Understanding TMJ/TMD Disorders

More than 15 percent of American adults suffer from chronic facial pain, such as jaw pain, headaches or earaches.

The source of these aches and pains may be related to one or both of the temporomandibular (TM) joints. Located on each side of the head, these joints work together, with a complex system of muscles, ligaments, discs and bones, to make different movements for chewing and speaking.

What is TMD?

Temporomandibular Disorder (TMD) refers to a variety of conditions that affect TM joints, jaw muscles and facial nerves. TMD may occur when the jaw twists during opening, closing or side-motion movements. People with TMD may experience these symptoms:

• pain in or around the ear
• headaches and neck aches
• tenderness of the jaw or jaw muscles
• jaw pain or soreness that is more prevalent in the morning or late afternoon
• jaw pain when chewing, biting or yawning
• difficulty opening and closing the mouth
• clicking or popping noises when opening the mouth
• sensitive teeth when no other dental problems can be found

TMD affects more than twice as many women (particularly those of childbearing age) as men and is the most common non-dental related chronic facial pain.

What causes TMD?

• Arthritis
• Improper bite (how teeth fit together)
• Jaw dislocation or injury

Stress and TMD

Stress is thought to be a factor in TMD. Even strenuous physical tasks, such as lifting a heavy object or stressful situations, can aggravate TMD by causing overuse of jaw muscles, specifically clenching or grinding teeth (also known as bruxism).

What can I do to treat TMD?

Diagnosis is an important step before treatment. However, because the exact causes and symptoms of TMD are not clear, diagnosing these disorders can be confusing. At present, there is no widely accepted, standard test to correctly identify TMD.

Other dental conditions, such as a toothache or sinus problems, can cause similar symptoms. Scientists are also exploring how behavioral, psychological and physical factors may combine to cause TMD.

In about 90 percent of the cases, says the Delta Dental Plans Association, your description of symptoms, combined with a simple physical examination of face and jaw by your dentist, provides useful information for diagnosing these disorders.

Your dentist may also take x-rays and make a cast of your teeth to see how your bite fits together, or may request specialized x-rays for the TM joints. Your complete medical history may be reviewed, so it is important to keep your dental office record up-to-date.

Your dentist will recommend what type of treatment is needed for your particular problem or refer you to a specialist, such as specially trained facial pain experts. You may also want to check with your physician about TMD-type symptoms.

Your dentist may also recommend one of the following:

Modify the pain. This can mean resting the joint, taking a non-steroidal anti-inflammatory drug, such as aspirin or ibuprofen, or applying moist heat to the painful areas.

Practice relaxation techniques. Biofeedback or relaxation training may help to manage stress. Your dentist may prescribe a nightguard to prevent your teeth from grinding during sleep.

Fix poorly aligned teeth. Your dentist may suggest some adjustment, including orthodontic treatment, to correct teeth alignment.

If you think you have TMD

Keep in mind that for most people, discomfort from TMD will eventually go away whether treated or not. Simple self-care practices, such as exercising to reduce teeth-clenching caused by stress, can be effective in easing TMD symptoms.

If more treatment is needed, it should be conservative and reversible. Avoid, if at all possible, treatments that cause permanent changes in the bite or jaw. If irreversible treatments are recommended, be sure to get a reliable second opinion.

Many practitioners, especially dentists, are familiar with the conservative treatment of TMD.

Pain clinics in hospitals and universities are also a good source of advice and second opinions for these disorders.

Always check your specific dental benefits coverage before undergoing any dental treatment.

Information courtesy of theAcademy of General Dentistryand theAmerican Dental Association.