Temporomandibular Disorders (TMD)
What is Temporo-Mandibular Joint (TMJ) problem?
The temporomandibular joint (TMJ) disorder refers to a group of conditions that lead to pain and dysfunction of the jaw, the TMJ, and its associated facial muscles. The TMJ connects the jawbone to the base of the skull and you can locate it on either side of the head in front of your ears. It acts as a flexible hinge, enabling you to move it from side to side, as well as to speak, chew, and yawn.
TMD may be associated with jaw-joint or chewing-muscle pain, restricted opening, locking and joint noises. Headache or ear-area symptoms can have other causes and may require medical assessment.
Sudden hearing loss, neurological symptoms, severe headache, trauma, facial swelling or persistent ear symptoms require appropriate medical assessment.
Common complaints if you have a TMJ problem.
- Frequent headache or migraine (particularly in the morning)
- Ear pain, blockage, or partial hearing loss
- Biting or chewing difficulty or discomfort
- Clicking or crunching sounds on opening or closing the mouth
- Orofacial pain just in front of the ear
- Limited jaw movement, locking of the jaw, or muscle spasms
- Impaired function when chewing, speaking, or yawning
- Neck and shoulder pain
Common causes of TMJ Problem
- Trauma/ injury (e.g. a blow to lower face and/ or jaw, biting on very hard food or extremely wide jaw opening)
- Bruxism – prolonged stress to the jaw joint from habitual clenching or grinding of the teeth unconsciously during the day or, more commonly, while sleeping. Stress is a common contributing factor
- Habits e.g. regular gum chewing, eating on one side
- Bite-related factors may be considered during assessment, but TMD is often multifactorial and cannot always be attributed to a single dental cause.
- Degenerative TMJ disease e.g. arthritis or wear and tear, certain neurological conditions
What is the process of TMJ Treatment?
Initial management may include explanation, jaw self-care, review of contributing habits, appropriate pain management and, in selected cases, a removable oral appliance. Irreversible changes to the bite are not routinely undertaken solely for TMD without clear clinical justification.
Referral to an oral and maxillofacial surgeon, oral medicine clinician, pain specialist, physiotherapist, ENT specialist or another healthcare professional may be considered according to the findings.
- Pre-treatment evaluation and Treatment Planning.
- Examination & Diagnosis
- X-ray and U/L Study models
- Medical History Inform your dentist about any heart condition or any serious illness you have or had.
- Drug Allergies Inform your dentist about any drug allergies you may have.
- Diagnosis of the cause/s of TMJ
- Definitive Treatment
- Medication
- Splint/ Nightguard
- Orthodontic Alignment of teeth
- Restorative Treatment
- Referral to TMJ specialist