The Temporomandibular Joint (TMJ)

What Is TMJ Syndrome?

Sixty million Americans have it. It's more common in the elderly, and affects men and women equally. Its exact cause is unknown, but women are nine times more likely than men to seek treatment for this malady.

The lower jaw (mandible) is attached to the skull by a joint on each side of the face, called the temporomandibular joint. We refer to it as the TMJ. Any number of problems associated with the chewing muscles, ligaments, bones or the joints can prevent the TMJ from functioning properly. Hence, the term TMJ Syndrome.

The TMJ In Motion

When you open your mouth very wide (as if to yawn) you can feel the lower jaw move downward and forward within the joint. As you open and close your mouth, the joint should move smoothly without discomfort or clicking sounds. Gentle side-to-side movement should also be possible without discomfort.

The Causes Of TMJ Syndrome

Accidents, including injuries to the jaw, neck, or head, or even diseases such as arthritis may cause TMJ disorders. The two most common causes of TMJ syndrome, however, are oral habits (teeth grinding and clenching) and improper bite.

The Symptoms Of TMJ Disorders

• Tenderness and pain in the jaw muscles
• Some headaches, particularly a "morning headache" that is present upon awakening
• Pain in or around the ear when no infection is present
• Pain when chewing, yawning, or wide opening of the mouth
• Some facial and neck pains
• Jaws that "go out," "get stuck," or "lock"
• Difficulty in opening the mouth wide
• Grating, clicking and popping sounds when opening the mouth
• Trismus, a muscle spasm that prevents the jaw from opening
• Swallowing difficulties
• Tinnitus, a ringing sound in the ears
• Sinus pain or eye pain when no infection is present
• Dizziness

Since many of these are also the symptoms of other medical problems, a prompt and accurate diagnosis is essential.

Diagnosing TMJ Disorders

• A comprehensive medical and dental history
• Palpating (gently feeling) the joint and muscle as they work
• "Listening" to the joint with a stethoscope
• Diagnostic study models of the teeth
• Special x-rays

Your dentist may recommend additional diagnostic tests, including evaluation by your physician. Because the diagnosis and treatment of TMJ disorders is complex, you may be referred to another dental or medical specialist.

1. The first step is to eliminate the muscle spasms and pain. We recommend moist heat packs applied to the face, muscle massage and switching to a soft, non-chewy diet. Sometimes mild muscle relaxant drugs and pain medication are prescribed.
2. Correcting the way the teeth fit together is another technique for treating TMJ syndrome. For example, if your bite is uneven, we can adjust it by selectively smoothing down the teeth that are too high. (This usually involves just one appointment and is painless). A corrective bite plate or splint will also help. Sometimes we refer TMJ patients to an orthodontist, who will prescribe and fit the necessary appliances to correct the bite.
3. Counseling and relaxation therapy also help some patients with TMJ syndrome. These techniques help the patient to become aware of stressful situations; they help patients to control tension throughout various parts of their bodies. Biofeedback involves the use of an electronic monitoring device to help reduce muscle tension in the jaws.
4. Surgery is the final method of treating TMJ syndrome. It may be used where muscle spasms have occurred for long periods of time, or where the joint itself, may have become injured or arthritic. Sometimes the bones and soft tissues of the TMJ may slip out of normal position as a result of an accident or injury, requiring surgical correction.

Many patients have been successfully treated for TMJ syndrome, using the above techniques. The first step is bringing to our attention any signs or symptoms of TMJ irregularities you may have noticed. In many cases we can successfully and conservatively treat the symptoms associated with TMJ disorders.

Paradise Dental