TMJ/TMD and Your Dentist

The temporomandibular joint is the point where the lower jaw connects with the temporal bone in the skull directly in front of the ears. This joint functions like a hinge, allowing movement of the jaw for chewing, talking, and yawning. If pain occurs in the jaw joint, a dentist or physician may diagnose TMD. The acronym TMJ stands for the joint itself and not for the disorder. TMD stands for temporomandibular disorder, and it may be caused by a variety of factors.

Symptoms of TMD

Someone suffering from TMD may experience mild or excessive discomfort on one or both sides of the face. Pain may occur at the jaw joint, in the ears, or in the neck and shoulders. The pain may be more pronounced when opening the mouth to talk or eat, and patients may also experience difficulty opening the mouth normally. The jaw may also become difficult to move, feeling stuck in the closed or open position. Grating and popping sounds in the jaw joint are also common. Some people also experience facial swelling. Other associated symptoms include headaches, toothaches, earaches, dizziness, and ringing in the ears.

Causes of TMD

Temporomandibular disorder can occur if the disk present in the jaw joint wears down or moves out of place. This misalignment can cause the joint to stop moving properly, or it can lead to painful rubbing if the joint is not cushioned adequately by cartilage. Arthritis is one common cause of TMD. The disorder can also be caused by a fall or a blow to the face. Some people also experience TMD without a clear cause for the onset of the disorder.

Treatment Options

A physician or dentist will use nonsurgical treatment options first to help alleviate the pain. Over-the-counter medication can help manage the pain and reduce inflammation. Some patients need stronger medication to control the pain, so a physician might prescribe tricyclic antidepressants and/or muscle relaxants under close supervision. A mouth guard is often prescribed as well, which patients wear over their teeth while they sleep. The mouth guard prevents teeth grinding, and this can be an effective component of TMD treatment. Mouth guards are usually used for a short time because longer use could cause a change in the natural bite pattern of a patient.

Physical therapy can also be beneficial, which can include the application of heat and ice to the jaw. Exercises that stretch and work the jaw muscles may also be helpful, and these stretches are often performed between the application of heat and ice. Corticosteroid injections in the joint may also alleviate pain for some patients. If nonsurgical treatment options do not provide relief of symptoms, surgery may be warranted. Arthroscopic surgery is one surgical option, but some patients may need more extensive open-joint surgery to repair or replace the TMJ.

Home Remedies

Some patients might opt to pursue home treatments to see if these options will be effective for relieving the pain of TMD. Over-the-counter anti-inflammatory medications can be effective for reducing swelling and pain. Applying ice and then moist heat in conjunction with gentle jaw-stretching exercises may also be beneficial. Avoiding foods that are difficult to chew should help reduce irritation, and it's important to avoid excessive jaw movements that might occur with yawning. Many people opt to eat a softer diet when experiencing TMJ pain because this reduces the amount of chewing necessary to eat. Maintaining a slight space between the upper and lower teeth can help reduce pressure on the jaw. Using relaxation techniques can also help reduce overall tension, which can help to keep the jaw looser. If home remedies are not effective, patients should seek treatment from a physician or dentist.

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