Temporomandibular disorders (TMD) are a common subgroup of orofacial pain disorders often referred to as “TMJ” (Tempromandibular Joint), which is nothing but the name of the joint. TMJ connects the temporal bone (the bone that forms the side of the skull) and the mandible (the lower jaw). TMD can be explained as pain in the jaw joint and surrounding tissues and limitation in jaw movements.
This complex pain can originate in the joint, bone, muscles, nerve, tendons, ligaments, connective tissue or teeth and is usually a dull ache, but may be sharp and occur suddenly. Jaw sounds like clicking sound or grating sensation when opening mouth or eating is one of the most prominent features for TMD.
Symptoms of TMD
Though variety of symptoms may be linked to TMD, some of the more common symptoms include:
- Clicking or grinding noises coming from one or both of jaw joints
- Pain, discomfort or tenderness of the jaw joints and surrounding muscles
- Locking of the jaw when opening the mouth
- Reduced opening of the mouth
- Difficulty to open or close mouth
- Pain on eating and yawning
- Headache or dizziness
- Neck Pain
- Swelling on the face or tired feeling on face
TMD might affect one or both sides of face and patient may also experience toothaches, hearing problems, upper shoulder pain, and ringing in the ears (tinnitus). TMD most commonly affects young adults, but can occur in children and older people. Women may be slightly more likely to suffer from it than men.
Causes of TMD
TMD may be caused by trauma or sometimes the exact cause is not known, while other causes of TMD may include:
- Degenerative processes of the joint
- Altered movement of the disc in the joint complex
- Occlusion, Psychological factors, prescription medication may increase levels of pain
TMD is likely to occur when people are stressed or anxious for example, when studying for exams, moving house, or starting a new job. It may also affect those in jobs, where it is necessary to talk frequently or hold the jaw in an awkward position – for example musicians.
TMD can affect eating and chewing, mood and sleep, it causes significant discomfort and can affect ones quality of life.
One should seek medical intervention, in case of having persistent pain or tenderness in the jaw during rest or movement or difficulty in opening or closing the jaw completely, deviated or restricted jaw movement. A TMD specialist can discuss probable causes and treatments of your problem.
Treatment of TMD
The goals of treatment for Tempomandibular joint Disorder (TMD) are to decrease pain, to improve jaw function, and to limit the impact of TMD on daily life therefore bringing improvement to quality of life of patients. TMD is managed like other joint and muscle problems in the body, possible treatment options for TMD include:
- Trigger Point Injections (TPI) is seen as effective means to provide immediate relief.
- Radio Wave Therapy is used stimulate the joint, which increases blood flow and eases pain.
- Low-level Laser Therapy to lowers pain and inflammation and for better joint movement.
- Splint or Night Guard (complete full arch coverage worn only at night) to manage occlusal forces on the joint.
- Transcutaneous Electrical Nerve Stimulation (TENS) – To provide pain relief by relaxing the jaw joint and facial muscles.
- Medications generally prescribed are traditional pain relievers.
- Psychotherapy is highly effective in people suffering from TMD may benefit from pain management psychology by developing required coping skills to help with the effects of living with chronic pain.
- Avoidance Protocol (Soft diet, not clenching, stretching exercises etc.)
- Surgery is needed in cases of severe, constant pain or loss of function.
- Combination treatment TMD is an interdisciplinary problem which may involve synergistic working between various medical specialists.