What is TMJ/TMD?

TMD or temporomandibular joint disorder is a group of symptoms including headaches, facial pain, jaw pain, sore, chipped, broken, or worn teeth, clicking or popping in the jaw, and limited jaw movement.

TMJ is temporomandibular joint or jaw joint. These small joints in front of each ear attach the lower jaw to the skull, and are the most complex joints in the body. TMJ is located in an intricate network of bones, including the teeth, muscles, and nerves. Due to this, TMJ conditions affect many areas of the body, from the top of the head in migraine-like headaches to numbness or tingling in the arms and pain in the neck or shoulders.

People suffering from TMD often report chronic pain in the jaw, teeth, face, head, neck, shoulders, or back, or any combination of these areas. Snoring, grinding of teeth, frequent ear infections, and restricted airway are also associated with TMD.

What causes TMD?

TMD stems from a condition called malocclusion, which is the misalignment of your upper and lower teeth, or accidents and trauma. When the teeth are misaligned, they cannot provide the support that the muscles in the face need for chewing and swallowing. This can result in muscle strain, causing pain throughout the face, head, arms, shoulders, and back. Although a person may have had orthodontics to line the teeth up for aesthetic reasons, the muscles and joints may not be comfortable.

Who suffers from TMD?

Although women report more pain from TMJ, in men it causes as much or more damage to the teeth, gums, bones, and joints. Children are especially sensitive to TMJ and early signs include ear infections, leaning their head on an arm, headaches, snoring, grinding their teeth at night, and lip/cheek/finger biting, sucking, or chewing.

How can I get my TMD diagnosed?

Technology has enabled neuromuscular dentists to distinguish their assessment from other health practitioners. To diagnose TMD, Dr. Hanson may recommend using the following tools:

ELECTROMYOGRAPHY:

This tool allows a neuromuscular dentist to monitor the electrical impulses generated by the muscles, associated with movement of the jaw and alignment of the bite. It can help to determine whether the muscles remain stressed at their resting position and the relative stress at different jaw positions. By analyzing this data, they are able to tell if the cause of jaw pain is structural or muscular.

ULTRASONOGRAPHY:

This tool emits sound waves to produce an image. The jaw contains varying densities of materials including bone, soft tissue, and muscle. While ultrasonography may not give a full view of the deepest area of the discs in the jaw joint, it provides other information that can give insight into the inner workings of the entire jaw. The neuromuscular dentist can use this imaging to analyze the structure of the jaw in different positions, allowing them to determine the specific cause of stress leading to pain.

TOMOGRAPHY (CBCT):

Creating an image in sections provides information on the bone structure such as the condyles and their relationship to the mandibular joint in different open and closed positions.

What is the treatment for TMD?

Dr. Hanson first measures the most relaxed position of your jaw to determine the goal for normal jaw positioning. Then the he works to realign the bite and restore the teeth and thus the jaw and joints to their optimal position. Once the bite realigns and the jaw is in place, pain that resulted from the imbalance disappears.

Treatment options in neuromuscular dentistry include adjusting the bite using orthotics, orthodontics, or restoring the teeth to their correct positions. The following are treatment options that may be used to correct TMJ dysfunction.

TENS THERAPY:

In cases where the neuromuscular dentist is able to determine that the alignment of the jaw is causing dysfunction, the next step is to find the natural resting position of the jaw. In order to do this, the dentist may use a TENS (transcutaneous electric nerve stimulation) unit to relax the jaw muscles and to allow it to settle into its natural position.

TMJ ORTHOTICS:

A customized orthotic is a device resembling an athlete’s mouth guard. They are particularly effective for symptoms such as bruxism at night (teeth grinding), sleep apnea, and lockjaw. Many patients report near-immediate relief of symptoms they have had for years upon using an orthotic.

ORTHODONTICS AND RESTORATIVE DENTISTRY:

In other TMD cases, there may be an issue with the teeth alignment. In order to prevent the jaw from moving back to a bad position and causing recurring symptoms, the dentist may recommend orthodontics, or restorative dentistry.  This ensures that the teeth and jaw work together and allow the muscles of mastication to work in the correct position, one that does not result in stress leading to neuromuscular pain.

Posted By:
Dr.Douglas T. Hanson
Dr. Douglas Hanson is a Greater City of Sudbury area Dentist driven by lifelong learning, advanced technologies, and online marketing. In addition to the obvious, Dr.Hanson has lectured and presented to audiences on topics such as; leadership from within, temporal mandibular disorders, implant dentistry, obstructive sleep apnea and most recently on world class customer service. Writing about some of these topics on social media and online has provided a new avenue for Dr.Hanson to share his passion for both dental subject matter, as well as leadership and personal awareness and enhancement. Check out his Twitter and Facebook feeds and allow Dr. Doug to share his passion!