TM Joint Disorders (TMD)

WHAT IS TMJ?

Temporomandibular Joint Disorders (TMD/TMJ) can be difficult to diagnose and treat because the problem often crosses over into several different specialties in medicine and dentistry.  It is estimated that as many as one in every four Americans suffer from one or more symptoms of TMJ disorders.  While the majority of sufferers are women; men, young children and adolescence also suffer with symptoms.  People who suffer from this disorder have typically visited many different health care professionals -- all of whom may have a piece of the puzzle, yet patients continue to have problems with their TM joints. 

The two TM joints, located on each side of your head in front of the ears, are the most used joints in the entire body because they work together for chewing, talking, singing, shouting and swallowing.  Muscles attach both the bones and joints that allow movement.  Each joint has a small disc which allows smooth movement of the jaw when functioning.  When the chewing muscles and jaw joints do not function properly together, TMJ disorder is the result.  Displaced joints can cause mild discomfort to severe pain. 

Here is a list of symptoms to determine if you have a TMJ disorder:

Yes, it is hard to believe symptoms that include eyes, mouth, throat, ears, jaw and neck are associated with TMJ disorders.  It is imperative that you be screened by a dentist trained and experienced in these disorders.  Pain complaints may involve headaches, the chewing muscles, the jaw joints, the jaws or even the teeth. Treatment is usually indicated when you suffer with any of the above listed symptoms. 

CAUSES 

There are many causes like trauma (blow to the head and whiplash), or skeletal malformation, arthritis in the joint or stress, hormonal problems, parafunctional habits, occlusion (deep overbite, over 5 missing back teeth, crossbite, etc.), psychological factors, systemic diseases, medications, lack of restorative sleep, poor posture, sleep apnea, bruxing, etc.  Anything that keeps these muscles, bones and joints from working together harmoniously is called TMJ disorder.  

DIAGNOSTICS

Our goal is to discover what is wrong and why.  The exam includes an evaluation of the jaws, teeth, cervical areas and shoulders along with muscle and nerve function.  Evaluations also include a health history, a comprehensive exam, appropriate x-rays, range of motion testing, sleep habits and diet to help us arrive at an accurate diagnosis.

TREATMENTS 

Our office provides bite guards (splints) for TMJ and sleep, muscle therapy, self-help techniques, education, diet, and counseling on work and sleep posture.  We also coordinate our therapy with physicians, chiropractors, physical and neuromuscular massage therapists as necessary.  Some of the therapies available in our office include:

A custom fitted orthotic -- also know as a splint - is the most suggested form of treatment.  The splint helps eliminate muscle spasm and pain which occur with bite imbalance.  It also stabilizes the TM joints.   

Once the proper jaw position is established, a small number of patients may need orthodontics or reconstruction.  We have knowledge of orthodontics and reconstruction.  We are happy to direct the completion of this jaw position to your orthodontist or dentist.     

TMJ surgery is rarely needed and is mostly used to remove tumors and free fibrosed joints.  In the 3-5% of all cases, surgery may be an option.  Occasionally, discs may need to be surgically reattached.  Usually, this is done with minimal invasive therapy.

Radiographs/MRI’s are to help confirm a diagnosis, not make one.  Clinical exams are usually more revealing than x-rays.  Panographs help rule out pathology.  They are poor for TMJ imaging.  MRI’s are expensive and normally only needed when surgery is being contemplated. Tomograms x-rays can be helpful. 

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