What is TMD? (Temporomandibular Disorder)

What is TMD? (Temporomandibular Disorder)

Dec 26, 2016

TMD (Temporomandibular Disease): Causes, Symptoms and Diagnosis

Temporomandibular disorder (TMD) affects millions of people worldwide, causing discomfort and difficulty in everyday activities like eating and speaking.

The temporomandibular joint is a hinge joint that links the jaw to the skull’s temporal bones located in front of each ear.  It facilitates the movement of the jaw up, down, and from one side to the other, thus facilitating talking, yawning, and chewing.

TMD or temporomandibular disease or disorders is the collective term given to problems with the bones and muscles that form this joint and help in its function.

Causes of TMD

Temporomandibular disorder (TMD) encompasses a range of conditions that affect the temporomandibular joint (TMJ), which connects the jawbone to the skull. Several factors can contribute to the development of TMD, and understanding these causes is crucial for effective treatment.  Common causes as follows:

  • Stress
    Stress can lead to jaw clenching or teeth grinding, putting excessive strain on the TMJ.
  • Misaligned Jaws
    Bites that don’t fit together properly can also contribute to TMD. This misalignment puts stress on the TMJ and surrounding muscles, leading to pain and discomfort.
  • Arthritis (Rheumatoid and Osteoarthritis)
    Arthritis can cause inflammation and TMD symptoms. By understanding the causes of TMD, we can better address the root issues and find appropriate treatment options.

Symptoms of TMD

Recognising the symptoms of TMD is crucial for early intervention and effective treatment. While jaw pain is the main symptom, TMD can present in many ways.

Mostly, this disease causes severe pain as well as discomfort. It can affect either side or both sides of the face. Also, it could be momentary or could last for several years. TMD is most prevalent among individuals aged between 20 and 40 years, with most victims being women.

The following are some of the common symptoms:

  • Aching or tenderness in the jaw joint area, face, neck, and shoulders, plus in and around the ear when talking, chewing, or opening the mouth wide
  • Difficulties when trying to open the mouth wide
  • Jaws getting locked or stuck in the open/closed mouth position
  • Problems with chewing or having an abrupt, uneasy bite as if the teeth are not fitting together correctly
  • Clicking, cracking noises in the jaw joint while opening or closing the mouth, or chewing (this may be painful or not painful)
  • Swelling on the side of the face
  • Toothaches, headaches, aching in the neck, upper shoulder pain, earaches, hearing difficulties, dizziness, and tinnitus (ringing in the ears) may also be experienced.

It’s important to note that these symptoms may vary in intensity and frequency, making it essential to consult with a healthcare professional for an accurate diagnosis. By being aware of the common symptoms, individuals can seek appropriate treatment and prevent the condition from worsening.

How TMD Is Diagnosed

There are several other disorders that cause the same symptoms, for example sinus problems, arthritis, tooth decay, or gum disease. The healthcare professional will therefore inquire about a patient’s health history and do a physical exam to find out what is causing the symptoms.

This will include checking the jaw joints for pain or swellings, listening for clicking, popping, or grating sounds that accompany any movement. The orthodontist will also ensure that the jaw works properly, without locking when opening and closing the mouth. The healthcare professional will test the patient’s bite to see if there are any problems with the facial muscles.

Full face X-rays may be taken to view the patient’s jaws, temporomandibular joints, as well as teeth to rule out other problems.

Non-surgical Treatments

Non-surgical treatments for TMD focus on relieving pain and managing symptoms.

  • Pain medication
    Such as nonsteroidal anti-inflammatory drugs (NSAIDs), to reduce inflammation and alleviate discomfort. Muscle relaxants may also be prescribed to help relax the jaw muscles and reduce jaw clenching or teeth grinding. In addition to medication, hot and cold compresses applied to the jaw area can provide temporary relief.
  • Physical therapy
    It aims to improve jaw function and strengthen the muscles surrounding the TMJ. Therapists may employ techniques such as exercises, manual therapy, and ultrasound to alleviate pain and improve jaw mobility.
  • Stress management techniques
    Such as relaxation exercises or counseling, can also be beneficial in reducing TMD symptoms.Non-surgical treatments offer a conservative approach to managing TMD and can be highly effective for many patients.

