TMJ Disorders

The Prevalence of Temporomandibular Joint (TMJ) Problems

According to  the National Institute of Dental and Craniofacial Research (NIDCR),  temporomandibular joint disorders (TMJ), also referred to as  temporomandibular disorders (TMD), are the most common source of chronic  facial pain and jaw dysfunction. It is estimated that more than 10  million people in the United States are affected by temporomandibular  joint problems.

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What is the Temporomandibular Joint?

There are two  temporomandibular joints that connect the left and right sides of the  lower jaw to the temporal bone. Both joints and their associated  muscles, ligaments and tendons work together to allow for all manner of  oral function as the jaw moves up and down, front to back and from side  to side. Containing a shock-absorbing, soft disc that sits between the  rounded condyles of both sides of the lower jaw and the corresponding  concavities in the skull’s temporal bone, the TMJ makes chewing,  speaking, yawning and all jaw movements possible.

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Since the TMJ  is a joint with both up and down hinge-like movements, as well as side  to side and front to back sliding motions to perform, it is often  considered one of the most complicated joints in the body and one of the  most difficult to treat when problems arise.

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Types and Symptoms of TMJ Disorders

TMJ disorders can fall into one or more of the following three categories:

• Myofascial pain- Refers to pain in the area of the jaw joint due to various causes of increased muscle tension and spasm

• Internal derangement-Involves displacement of the disc, jaw dislocation or trauma to the condyles of the jaw

• Degenerative joint disease - Arthritis

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The risk for developing a TMJ problem is greater in the presence of long-term teeth grinding or bruxism, a jaw injury or various types of arthritis such as rheumatoid arthritis and  osteoarthritis. Furthermore, the manifestations of a TMJ disorder can  vary from person to person with a wide range of symptoms possible,  including earaches, ringing in the ears (tinnitus), headaches, back and  neck pain, vertigo, muscle spasms and joint tenderness as well as jaw  pain, popping or grating sounds with jaw movement, jaw locking and  limited jaw movement. For some people a TMJ disorder can be resolved  within a relatively short period of time, while for others it will  continue to persist despite extensive therapy.

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TMJ Diagnosis and Treatment

When  evaluating for the presence of a TMJ disorder, the dentist will perform a  thorough clinical assessment of joint symptoms and function. Special  radiographic imaging and other diagnostic tests will be ordered as  needed. The treatment of a TMJ disorder may include oral appliances such  as night guards or stabilization splints to alleviate strain on the joints. Other types of therapy may include steroid injections, occlusal adjustments as well as orthodontic or prosthodontic treatment to improve occlusion. In cases of persistent and serious TMJ problems, surgery may be recommended.

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Methods of  self-care can be helpful in alleviating some of the symptoms of a TMJ  disorder. Patients are typically advised to eat soft foods, avoid  extreme jaw movement such as wide yawning and gum chewing, to practice  stress reduction and relaxation techniques and applying ice packs or  moist heat as directed. If recommended, a patient should follow the  dentist or therapist’s instruction for gentle stretching exercises. The  short-term use of over-the-counter, non-steroidal, anti-inflammatory  drugs and pain medications may provide relief. If not the dentist or  physician may prescribe stronger pain or anti-inflammatory drugs, muscle  relaxants or anti-depressants.