Procedures

Your temporomandibular joint (TMJ) is a jaw-to-skull joint that slides and rotates. Located just in front of your ear, the joint includes the side and base of your skull (temporal bone) and lower jaw (mandible). Strong chewing muscles connect your lower jaw to the skull, allowing you to move your jaw forward, sideways, and open and close your mouth. The joint is aligned properly when your lower jaw and its joint on both sides are synchronized during movement.

A small cartilage disk (called the articular disc) sits in the joint. It moves with the lower jaw, absorbing the terrific pressure of chewing. Like the discs in your spine, the articular disc has no nerves, so it is ideal for absorbing stress. Sometimes this disc moves out of place, which can cause pain of many types.

TMD describes a variety of conditions that affect jaw muscles, temporomandibular joints, and nerves associated with chronic facial pain. Your symptoms may occur on one or both sides of your face, head or jaw, and can develop after an injury. TMD affects more women than men and is the most common non-dental-related chronic orofacial pain. There can be pain on chewing, or constant pain in front of the ear. Headaches are common.

Normal function for these muscles involve chewing, swallowing, speech and communication. Experts suggest that certain mental or physical tasks cause or aggravate TMD, including strenuous physical tasks or stressful situations. Most discomfort is caused from overusing your chewing muscles, specifically through tooth clenching or grinding (bruxism). Chewing hard foods or chewing gum can aggravate TMD.

These excessive habits tire your jaw muscles and lead to headaches, neck pain, or other discomfort. Abnormal jaw function can also lead to worn teeth, muscle soreness, sensitive teeth, jaw discomfort when eating, and temporal (side) headaches.

• An earache with no infection
• Jaw pain or soreness, often greater in the morning or late afternoon
• Jaw pain when you chew, bite or yawn
• Clicking when opening and closing your mouth
• Difficulty opening and closing your mouth
• Locked or stiff jaw when you talk, yawn or eat
• Sensitive teeth when no dental problems can be found
• Headaches, usually in the temple region.

The majority of cases can be treated by 'unloading' (resting) the joint, taking a non-Tylenol pain reliever and practicing stress management and relaxation techniques. It's important to break bad habits to ease the symptoms. Most TMD treatment is simple, can often be done at home, and doesn't need surgery. For example, you can control clenching or grinding during the day by sticking your tongue between your teeth. If you still experience pain, you may be grinding or clenching your teeth at night. So see your dentist about a nighttime mouthguard.

Most people experience relief with minor treatment. More severe cases may be treated with physical therapy, ice and hot packs, posture training and neuromuscular dentistry-please see the PDF file at the beginning of this article. Eating soft foods and avoiding chewing gum also helps relax your jaw muscles.

Some patients require alterations to their bite to reduce pressure points. Therapy can involve splints, orthodontic work, or restorations on the teeth to change the bite.

The condition is often cyclical and may recur during times of stress, good or bad. As the patient, you should become active in your treatment, by understanding the causes of your jaw problems. Visit your dentist for a diagnosis and therapy regime. Make routine dental appointments, so we can check for TMD on a regular basis.