Temporomandibular Disorder
Temporomandibular disorder or TMD is one of the most controversial topics in the field of dentistry. This is because dentists and physicians still can not figure out the causes of such disorder and how to prevent it. Moreover, there are also several debates on how it should be treated.
Even if such ailment is surrounded by confusion, TMD is still very common. More than ten million Americans have TMD symptoms at one point in time or another. Majority of these people are between the ages of twenty and forty.
The good news for TMD sufferers is that the symptoms do not lead to serious long term problems anyway. In fact, with or without treatment, people usually get better over time although there are still some people out there that experience sever pain and discomfort that last for several years.
What is the temporomandibular joint and temporomandibular disorder?
TMD is just not one particular problem. It is group of conditions that affect the jaw joint or the temporomandibular joint. The temporomandibular joint is also known as the TMJ. The group of conditions that affect the TMJ are the muscles that control the chewing and the movement of the jaw.
The TMJ is like a ball and a socket. When you open your mouth, the ball or condyle moves out of the joint socket or glenoid fossa. When you close your mouth, the ball slides smoothly back into place. A soft cushion or disk lies between the ball and the socket in order to prevent them from rubbing. This also absorbs shocks from movements like chewing. Holding all of these things together are muscles that stretch from the top of the skull all the way to the lower jaw. Usually, the muscles that help close the jaw are the ones affected in the TMD.
The jaw joint allows you to open and close your mouth. It also allows movement of your jaw from side to side, backward and forward. As a result, you can talk, yawn, chew, and swallow. You can feel these two joints when you place your fingers on each side of your face, right in front of the ears. When you open and close your mouth, you should feel the condyle moving in and out of the socket.
Today, experts agree that TMD falls into three categories
- problems that affect the muscles in the jaw and in the neck
- problems that affect the bones and the cartilage within the joint
- TMD that falls into both categories
What are the symptoms of TMD?
TMD can cause several types of symptoms. In fact, it causes symptoms that are very similar to other diseases and conditions. This is why it can be difficult for doctors to diagnose such disorder. The most common symptom of TMD is pain or discomfort in the jaw joint or in the chewing muscles. Other symptoms may include
- popping, clicking, or grating noises when the jaw opens and closes
- the inability to open the mouth widely
- pain in the face, on the neck, and on the shoulders
- a tired feeling on the face
- a sudden uncomfortable bite as if the upper and lower teeth do not fit together in the right way
- swelling on the sides of the face
- earaches
- toothaches
- headaches
- ringing in the ears
- dizziness
- hearing problems
What are some of the possible causes of TMD?
Experts are not sure about the causes of TMD. However, many of them think that the symptoms are a result of
- injury to the jaw, chin, or TMJ as a result of a car accident, fight, or fall. It is also possible to injure the jaw by opening the mouth too wide like when you bit into a huge sandwich
- grinding or clenching of the teeth which put a lot of pressure on the TMJ
- dislocation of the soft cushion or disk in between the ball and the socket
- arthritis like osteoarthritis or rheumatoid arthritis
- stress which causes a person to tighten the facial jaw and the muscles used to clench one's teeth
Occasionally, dentists are unable to pinpoint the exact cause of a person's TMD.
Making a tough diagnosis on TMD
Since the symptoms of TMD resemble or mimic other conditions and diseases, it is difficult to diagnose. Migraines, headaches, and neuralgia can complicate the diagnosis. To make matters worse, there are no guidelines for dentists to follow. Diagnosing these disorders does not guarantee a definitive answer. If your dentist thinks that you have TMD then they will have to review your medical history including
- your unique symptoms
- when your symptoms began
- whether the symptoms are consistent or if they come and go
- how the symptoms will affect your life
- whether you have other conditions or diseases like arthritis
- whether you take medicine for other conditions or diseases
- whether there have been recent changes in your life that are causing a lot of stress
Your doctor will also do a physical examination that will include
- feeling your joints and your facial muscles
- listening for popping or clicking noises as you open and close your mouth
- examining how far you can open your mouth
- looking at your teeth for signs of grinding or clenching, also known as bruxism
Your dentist will usually get enough information to identify the problem, make a diagnosis, and determine the best form of treatment. Your dentist may also take a panoramic X-ray that will be used to evaluate the bony anatomy of the TMJ. This will allow your dentist to be sure that other problems are not causing these symptoms.
In certain cases, more and more testing is needed. Your dentist may make you go through an MRI or a magnetic resonance imaging. This special test will provide an image of the TMJ disk and its relationship to the ball and the socket joints. This image can also be used to evaluate the health of the bone and the joint. In some other cases, more imaging tests are needed.