TMJ / TMD

The temporomandibular joint (TMJ) is the joint that connects the jaw to the temporal bones of the skull. Temporomandibular joint disorder, known more commonly as TMD, occurs when there are problems with the muscles and jaws in the face. The hinge connecting the upper and lower jaw is not working properly. This hinge is one of the most complex joints in the body, responsible for moving the lower jaw forward, backward and side-to-side. Any problem that prevents this complex system of muscles, ligaments, discs and bones from working will feel like your jaw is popping or clicking or even “getting stuck” for a moment.

In most cases, the pain and discomfort associated with TMD is temporary and can be relieved with self-managed care or nonsurgical treatments. Surgery is typically a last resort after conservative measures have failed, but some people with TMD may benefit from surgical treatments.

Causes

The exact cause of a person’s TMD is often difficult to determine. Painful TMJ disorders can occur if:

  • The disk erodes or moves out of its proper alignment
  • The joint’s cartilage is damaged by arthritis
  • The joint is damaged by a blow or other impact
  • If you grind your teeth
  • General wear and tear of the joint
  • A blow to the head or face
  • Stress
  • Genetics
  • Arthritis
  • An uneven bite

Symptoms

There are many sign and symptoms of TMD. It is hard to know for sure if you have a relevant one, as one or all of these symptoms can also be present for other problems.

At the Surbiton Smile Centre, we can help make a proper diagnosis by taking a complete medical and dental history and performing a detailed investigation with the use of associated X-rays.

Signs and symptoms of TMD may include:

  • Pain or tenderness of your jaw
  • Your jaw “gets stuck” locked or goes out of place
  • Headaches (often like migraines), earaches, pain and pressure behind your eyes
  • Pain in one or both of the temporomandibular joints (TMJ)
  • Aching pain in and around your ear
  • Difficulty chewing or pain while chewing
  • Facial pain, ear pain and/or jaw pain
  • Trouble chewing and biting
  • Swelling of your face
  • Tenderness of jaw muscle.
  • Pain brought on by yawning, opening the mouth widely or chewing.
  • Locking of the joint, making it difficult to open or close your mouth
  • A sudden change in your dental occlusion (the way the upper and lower jaw fits together).

TMD can also cause a clicking sound or grating sensation when you open your mouth or chew. But if there is no pain or limitation of movement associated with your jaw clicking, you probably do not need treatment for a TMJ disorder.

The proper diagnosis of TMD

At the Surbiton Smile Centre our dental staff will carry out a proper and thorough   medical and dental examination and may take certain X-rays (panoramic) to evaluate the jaw joint and surrounding structure and also check your occlusion. Our Dentist may check the muscles and tissues of your head and neck to test for inflammation. Certain exercises and movements may be involved, and you may get a referral to an oral maxillofacial surgeon or further evaluation and diagnosis.

While there is no single cure for TMD, there are different treatments that may reduce your symptoms dramatically. Our Dentist may recommend one or more of the following:

  • Try to eliminate muscle spasm and pain by applying moist heat or taking medication, such as muscle relaxants, aspirin, other over-the-counter pain-relievers or anti-inflammatory drugs.
  • Reduce the harmful effects of clenching and grinding by wearing a night guard or splint. Custom-made to fit your mouth, the device slips over the upper teeth and keeps them from grinding against the lower teeth.
  • Learn relaxation techniques to help control muscle tension in the jaw. Our Dentist may suggest you seek training or counselling to help eliminate stress.
  • Transcutaneous electrical nerve stimulator (TENS) uses low-level electrical currents to relax joint and facial muscles and provide relief. Low-level laser therapy will assist in helping the neck to move more freely.
  • A dentist may prescribe non-steroidal anti-inflammatory drugs to relieve pain and swelling.

 

How to ease TMD symptoms yourself

 

TMD Exercise

A: First, stand in front of a mirror

  • Open and close your mouth slowly.
  • Keep your head straight. If you suffer from TMJ dysfunction, your jaw will usually open to one side.
  • Concentrate very hard on opening your mouth straight. This will be difficult at first because the muscles on one side of your mouth or jaw are weak and will not function properly.
  • Keep trying and you will get there. Be patient! After all you are undoing many repetitions of opening it wrongly.
  • Open and close your mouth correctly 10 times, then take a rest.
  • Do10 repetitions of this TMD exercise 3 times a day. This exercise will help the jaw re-learn to open and close correctly. Repetition is the key to the re-training of your jaw.

To ease muscle pain around your jaw due to tight jaw muscles, try this following TMJ exercise:

  • Slowly open your mouth as wide as you can, and then slowly close it.
  • Slowly open your mouth to the right as wide as you can, then slowly closes it.
  • Slowly open your mouth to the left as wide as you can, then slowly close it.
  • Repeat this sequence 5 times, 3 times a day or until you feel a degree of relief from your jaw pain. If at any stage your symptoms increase seek professional help.

B: Other remedial actions

1.Eat soft food

  1. Take paracetamol or ibuprofen

3. Hold an ice pack or heat pack to your jaw, whichever feels better for you

  1. Massage your jaw muscles

5. Try to relax

  1. Do not chew chewing gum
  2. Do not bite food with your front teeth

8.Do not open your mouth too wide

9.Avoid nail biting

  1. Avoid clenching your teeth. Apart from when eating, your teeth should be apart
  2. Do not rest your chin on your hand

When to see a GP

You should seek medical attention if you have persistent:

  • pain or tenderness in your jaw, or
  • if you cannot open or close your jaw completely.
  • Your GP, the dental staff at the Surbiton Smile Centre can discuss possible causes and treatments for your problem.
  • You are unable to eat or drink
  • the pain is affecting your life
  • the pain is affecting your sleep
  • the pain and discomfort keep coming back

Risk factors

Factors that may increase the risk of developing TMJ disorders include:

  • Various types of arthritis, such as rheumatoid arthritis and osteoarthritis
  • Jaw injury
  • Long-term (chronic) grinding or clenching of teeth
  • Certain connective tissue diseases that cause problems that may affect the temporomandibular joint

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