TMJ is a common term used to describe a group of musculoskeletal disorders. The field of study of these disorders is more appropriately known as Orofacial Pain. The actual meaning of TMJ is “TemporoMandibular Joint”, which is the name of the jaw joint just in front of the ears on each side of the head. This joint connects the lower jaw to the skull. Movements of this joint include opening the mouth, closing the mouth, sliding the lower jaw side-to-side and pushing the lower jaw forward.
The temporomandibular joint is made up of the jaw bone that fits into the socket of the skull and a disc between the top of the jaw bone and the bony socket. The TMJ disc is not composed of bone or cartilage as in a knee disc or a disc between the vertebrae. The TMJ disc is a dense fibrous connective tissue band. Think of it like a thick pad of scar-like tissue. There are a number of problematic conditions that may arise as a result of malfunction within the joint. The disc may become displaced and cause pain, inflammation or difficulty opening and closing the jaw, inflammation may occur inside the joint without the disc being displaced, and nerves within the joint may become inflamed. Orofacial pain disorders may involve the jaw joint or multiple other structures of the head and neck region such as muscles, bones, nerves, ligaments, or blood vessels.
Other general terms used to describe Orofacial Pain conditions are TMD, temporomandibular disorders; TMJD, temporomandibular joint disorders; temporomandibular muscle disorders. The most commonly used term is likely “TMD”.
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IS TMD COMMON?
The exact number or percent of sufferers is not known, but numerous research projects have found that TMD signs and symptoms are very common. We do know that millions of people living in the United States have TMD problems and most have not been diagnosed or treated. One such research project (Lipton, 1993) Surveyed 45,000 US homes and found the incidence of TMD signs and symptoms to be roughly 22% for the previous 6 months. Extrapolated to the population of the United States as a whole, the number of persons for that 6 month period with a sign or symptom of orofacial pain would be about 40 million people. Therefore, signs and symptoms of TMD and orofacial pain are extremely common.
Pain and dysfunction associated with TMD may severely disrupt the lives of those suffering these difficulties, this is very unfortunate as most TMD conditions will improve or resolve with some simple home care measures.
Relief may be as simple as temporarily changing a couple of habits or doing a couple of jaw or facial stretches targeted at the appropriate problem areas. Regrettably, this is not true of all TMD conditions and treatment with a residency trained Orofacial Pain provider will be necessary for some disorders.
Scientific literature commonly cites the incidence of TMD problems to be greater in women. Though this is true according to past research, and there are some significant scientific reasons in support of this statement, this is of little help to individual patients. In a clinical practice orofacial pain providers treat all types of people on a daily basis, male, female, young, old, various races and nationalities. So, even though these conditions may be slightly more common for women there are still millions of men and women suffering needlessly from these disorders. The age of patients also may vary, young children to the elderly and all ages in between.
POSSIBLE SIGNS AND SYMPTOMS OF TMD
- Jaw pain or tenderness
- Facial pain or tenderness
- Pain with jaw movement (opening, biting, chewing, yawning, talking)
- Inability to fully open or close the jaw
- TMJ noises (popping, clicking, crunching, grating)
- Neck pain
- Ear pain, fullness, ringing
POSSIBLE CAUSES OF TMD?
To identify particular causes of orofacial pains is often a difficult or impossible task. In a small percentage of cases the cause is easy to identify when associated with an accident, but providers will not be able to ascertain the specific cause for the majority of jaw, facial, neck and head pains. Typically, the provider is trying to identify factors that interfere with the healing process, and the diagnosis. The fortunate part is that it is not imperative to know the exact cause to determine appropriate treatment.
And, as previously stated, a great number of these conditions can be self-treated once the patient has the appropriate information and treatment tools. There are several different diagnoses possible and it is important that the pain patient have the appropriate information for their particular problem. It is NOT as simple as one-size fits all when it comes to treating the various pain problems.
There are a number of common misconceptions within the medical and dental community with respect to the causes, perpetuating factors, and treatments of TMD and orofacial pain. One of the most popular is that “bad bites”, poor teeth alignment, are the primary causes of these conditions. This was made popular many years ago through an erroneous research project and is still touted by a great number of dentists and physicians today. Another misconception is that orthodontics (braces) cause TMD problems or is a treatment for TMD problems. Modern research has proven that this is NOT the case. The National Institute of Health (NIH) has stated the same and recommends conservative, reversible therapies for the management of TMD conditions. It is mostly inappropriate for dentists to perform occlusal adjustments (grinding of the teeth to make the bite “fit” better) to the overall bite in an attempt to “treat” TMD pains, and these treatments may make the condition and future treatments much more problematic. As well, this treatment is NOT reversible. Once grinding of the teeth has been performed there is no way to restore the lost tooth structure and the patient may now feel the bite to be out of place. This can be very frustrating and permanent.
It is stated very well by the NIH; “Simple self-care practices are often effective in easing symptoms. If treatment is needed, it should be based on a reasonable diagnosis, be conservative and reversible, and customized to your special needs. Avoid treatments that can cause permanent changes in the bite or jaw. If irreversible treatments are recommended, be sure to get a reliable, independent second opinion.”
The goal of the specific information provided by MYTMJ.com is to follow these guidelines in providing simple and conservative self-care recommendations.