Ten Million Americans, mostly women suffer from Temporomandibular Disorder (TMD). The jaw, unlike other joints in the body, moves up and down, side to side, as well as, forward and backward; enabling chewing, speaking even kissing. When the temporomandibular- joint and surrounding muscle, nerve and tendons, stops being able to move in this manor – pain free, the resulting disorder is TMD or TMJ* pain. TMJ pain is headache, ear ache, toothache; coupled with tinnitus, (ringing in the ear.) TMJ pain is confused with ear pain. Because the brain stem nuclei that supply the jaw muscles and the face are united with those of the neck muscles, the Temporo-Mandibular Joint, the jaw joint, can mimic cervico-genic headache and neck pain. It can also cause severe facial pain and very severe migraine type headaches. In addition popping or clicking may occur when the jaw opens and closes Swelling and inflammation, or a change in the bite of the upper and lower teeth may also be exhibited.
Image showing TMD and Jaw Recovery Site
As varied as the symptoms are, the causes are just as many. The soft disc that cushions the temporal bone at the side of the head and the condyles, (the rounder end of the lower jaw) can become displaced, rip or become deformed. Rheumatoid Arthritis, Psoriasis, and Lyme disease have been associated with TMD/TMJ pain. Possible hormonal issues are often cited as cause, due to the overwhelmingly female patient populous. TMJ pain can also co-exist with other disorders, such as Fibromyalgia, a disorder causing muscle pain and fatigue, also common to women. Trauma or simple stress , too, have been called out as causes. Even poor posture has been explored as the root of the problem. An Air Force study published in 2000 showed a 42% reduction in patient’ symptoms following posture training.
The successful treatment; be it hot/cold therapy, mouth guard, or arthritis drugs such as Vioxx, is elusive. It is suggested that the diagnostic approach not be radical, with surgery as a last resort. 80% of patients recover on their own once they understand the condition and exercise precaution when eating and opening and closing their mouth.
Basic, Conservative Treatments for TMD include the following:
· Cryotherapy: Hot/Cold Treatments, a few times a day, Cold gel pack to the jaw for 10 minutes. Followed by doctor prescribed simple stretching exercises. After the exercises, warm compress is applied for 5 minutes
· A plastic mouth piece, splint, or night guards prevent grinding or clenching of the teeth. This also positions the bite correctly.
· Decrease the amount of chewing. Cut up foods and sort foods limit the amount of chewing required. Avoid hard foods like carrots, hard rolls candy. Omit the Big Bite, involving a wide open mouth.
· Low level laser therapy increases range of motion to the neck and mouth while reducing muscle pain and swelling.
· Nonsteroidal anti-inflammatory drugs, (ibuprofen,) alleviate pain. Your dentist may in addition prescribe antidepressants or muscle relaxants.
*TMJ-The abbreviation for the joint that connects the mandible (lower jaw) to the temporal bone (skull).
