Temporomandibular Joint Disorder
Dr. Kripa Shetty, Smile Care, Bandra 1.
Temporomandibular joint disorder (TMD), or TMJ syndrome, is an umbrella term covering acute or chronic inflammation of the temporomandibular joint, which connects the mandible to the skull. The disorder and resultant dysfunction can result in significant pain and impairment. Because the disorder transcends the boundaries between several health-care disciplines — in particular, dentistry, neurology, physical therapy, and psychology — there are a variety of treatment approaches.
The temporomandibular joint is susceptible to many of the conditions that affect other joints in the body, including ankylosis, arthritis, trauma, dislocations, developmental anomalies, and neoplasia.
Predisposing Factors
- Modification of chewing surfaces of the teeth through dental neglect or accidental trauma
- Speech habits resulting in jaw thrusting
- Excessive gum chewing or nail biting
- Excessive jaw movements associated with exercise
- Repetitive subconscious jaw movements associated with bruxing or clenching
- Size of foods eaten
Signs and Sysmptoms
- Jaw pain and/or stiffness
- Headaches, usually at the temples and side of head Vague tooth soreness or toothache which often move around the mouth
- Sensitive teeth
- Painful or tender jaw joint
- Difficulty opening jaw
- Pain and fatigue when eating hard or chewy foods
- Clicks, pops, or grinding sound in jaw joint
- Ear pain
- Cervical neck tension and pain
- Tooth wear
- Awareness of grinding/clenching teeth while sleeping or awake (Bruxism)
- A pattern of breaking or cracking teeth with no other cause, i.e. tooth decay or trauma
- History of medically diagnosed migraine headaches (common incidence of concurrent TMD
Treatment
The key words to keep in mind about TMD treatment are "conservative" and "reversible." Conservative treatments are as simple as possible and are used most often because most patients do not have severe, degenerative TMD. Conservative treatments do not invade the tissues of the face, jaw or joint. Reversible treatments do not cause permanent, or irreversible, changes in the structure or position of the jaw or teeth.
TMJ Symptom Relief
Many self-help remedies have been suggested to treat TMJ symptoms, but beware that these remedies do not treat the cause. In fact, TMJ treatment through the right dentist may be less costly, less time intensive and can produce a fully satisfactory result.
Although the following self-help remedies do not treat TMJ long-term, temporary relief may be found :
Heat and Cold Packs : Heat and cold packs applied to the side of the face and temple for 10 minute intervals may reduce the intensity of the pain affecting the muscles and surrounding area of the jaw.
Limit Jaw Movement : It is important to avoid large movement of the jaw such as singing and wide yawning. Also, do not apply pressure with your hand against your jaw for an extended time period during sleep. Limit the pressure you apply with a phone receiver.
Diet : Choose soft food and stay away from foods requiring repetitive chewing or the mouth to open wide. In particular, avoid chewing gum, taffy, pretzels and raw carrots.
Dental Treatment : Continue to receive dental treatment for any teeth requiring restoration. Tooth decay may affect the bite, a contributing factor to TMJ.
Physical Therapy, Biofeedback, and Massage : In some cases, physical therapy, biofeedback and massage provide temporary relief from TMJ.
Medications : Some doctors may prescribe non-steroidal anti-inflammatory drugs (NSAIDs like ibuprofen), muscle relaxants, anti-anxiety medications and in some cases anti-depressants. The choice of medication depends on the intensity of the disorder and your medical history. However, the need for medication is greatly reduced when treatment is received by an experienced TMJ dental professional.
Dental Appliances : Your dentist may prescribe a dental appliance such as a mouth guard or splint to reduce the effects of tooth grinding and clenching. Such appliances may also help improve your bite and the ability for the lower jaw to fall properly into the temporomandibular joint socket.
