflammatory joint disorders that can affect the temporomandibular joint
A person may have one or more of these
conditions at the same time. Some people have other health problems that coexist
with TMJ disorders, such as chronic fatigue syndrome, sleep disturbances or
fibromyalgia, a painful condition that affects muscles and other soft tissues
throughout the body.
How jaw joint and muscle disorders
progress is not clear. Symptoms worsen and ease over time, but what causes
these changes is not known.
Most people have relatively mild forms of
the disorder. Their symptoms improve significantly, or disappear spontaneously,
within weeks or months.
For others, the condition causes longterm,
persistent and debilitating pain. The condition is more common in women than in
men.
Prosthodontic treatment, in order to
stabilize the occlusion as a result of a TMD articular diagnosis such as
localized osteoarthritis or degenerative joint disease (DJD), may be required
once the condition has been successfully stabilized.
The degenerative process creates a smaller
condyle which often alters the jaw posture causing an uneven bite. Thus, it may become necessary to re-establish
a more stable occlusion as a result of changes within the joint.
Trauma to the jaw or temporomandibular joint
plays a role in some TMJ disorders. But for most jaw joint and muscle problems,
scientists and clinicians don’t know the causes.
There is no scientific evidence that
clicking sounds in the jaw joint lead to serious problems. Jaw noises alone,
without pain or limited jaw movement, do not indicate a TMJ disorder and do not
always indicate that treatment is needed.
What causes TMJ Disorders?
The roles of stress and tooth grinding as
major causes of TMJ disorders are also unclear. Many people with these
disorders do not grind their teeth, and many longtime tooth grinders do not
have painful joint symptoms.
Scientists and clinicians note that people
with sore, tender chewing muscles are less likely than others to grind their
teeth because it causes pain.
Stress may play a role in many persons
with jaw joint and muscle disorders that is more likely the result of dealing
with chronic jaw pain or dysfunction than the cause of the condition.
How are TMJ Disorders Treated?
Because more studies are needed on the
safety and effectiveness of most treatments for jaw joint and muscle disorders,
experts recommend using the most conservative and reversible treatments when
possible.
Reversible treatments do not cause
permanent changes in the structure or position of the jaw or teeth. Even when
TMJ disorders have become persistent, most patients still do not need
aggressive types of treatment.
Treatment by a Prosthodontist may be
needed for other reasons such as to restore severely worn, damaged, or diseased
teeth or to replace teeth for the purpose of improving chewing, providing
enhanced support for your lips or cheeks, or improving the appearance of your
smile.
Extensive prosthodontic treatment should
only be provided after the TMJ disorder has been adequately diagnosed
and its pain successfully managed.
Conservative Treatments
Most jaw joint and muscle problems are
temporary and do not get worse. Treatment is based on a proper diagnosis which
should be conservative and reversible.
Self-Care Practices
Pain Medications
Stabilization Splints
Prosthodontic Treatment
Self-Care Practices
Your Prosthodontist may recommend steps that you can take that may be
helpful in easing symptoms, such as:
- eating soft foods,
- applying ice packs to recommended areas,
- avoiding extreme jaw movements (such as wide yawning, loud singing, and gum chewing),
- learning techniques for reducing stress,
- practicing gentle jaw stretching and relaxing exercises that may help increase jaw movement.
Pain Medications
For many people with TMJ disorders, short-term
use of over-the-counter pain medicines or nonsteroidal anti-inflammatory
drugs (NSAIDS), such as ibuprofen, may provide temporary relief from jaw
discomfort.
When necessary, your dentist or doctor can
prescribe stronger pain or antiinflammatory medications, muscle relaxants, or
antidepressants to help ease symptoms.
Stabilization Splints
Your Prosthodontist may recommend an oral
appliance, also called a stabilization splint or bite guard, which is a plastic
guard that fits over the upper or lower teeth. Stabilization splints are the
most widely used treatments for TMJ disorders.
If a stabilization splint is recommended,
it should be used only for a short time and should not cause permanent changes
in the way your teeth bite together when the splint is removed from your mouth.
Prosthodontic Treatment
Occlusal splints may also be used to
reestablish the bite prior to prosthodontic treatment.
It is used when the bite is not contacting
evenly due to missing or worn teeth and may relax the muscles.
