What is Temporomandibular Joint Disorder (TMD)?
TMD is classified as a type of headache disorder that is caused by a malfunction of the jaw. It is more common in women, and the average age of onset is 18 to 44 years. There are a number of risk factors associated with the disorder, including depression and other psychiatric illnesses, rheumatoid arthritis, and bruxism (teeth grinding). There are also a number of activities that are thought to contribute to TMJ problems, such as gum chewing, pencil biting, pipe smoking, and performing repetitive jaw motions such as those associated with singing or playing a woodwind instrument.
There is some evidence that poor dental occlusion (alignment of your teeth) can affect the position of the jaw, which can then affect function. However, jaw trauma is also a major source of problems, as the local inflammation that it causes can create degeneration of the joint. This type of injury can occur as a result of whiplash, blunt trauma, or grinding. Scientists are still studying it, but there may be some causation from chronic head and neck posture. And finally, both pain perception and behavioral factors can contribute to TMD. There is an association between TMD and illnesses such as depression, anxiety, and post-traumatic stress disorder. It may also be that the physical response to this type of stress may result in clenching and grinding, which can damage your TMJ. Because the response to pain is a subjective experience, there is some evidence that people with TMD often exhibit a lower tolerance for pain.
What are the Symptoms and How is it Diagnosed?
There are a number of symptoms that are characteristic for TMD – some involving the jaw, and some which are experienced in more remote areas. Not surprisingly, an overwhelming majority of people with TMD experience jaw pain. However, at least three-quarters of all people who see a doctor for this disorder report ear pain, ear fullness or ringing, a headache, and/or altered function of the joint. This is manifested by an inability to open your mouth fully, clicking or popping noises, jaw clenching, teeth grinding, or an uneven jaw closure. Rarely, jaw locking may occur.
All symptoms are generally unilateral, meaning they only occur on one side of the head. Additionally, any symptoms associated with jaw function are usually worse in the morning. Other symptoms that occur less frequently are neck or back pain, facial pain, eye pain, arm pain and dizziness. Diagnosis is often made by your dentist on the basis of your reported symptoms, however, X-rays, CT scans, or MRI scans may be performed to either rule out other causes or confirm that you have TMD.
What Can be Done to Relieve the Symptoms of TMJ Disorders?
The simplest way to manage TMD, and frequently the first suggestions you will get from your dentist, is to try to avoid activities that are contributing to the problem. For instance, if you chew gum you should try switching to lozenges. Other suggestions may be changing sleep position, addressing head and neck posture, and controlling anxiety or depression symptoms through cognitive behavioral therapy. If symptoms persist, medications such as nonsteroidal anti-inflammatory medications (NSAIDS) like ibuprofen, tricyclic antidepressants, and muscle relaxants can be tried to relieve your discomfort. However, there are potential side effects, and long-term studies have not determined that these medications are generally effective. Physical therapy may also have some beneficial effect on jaw function and pain.
However, your dentist may also be able to improve your TMJ function through a number of interventions. First, you may be fitted for a splint or night guard. This is a rigid device to be worn at night to prevent teeth grinding. He or she may also suggest treating you with an injection of cortisone and anesthetic into the joint to decrease inflammation and pain. Additionally, injections of Botox can be used to relax the muscles in the jaw, resulting in less stress, less inflammation, and less pain of the joint.
If you have any more questions about TMJ disorders, or if you are suffering from these symptoms or any other dental problems, please call Hagerman Dental Care at (651) 646-2392, or request an appointment online. We look forward to caring for you, and all of your dental needs.