The words “temporomandibular joint,” “jaw joint,” and “TMJ” all mean the same thing. You can feel this joint move if you put your finger in front of your ear and open and close your mouth. Temporomandibular disorder (commonly called TMJD, or just TMD) is any disorder affecting this joint. Common symptoms of TMD include:
- headaches on the side of the head
- facial pain
- jaw pain
- ear pain, ringing in the ears, or hearing loss
- jaw clicking or popping
- difficult or painful chewing
- jaw locking in an open or closed position
- dizziness or nausea
The TMJ contains a disc that cushions and lubricates the joint. With healthy jaw movement, the disc stays between the bones no matter what you do with your jaw—eat, talk, swallow, smile, or stick out your chin.
Sometimes, for a variety of reasons, the alignment of the joint can be disrupted: the disc goes out of place, and the bony structures in the joint impinge on the delicate tissues directly in front of the ear. This is known as internal derangement of the joint.
In other cases, a TMJ disorder may originate with the muscles, meaning that joint problems are an effect rather than the cause of the problem. The jaw muscles extending into the cheeks and over the side of the head respond and tighten up to protect the joint. This muscle tension produces symptoms such as headaches on one or both sides of the head, pain from the cheekbone down to the jaw, and eye pain. Some sufferers even report that their hair hurts.
Putting up with these disorders puts you at risk of progressive arthritic changes inside the jaw joints. Early treatment is highly recommended to avoid long-term damage.
What causes TMD?
TMD has many potential causes, including: motor vehicle accidents, especially those involving a neck injury; childhood or sports injuries to the jaw; occupational injuries that involve a blow to the jaw; chronic clenching or grinding of the teeth; or a bad bite. Sleep apnea is a significantly related cause, as people who do not breathe well at night tend to clench and grind their teeth, straining the TMJ.
How is TMD treated?
Because TMJ disorders are progressive, early treatment is important to prevent bigger problems later on. Effective treatment starts with an accurate diagnosis. When you visit our office for the first time, we perform a comprehensive examination of the head and neck, including range of motion, muscle sensitivity, facial symmetry, jaw function, and posture, and perform a neurological screening. We also consider your medical history, including the entire history of your pain problems. Our state-of-the-art cone beam radiographic equipment uses remarkably low and safe levels of X-ray exposure to provide three-dimensional images of the head, neck, and TMJ.
Often, depending on your symptoms, we may need to take an impression of your bite.
Jaw misalignment requires re-alignment of the jaw and TMJ. Most of the time, this is done with unobtrusive appliances that fit entirely inside the mouth, provide a balanced bite, and allow the muscles of the head and neck to return to symmetry. Treatment may include other modalities such as prolotherapy, therapeutic injections including PRF/PRP, low level laser therapy, and ultrasound. Orthodontic treatment may be considered. Home care, including exercises and dietary restrictions, is essential. Physical therapy is often required. As jaw alignment improves, re-evaluation appointments are necessary to adjust these oral appliances to accommodate improvements in TMJ alignment and to continue to provide effective treatment. Other therapies may be provided at the followup appointments.
We work with specialists including chiropractors, physical therapists, neurologists, ear nose and throat specialists, dentists, orthodontists, family physicians, myofunctional therapists, and massage therapists to attain the best possible treatment results.
TMJ surgery is considered a last resort to be used only when all other treatment alternatives have been unsuccessful. The vast majority of TMD cases are treated without surgery.