Orthodontic Treatment

Orthodontic treatment plays a crucial role in the treatment of TMD, particularly when the condition is caused by bite misalignment or dental issues.

Common orthodontic treatment is the use of oral splints or occlusal guards, which are custom-made devices that fit over the teeth to help align the bite and relieve pressure on the TMJ. These splints are typically worn at night to prevent teeth grinding and reduce strain on the jaw joint.

In some cases, orthodontic treatment may be recommended to correct bite misalignments or tooth irregularities that contribute to TMD. This can involve braces, retainers, or other orthodontic appliances to realign the teeth and optimize the bite.

Orthodontic treatments are highly effective in addressing TMD cases related to dental issues and can provide long-term relief for patients.

Alternative Therapies for Relief

Some individuals may find relief from TMD symptoms to be effective through alternative therapies.

Acupuncture, a traditional Chinese medicine practice, involves the insertion of thin needles into specific points on the body to restore balance and relieve pain. This therapy has shown promising results in managing TMD symptoms by reducing muscle tension and promoting relaxation.

Chiropractic care is another option, which focuses on the alignment of the spine and musculoskeletal system. Chiropractors may use techniques such as spinal adjustments or massage to alleviate TMJ pain and improve jaw function.

While alternative therapies may not be suitable for everyone, exploring these options under the guidance of a qualified practitioner may provide additional relief for TMD sufferers.

Lifestyle changes to manage TMD

Making certain lifestyle changes can significantly help manage TMD symptoms.

One important lifestyle change is modifying diet and chewing habits. Avoiding hard or chewy foods that require excessive jaw movement can reduce strain on the TMJ. Opting for softer foods or cutting food into smaller pieces can make eating more comfortable for individuals with TMD. Avoiding habits like gum chewing or nail biting can help prevent unnecessary stress on the jaw joint.

Stress management techniques, such as meditation, deep breathing exercises, or engaging in hobbies, can also help reduce jaw clenching and improve overall well-being.

Maintaining good posture and avoiding activities that require excessive jaw movement, such as wide yawning or singing loudly, can also minimize TMD symptoms.

By adopting these lifestyle changes, individuals can actively participate in managing their TMD and experience improved jaw function.

Surgical options for severe TMD cases

In severe cases of TMD, where conservative treatments have failed to provide relief, surgical intervention may be necessary. Surgical options for TMD aim to address structural abnormalities or correct severe bite misalignments.

Arthroscopy is a minimally invasive surgical procedure that involves the insertion of a small camera into the TMJ to assess and treat any internal joint problems. This technique allows the surgeon to remove inflamed tissue, repair damaged structures, or realign the joint if necessary.

In more complex cases, open-joint surgery may be required to address severe joint damage or structural issues. This procedure involves making an incision near the TMJ to access and repair the joint.

While surgical intervention is reserved for severe cases, it can provide significant relief for individuals who have exhausted non-surgical options.

Maintaining Jaw Health

Prevention is always better than cure, and this holds true for TMD as well. While not all cases of TMD can be prevented, certain measures can help maintain jaw health and reduce the risk of developing TMD.

  • Avoiding excessive jaw movement, such as habitual gum chewing or teeth grinding, can help minimize strain on the TMJ.
  • Maintaining good posture and practicing stress management techniques can also reduce jaw clenching and muscle tension.
  • Wearing a mouthguard at night can protect the teeth from grinding and alleviate pressure on the jaw joint.
  • Regular dental check-ups and addressing any dental issues promptly can prevent bite misalignments that contribute to TMD.
  • Incorporating relaxation exercises into daily routines and adopting a balanced lifestyle can promote overall well-being and jaw health.

By following these preventive measures, individuals can minimize the likelihood of developing TMD and enjoy a pain-free jaw.