What is TMJ(TMJ/Neuromuscular Disorder)?
You may not have heard of it, but you use it hundreds of times every day. It is the Temporo-Mandibular Joint (TMJ), the joint where the mandible (the lower jaw) joins the temporal bone of the skull, immediately in front of the ear on each side of your head. A small disc of cartilage separates the bones, much like in the knee joint, so that the mandible may slide easily; each time you chew you move it.
But you also move it every time you talk and each time you swallow (every three minutes or so). It is, therefore, one of the most frequently used of all joints of the body and one of the most complex.
You can locate this joint by putting your finger on the triangular structure in front of your ear. Then move your finger just slightly forward and press firmly while you open your jaw all the way and shut it. The motion you feel is the TMJ. You can also feel the joint motion in your ear canal.
These maneuvers can cause considerable discomfort to a patient who is having TMJ trouble, and physicians use this motion with patients for diagnosis.
How does TMJ dysfunction feel?
The pain may be sharp and searing, occurring each time you swallow, yawn, talk, or chew, or it may be dull and constant. It hurts over the joint, immediately in front of the ear, but pain can also radiate elsewhere. It often causes spasms in the adjacent muscles that are attached to the bones of the skull, face, and jaws. Then, pain can be felt at the side of the head (the temple), the cheek, the lower jaw, and the teeth.
A very common focus of pain is in the ear. Many patients come to the ear specialist quite convinced their pain is from an ear infection. When the earache is not associated with a hearing loss and the eardrum looks normal, the doctor will consider the possibility that the pain comes from a TMJ dysfunction.
TMJ can cause a number of other symptoms aside from pain. For example, it can make popping, clicking, or grinding sounds when the jaws are opened widely. The jaw may lock wide open (dislocation) or at the other extreme, TMJ can prevent the jaw from opening fully. Some people may also experience a ringing in their ears from TMJ trouble.
Diagnosis and Treatment
The first step is to identify the source of the pain. We do so with a thorough exam and the taking of appropriate X-Rays. TMJ dysfunction (TMD) is not the only affliction that displays such symptoms and thus we must determine whether or not it truly is TMD causing these symptoms for you. Treatments for TMD pain may include stress reducing exercises, muscle relaxants, or a mouth protector to prevent teeth grinding. These treatments have been successful for many of our patients and we can determine which of these is best for you.
Several conditions may be related to TMD, but they can be quite varied, and they are often difficult to pinpoint. TM disorders can result when the jaw muscles or jaw joints are affected.
The joint, ligaments, and muscles used for chewing and grinding food may all be involved. In some cases, it is not possible to clearly determine the causes. In some complex cases, where more than one doctor is involved, it may be difficult to get a consensus on treatment.
Some TM problems result from arthritis, dislocation, and injury. All of these conditions can cause pain and dysfunction. Muscles that move the joints are also subject to injury and disease. Injuries to the jaw, head or neck, and diseases such as arthritis, might result in some TM problems. Other factors that relate to the way the teeth fit together-the bite-may cause some types of TMD. Stress is thought to be a factor. TMD affects women of childbearing age more than men, or older men and women.
There are several ways the TMJ disorders may be treated. We will recommend what type of treatment is needed for your particular problem. Treatment may involve a series of steps. The step-by-step plan is in your best interest because only minor, relatively non-invasive treatment may be needed.
Diagnosis is an important step before treatment. Part of your clinical examination includes checking the joints and muscles for tenderness, clicking, popping or difficulty moving. Your complete medical history may be reviewed, so it is important to keep your dental office record up-to-date. We may make a "cast" of your teeth to see how your bite fits together.