Temporomandibular Disorders (TMDs)
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| David Keith, is an Oral and Maxillofacial Surgeon at the Kenmore office. |
By David Keith, DMD
Temporomandibular Disorders are conditions that effect the jaw joints (Temporomandibular joints or TMJs) and the muscles that move the jaws. These conditions can create pain, stiffness, clicking and cracking sounds in the jaw joint and may be associated with headaches, ear ache, dizziness or ringing in the ears.
The Temporomandibular joints are the two joints located just in front of the ears which connect the mandible (lower jaw) to the temporal bone (base of the skull). The joint is a 'ball and socket joint' with a meniscus or disc between the two bones which allows the mouth to open and close smoothly in chewing, speaking, yawning, etc.
Temporomandibular disorder symptoms
Most commonly people complain of pain in the jaws, ear or side of the head. There may be limitation of jaw motion, locking or sticking of the jaw. Popping, clicking, or cracking of the jaws may also be present. Some patients experience soreness or sensitivity of the teeth.
Causes of Temporomandibular Disorders
There are many potential causes of TMD symptoms. Most commonly people clench, grit, grind or tap their teeth together. These habits can occur at night when people are unaware of the habit. Excessive clenching or grinding is called Bruxism. Sometimes disordered sleep habits are associated with these symptoms. Trauma to the jaw can also damage the delicate joint mechanism. Some people with Rheumatoid or Osteoarthritis also have degenerative changes in their jaw joints.
Home care for TMDs
- Many people develop mild and transient symptoms from to time and these can best be managed with home care
- Rest the jaws-avoid chewing hard foods and have a soft diet for a few days.
- Relax-exercise and take a break from any activities at home or work that may be causing you to clench your teeth or tense your muscles. Try to actively relax your jaw muscles if you find yourself clenching during the day.
- Apply heat to the jaws-use a heating pad, hot water bottle or warm face cloth for 20 minutes three times a day.
- Get a good nights sleep-the muscles of the jaw will not relax if you are not sleeping well.
- If your symptoms persist contact your Dentist or Primary Care Physician for further advice.
Further treatment for TMD
Your Dentist or PCP may decide to refer you to an Oral and Maxillofacial Surgeon who has training in the evaluation and treatment of TMDs. After taking a history and reviewing your Medical history an examination of the jaws and mouth will be done and a Panoramic X ray of the jaws taken. On the basis of this evaluation a diagnosis can be made and an appropriate treatment plan formulated. In some situations a Magnetic resonance image of the jaw joints may be necessary. Further treatment may include:
- A night guard-this is like a retainer that is worn after Orthodontic treatment and is worn at night to rest the jaws and prevent damage to the teeth due to bruxism.
- Medications such as muscle relaxants or prescription anti-inflammatories may be necessary for the acute phase.
- Behavioral Medicine techniques such as Stress management, Relaxation exercises and Biofeedback can all be helpful. Harvard Vanguard Medical Associates has a excellent Personnel Health Improvement Program which has been extremely helpful to our patients with TMDs.
- Physical Therapy can help to relax the muscles, reduce pain and improve range of jaw motion. Improvement in the posture of the upper back, neck and shoulders can also be valuable.
- Surgery is indicated in a small number of patients.