What is Temporomandibular Joint Disorder (TMD)?
Temporomandibular joint disorder (TMD) refers to a group of related disorders that are a result from problems with the jaw or jaw joint, or the facial muscles involved in jaw movement. The temporomandibular joint (TMJ) is the small joint located in front of the ear where the skull and lower jaw meet. This joint enables the jaw to move and function normally, and is one of the most frequently used joints in our body.
Everyday activity such as talking, yawning, chewing and swallowing all involve the TMJ. For the TMJ to function properly, the muscles, ligaments and bones involved in its movement must be working properly; any conditions that prevent them from doing so may cause TMD.
What is the Temporomandibular Joint (TMJ)?
Temporomandibular Joint, or TMJ, refers to the joints in the jaw responsible for comfortable movement and strength. Typically, when people use the term TMJ, they are referring to TMD – Temporomandibular Joint Disorder.
This is a relatively common jaw problem that involves painful jaw movement, or in extreme cases, barely being able to move the jaw at all. It is often associated with other ailments and symptoms (see below) and can greatly impact a person’s daily life.
As a certified neuromuscular dentist, Dr. Barney views the patient’s TMJ as a whole system, including the jaw, neck, and head.
Who Is At Risk for Temporomandibular Joint Disorder?
There are certain risk factors that increase the likelihood that you could develop TMD. This disorder can occur if the small shock-absorbing disk that normally keeps movement of the jaw smooth and unstressed is damaged. This disk can erode or move out of proper alignment. This can occur due to a blow or other impact, or it can be damaged by arthritis.
These are factors that increase your risk of developing TMD:
- Various types of arthritis, specifically rheumatoid arthritis and osteoarthritis
- Jaw injury
- Long-term teeth grinding and jaw clenching
- Connective tissue diseases that may impact the temporomandibular joint
TMJ can include a variety of symptoms, coupled with jaw pain and/or stiffness. The combination symptoms can be:
- Headaches or migraines
- Neck and shoulder pain
- Ringing in the ears
- Finger numbness
- Lower back pain
- Loose teeth (without decay)
- Jaw locking
If you are experiencing these symptoms regularly, it’s a good idea to be examined for TMJ. Dr. Barney will go over your complete medical history with you, and conduct a neuromuscular dental exam to determine whether TMJ is the root cause of your problems. After Dr. Barney completes a full TMJ examination, he will let you know the best course of treatment and how to proceed.
What Causes TMJ/TMD?
Diagnosing TMD can be difficult unless the dentist has experience with neuromuscular dentistry, as West Virginia dentist Dr. Barney does. Because of his continuing education both with neuromuscular dentistry and TMD, Dr. Barney is open to attributing symptoms to the condition. For other dentists, symptoms such as earaches, headaches, and facial pain can be incorrectly attributed to sinus infections, tooth decay, even gum disease.
The actual causes of temporomandibular joint disorder can be related to problems with the bite, but also from subtler issues such as stress and nightly teeth clenching during sleep. Traumatic injury to the jaw joints or related muscles can also lead to TMD. Some causes of TMD are still unknown, although research points to a possible genetic predisposition. Here are some causes of TMD:
- Grinding or clenching the teeth
- Movement of the soft cushion or disc between the ball and socket of the joint
- Arthritis in the joint
- Stress, which can cause a person to tighten facial and jaw muscles or clench the teeth
Can TMD Go Away On It’s Own?
People sometimes believe their temporomandibular joint disorder is simply the result of a phase in life, such as a stressful situation at work. They believe that if the stressors are removed, a person’s jaw pain may resolve itself. This is only the case if stress and stress behaviors such as clenching your teeth are behind your problem, but this is often not the case.
If the jaw is out of alignment, then the condition requires medical treatment. Correction may be as simple as creating a custom night guard to wear while sleeping to stop teeth grinding and clenching, or treatment may be much more involved. Every case is unique. In extreme cases, surgery could be necessary.
Treatment for TMJ can involve many different options, depending on the severity of the case. Dr. Barney will assess your head, neck, teeth, and jaw to diagnose the severity of your case. If your problems are not very severe – light cracking or pain in the jaw every now and then, for example, you will probably be advised to take some lighter approaches. These include:
- Adding some new self-care habits to your dental routine
- Applying heat or cold to the area
- Jaw, neck, and shoulder stretches
- Eating a soft food diet, avoiding hard or crunchy foods
- Wearing a mouth guard at night to stop teeth grinding
- Light painkillers such as ibuprofen that are also anti-inflammatory. If these do not work, higher-strength medications can be prescribed
- Relaxation exercises to help alleviate jaw clenching
Dr. Barney will give you a full examination and let you know the best course of treatment, and how to proceed.
What Is Transcutaneous Electrical Nerve Stimulation (TENS)?
If previous treatments do not work, or if you have a more severe case of TMJ, Dr. Barney will use more involved treatment options. First, your jaw will be measured with a tool named the “Myo-Monitor”, which measures where your jaw should set for a comfortable position. Once this is determined, a treatment named Transcutaneous Electrical Nerve Stimulation (TENS) helps push the jaw into a good position. But what is TENS?
Transcutaneous electrical nerve stimulation (TENS) utilizes electrical pulses delivered through a small wand. These electrical pulses stimulate the nerves, encouraging the muscles to relax and the jaw to fall into alignment. The goal with TENS treatment is to get the muscles to relax and quit fighting against the hard tissues of the jaw and skull. TENS pulses also stimulate the release of endorphins from your brain. These are part of your body’s natural pain relieving chemicals, lessening the symptoms of TMD.
When Is TENS Treatment Needed?
TENS treatment is necessary when TMJ is affecting you everyday. TENS treatment work best when your TMJ is seriously affecting your concentration and mood. It’s also used for more serious conditions related to TMJ such as jaw locking.
What Is Splint Therapy For TMD?
Some people assume night guards/mouth guards and mouth splints are the same thing, but they are not. A mouth splint is constructed from hard dental acrylic based off of a dental impression. The job of the splint is to discourage grinding of your upper and lower teeth. A mouth guard is meant to protect your teeth from grinding, but it doesn’t necessarily work to stop the grinding. With some of these devices, the difference can be a fine line.
Surgical Treatments for TMJ/TMD
Surgery is generally the last resort for treatment of TMD. Dr. Barney does not perform these surgeries, but can refer you to the perfect surgeon. These are possible surgical treatments for TMD:
- Arthrocentesis — This is a minimally invasive procedure that involves the insertion of small needles into the joint so that fluid can be irrigated through the joint to remove debris and the causes of inflammation.
- Modified condylotomy — This surgery is done on the mandible/jawbone, not on the temporomandibular joint itself. This may be valuable if the patient suffers from jaw locking.
- Arthroscopy or open-joint surgery — If more conservative TMD treatments do not seem to be having any success is alleviating your TMD, surgery to repair or replace the joint may be necessary. Just as with any joint repair, there are options between minimally invasive arthroscopic methods or open surgery.
Schedule a Consultation
If you are experiencing signs of TMJ, it is important to seek treatment so that your symptoms do not worsen, and you can find relief as quickly as possible. Call (304) 754-8803 to schedule an appointment with Dr. Barney and get his expert advice on what the next step should be for you.