TEMPOROMANDIBULAR JOINT (TMJ):
“TMJ” stands for TemporoMandibular
Joint, or the jaw joint. You have two TMJ’s, one in front of each ear, which connects the lower jaw bone (the mandible) to the skull.
The joints allow movement up and down, side to side, and forward and back – all the mobility needed for biting, chewing, swallowing food, speaking, and making facial expressions.
A small cartilage disc between your lower jaw bone and skull acts as a “shock absorber” for the joint.
TEMPOROMANDIBULAR JOINT DISORDERS (TMD):
Researchers generally agree that temporomandibular joint disorders fall into 3 main categories:
- Myofascial Pain – The most common form of TMD, which is pain or discomfort in the muscles that control jaw function and the neck and shoulder muscles.
- Internal Derangement of the Joint – A dislocated jaw, displaced disc, or injury to the condyle.
- Degenerative Joint Disease – Osteoarthritis or rheumatoid arthritis in the jaw joint.
- Affects over 10 million Americans and is most common in people 20 – 40 years of age.
- Second most common cause of facial pain after toothache.
- Women are 4 times as likely to be affected as men, and the majority of those seeking treatment are women in their childbearing years.
TMD SIGNS AND SYMPTOMS:
- Pain, tenderness, or stiffness in the jaw joint and/or muscles.
- Clicking, popping or grating sounds in the jaw joint when opening or closing the mouth.
- Limited movement or locking of the jaw.
- Tooth sensitivity, or vague “toothaches” which often move around the mouth.
- Headaches, especially in the area of the temples.
- Neck, shoulder, or upper back pain.
- Uncomfortable bite or change in the way the teeth fit together.
- Earaches, ringing in the ears, decreased hearing, and/or dizziness.
- Clenching and grinding of the teeth (bruxism) while sleeping or awake.
- Tooth wear and/or a pattern of breaking teeth with no other cause (i.e. decay ortrauma).
Because most TMD problems are temporary, conservative and reversible treatment is typically all that is needed to reduce pain and establish a return to function.
- Eat a diet of soft foods while avoiding hard, tough and chewy foods.
- Avoid biting into foods such as apples or corn on the cob with your front teeth.
- Cut food into small pieces and chew evenly on both sides of your mouth with your back teeth.
- Avoid activities that increase stress on your jaw joint such as gum chewing, ice chewing, yawning, loud singing, nail biting, etc.
- Monitor your jaw position during the day in order to maintain a relaxed and comfortable position. Focus on keeping your lips together, teeth slightly apart, and tongue against the roof of the mouth as if to make a “cluck” like sound.
- Avoid clenching and grinding of the teeth and popping of the jaw joint.
- Avoid protruding the lower jaw while putting on lipstick, shaving your neck, smoking or talking.
- Do not lean your jaw on the palm of your hands while reading or watchingTV.
- Avoid sleeping on your side or stomach due to stress on the jaw and neck.
- Maintain good posture of the head and neck, especially when sitting for long periods of time.
- Over the counter analgesics such as Ibuprofen are useful for both relieving pain andreducing inflammation. Take 400 mg every 4 – 6 hours; do not exceed 1200 mg in 24 hours.
- Prescription medications such as Skelaxin or Flexeril can help relax tense facial muscles andimprove jaw mobility. Take as directed.
Hot / Cold Treatments:
- Moist heat increases blood circulation and relaxes muscles. Microwave a wet washcloth or towelfor~1 min. or until warm and apply 2 – 4 times daily for 10 - 15 min.
- If an acute injury has been experienced, apply a cold compress (such asa bag of ice wrapped in a thick washcloth) for about 10 – 15 min., at least 3 times per day for the first 24 – 48 hours.
Help From Your Dentist:
- A custom made “nightguard” (a.k.a. occlusal guard or bite splint) constructed by your dentist can help prevent clenching and grinding, tooth wear, and pain from fatigued muscles. This thin plastic guard fits on the upper teeth and is specially made to stabilize the TMJ by providing you an “even bite” against your opposing teeth.
- Exercising, listening to music, reading, meditating, and/or other leisure activities can help reduce stress that often contributes to TMD problems.
- Counseling by a psychologist or therapist can be useful for dealing with underlying emotional issues, as well as for learning stress management techniques.
- If conservative treatment is unsuccessful, specialists such as physicians, oral surgeons, orthodontists, physical therapists, or orofacial pain specialists may be needed to optimally treat your condition.