Temporomandibular and Temporomandibular Joint Disorders
Temporomandibular disorders are defined as chronic pain disorders resulting from damage or dysfunction in the joints and muscles of the jaw. They are most often (mistakenly) referred to as TMJ – discomfort caused by a problem with the temporomandibular joint itself. However, anything that disrupts the intricate function of your jaw’s intricate systems of soft and hard tissue structures can cause TMD. Many people use the terms interchangeably.
TMJ pain disorders usually occur because of unbalanced activity, spasm, or overuse of the jaw muscles. Because muscles and joints work together, a problem with either one can lead to stiffness, headaches, ear pain, bite problems (malocclusion), clicking sounds, or locked jaws.
What is the Temporomandibular Joint?
The temporomandibular joint (TMJ) is the area directly in front of the ear on either side of the head where the upper jaw (maxilla) and lower jaw (mandible) meet. Within the TMJ, there are moving parts that allow the lower jaw to close upwards into the upper jaw. This joint is a sliding “ball and socket” that has a disc sandwiched between it. The temporomandibular joint is what allows your jaw the full range of motion in eating, speaking, yawning, etc.
Causes of TMD/TMJ
Causes of TMD can be elusive, but they are based in damage or disease to the soft and/or hard tissues of the jaw and TMJ. The following are behaviors or conditions can lead to TMJ disorders:
- Arthritis in the TMJ
- Chronic/excessive stress: Stress frequently leads to unreleased nervous energy. It is very common for people under stress to release this nervous energy by, either consciously or unconsciously, grinding and clenching their teeth/jaw.
- Damage or movement of the soft tissue disc in the TMJ
- Dental problems and misalignment of the teeth
- Habitual gum chewing or fingernail biting
- Occupational tasks: Jobs that are strenuous may contribute to TMJ disorders.
- Teeth grinding and teeth clenching (bruxism): This can cause increased the wear on the cartilage lining of the TMJ.
- Trauma to the jaws: Previous fractures in the jaw or facial bones can lead to TMJ disorders.
TMJ Signs & Symptoms
Because it’s often difficult to pinpoint the exact cause of TMD, symptoms of TMJ pain disorders tend to be chronic, so treatment is aimed at eliminating the precipitating factors. However, because of the TMJ’s proximity to the inner ear, many symptoms may not appear related to the TMJ itself. Sometimes the most important symptom is ear pain.
Broadly, medical professionals categorize TMJ symptoms under three categories: myofascial pain (most common), joint derangement (damage to the condyle, jaw misalignment, displaced disc, etc.), and degenerative joint disease (usually caused by rheumatoid arthritis or osteoporosis in the joint).The following are common symptoms:
- Changes in your bite
- Difficulty chewing or opening your mouth wide
- Ear pain and/or tinnitus (chronic ringing in the ear)
- Fullness of the ear: About 33% of patients with a TMJ disorder describe muffled, clogged, or full ears.
- Neck and shoulder pain
- Sounds: Grinding, crunching, clicking, or popping sounds (medically termed “crepitus”) are common for patients with a TMJ disorder.
- Swelling in the face
- Tooth pain
- Joint clicking
How is a TMD Detected & Diagnosed?
Most of the time, your dentist is the one to notice and diagnose temporomandibular joint disorders. If they detect an issue with the temporal bones themselves, they may send you to a maxillofacial specialist. Ways dentists and doctors identify TMJ in a patient are:
- Arthroscopy: This is where your doctor takes a tiny camera set in the end of a flexible probe and looks at the space between the jaws directly to detect any issues.
- Dental X-rays and CT scans: These scans take thousands of images that take a comprehensive, 3D look at all the sinus structures, jaw, and facial bones.
- MRIs: This type of scan allows medical professionals to look at what’s happening with the soft tissues in the jaw. This scan can detect disc movement, deformity or damage, and will show if there’s inflammation that’s causing your jaw to lock.
- Observation: They’ll check your range of motion in jaw movement, and press on different areas of your face and jaw as you open and close your mouth. This can help them identify possible dislocations, painful areas, or a bite misalignment that may contribute to the TMD.
Common Treatments for Temporomandibular Disorders
There are a host of methods your doctor might recommend to help relieve your TMJ symptoms, and/or resolve the underlying cause of the disorder, both surgical and non-surgical:
Non-Invasive Conventional/Standard Medicine Treatments for TMD:
- Counseling/therapy if symptoms are due to chronically clenching the jaw due to anxiety/stress
- Dental work if symptoms are due to misalignment
- Lifestyle changes like avoiding hard foods
- Medications like antidepressants, anti-inflammatories and muscle relaxers
- Mouth guard to wear while sleeping
- Physical therapy
- TENS therapy
- Ultrasounds and RF therapy
Surgical/Invasive Treatments for TMD:
- Arthrocentesis to help fluid and debris drain from the joint
- Arthroscopic surgery to repair the joint and/or disc
- Modification of the condoyle to reposition the bone and take stress off the TMJ
- Open-joint surgery if the problem lies in the jawbone itself
Innovative Treatments at Blatman Health and Wellness Center
- Glucosamine cream (helps body restore cartilage in TMJ)
- Regenerative therapies like stem cell and PRP injections
- Trigger point injection therapy
- Non-inflammatory diet
A Holistic Approach to Solving the Source of your TMJ
At the Blatman Health and Wellness Center, our goal is not only to treat and relieve your TMJ Syndrome symptoms, but also to unlock the source of your pain and work towards eliminating the cause. While often referred to as “alternative therapies,” we create a comprehensive treatment plan tailored to your specific case of TMJ.
Treatments we might recommend include physical therapy, regenerative injections, massage, relaxation techniques, posture correction, glucosamine cream and biofeedback. As well, we have a list of “toxic foods,” to avoid, that can cause buildup of toxins in the body and damage/inflammation of hard and soft tissues. If you’ve been suffering from the pain and discomfort of chronic TMD/TMJ, call our Cincinnati-based health and wellness center to schedule a consultation in Cincinnati or New York City.