Posts for tag: tmd
Have you noticed a clicking, popping, or grating sound when you open or close your jaw? As many as 36 million U.S. adults experience this phenomenon in one or both of the joints that connect the lower jaw (mandible) to the skull.
While the sounds may be disconcerting, there’s generally no cause for concern in the absence of other symptoms. They’re most likely caused by a harmless shift in the position of the disk inside each temporomandibular (jaw) joint, and it can diminish or disappear entirely over time. But, if you’re also experiencing persistent discomfort, severe pain, or limited function in your jaw (which can include getting it “stuck” in an opened or closed position), then you may be suffering from a temporomandibular joint disorder — part of a complex set of conditions affecting one or both jaw joints, muscles and/or other surrounding tissues. (You may have heard the condition called TMJ, which is actually the abbreviation for the temporomandibular joint itself. Health care professionals prefer TMJD or TMD.)
Depending on the severity, TMD can interfere with your ability to speak, chew and even make facial expressions. The cause is unclear, but genes, gender, environment, stress and behavior are believed to play a role. It can also be symptomatic of a larger medical problem, such as fibromyalgia, which can produce pain all over the body.
Management Options for TMD
TMD traditionally was viewed as a bite problem (malocclusion) requiring mechanical correction — e.g., through orthodontic braces or surgery. But the current therapeutic model approaches TMD as an orthopedic problem (joint inflammation, muscle soreness, strained tendons and ligaments, and disk damage) and favors a sequence of conservative, reversible procedures — hot or cold compresses in the jaw area, soft foods, physical therapy/massage, medication, and/or a bite guard to decrease pressure on jaw joints from tooth clenching and grinding — prior to more aggressive, irreversible treatment alternatives.
If you would like more information about TMD, please contact us or schedule an appointment for a consultation. You can also learn more about the subject by reading the Dear Doctor magazine articles “Seeking Relief from TMD” and “Chronic Jaw Pain and Associated Conditions.”
After ruling out other causes for your jaw pain, your doctor or dentist has made a diagnosis: a temporomandibular joint disorder (TMD). With TMD, your pain symptoms and other dysfunctions are due to a problem associated with the temporomandibular joint (TMJ) that connects your lower jaw (mandible) to your upper skull (cranium).
There are a number of treatment options, but most can be classified as either aggressive or conservative. Aggressive treatments are more interventional and target problems with the teeth such as bite problems or jaw relationships as they relate to the bite, which are thought to be underlying causes for TMD. Such treatments include orthodontics to realign teeth, crown or bridgework, or surgical treatment to the jaw or joint itself. These treatments are controversial and irreversible — with no guarantee of symptom relief.
It’s thought by many to be appropriate, then, to start with more conservative treatments. Many of these are based on treating the TMJ — which is a joint, a moveable bony structure connected by muscles and tendons — with an orthopedic approach, using treatments similar to those used for other joint problems.
Here, then, are some of those conservative therapies that may relieve your TMD pain and other symptoms.
Physical Therapy. Commonly used to treat pain and dysfunction in other joints, physical therapies like manual manipulation, massage, alternating hot and cold packs or exercises can be used to relax, stretch or retrain the muscles that operate the TMJ while reducing pain and inflammation.
Medications. Medications may be incorporated into the treatment plan to relieve pain, reduce inflammation or relax tense muscles. Besides prescription drugs, over-the-counter anti-inflammatory drugs (such as ibuprofen or acetaminophen) are also commonly used.
Bite Appliances. If night-time teeth grinding or clenching habits are a primary cause for the TMD, you may benefit from wearing an occlusal bite guard while you sleep, designed to specifically fit your upper teeth. Because the lower teeth can’t grip the guard’s smooth plastic surface when biting down, they’ll more likely produce less force. This gives the jaw muscles a chance to relax during sleep.
Diet changes. Changing to softer foods, which don’t require strenuous chewing, and eliminating the chewing gum habit will further help reduce stress on the TMJs and also give your muscles a chance to relax and heal.
If you would like more information on TMD and treatment options, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “Seeking Relief from TMD.”
You’ve suddenly noticed a significant amount of pain radiating from your jaw, so severe you can barely bring your teeth together.
First things first: with this level of pain you should see us as soon as possible. There are a number of possible causes, but only a thorough examination will give us the correct diagnosis and answers we need to develop a plan to treat the cause and alleviate the pain.
With that said, here are a few possible causes for that severe jaw pain.
Injured or diseased teeth. Although the pain you feel seems to come from the jaw in general, the true source may be an individual tooth that’s been traumatized or infected. Because of the interconnectivity of nerves throughout the oral structure, the pain could be radiating from the teeth to the jaws. By effectively treating the affected tooth, we may in turn reduce the jaw pain.
Trauma around the joint. If you’ve taken a physical blow to the area around the jaw joint, the resulting swelling in the joint space is keeping the head of the jaw joint (the “condyle”) from seating in the space properly. You may also notice the upper and lower teeth in the back of your jaw won’t touch. As the swelling from the injury subsides (aided by anti-inflammatory drugs that also reduce pain), the joint should eventually return to its normal position.
Jaw fracture. The most common jaw fracture occurs in the area just below the condyle. The pain is usually much more severe than you might experience with indirect trauma. Fractures are normally treated by repositioning the broken bone and immobilizing the area to allow healing.
Joint dislocation. The injury you’ve sustained may have actually moved the condyle out of the joint space. If this is the case careful manipulation may be needed to reseat the condyle back into place, along with anti-inflammatory medication to reduce swelling.
TMJ or TMD. Muscle spasms can cause significant pain with similar symptoms, including limiting jaw movement. Only an examination with x-rays (to determine if it’s a soft tissue or bone-related injury) can narrow down the possibilities to the true cause. The sooner we make that determination and begin treatment the better you’ll feel — and the less likely the injury will result in irreversible damage.
If you would like more information on the causes of jaw pain, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “Jaw Pain — What’s the Cause.”