Most of the people don’t know what the acronym TMJ stand for?
It stands for Temporo-mandibular joint, which are small joints located just in front of each ear. They connect the lower jawbone to the skull. And in making this connection, various ligaments, muscles, and connective tissues are also involved.
These two joints are used over a thousand times a day and makes it possible for a person to talk, eat, chew, swallow, sing, kiss and make facial expressions. The joint is still working when we are sleeping, as we still swallow saliva in sleep.
These joints allow the jaw to move up and down, side to side and back and forth, allowing us to bite, chew, talk and swallow. This is the second most used joint in human body after the knee joint.
TMJ can be located by placing the index finger on the triangular section in front of your ear. When opening and closing the jaw all the way, move your finger just slightly forward and press firmly. The motion you feel is in the TMJ.
With a normally functioning TMJ, this procedure should not cause any discomfort. If you get bothered by it, it reveals a strong likelihood of TMJ dysfunction. It is then advisable to seek professional advise.
What is a TMJ Disorder?
TMD or Temporo-mandibular Joint Disorder is a term used to describe a group of symptoms such as headaches, facial pain, jaw pain, sore /chipped/broken or worn out teeth, clicking or popping in the jaw and limitation or pain during jaw movements.
The TMJ dysfunction can affect many different parts of the human body. It begins from head with headaches to tingling or numbness in arms and pain in the neck or shoulders or back. The diagnosis and treatment of these need both time and understanding. The intricate nature of bones, teeth, muscles and nerves often complicates the presentation symptoms.
There are many symptoms falling under TMD’s. The common symptoms of TMD are:
- Jaw Pain or discomfort in the jaw and surrounding areas.
- Pain, a catch or difficulty in opening and closing the mouth.
- Clicking or grating sounds in the joint
- Jaw locking while opening or closing
- Ear pain, ringing in the ears but no ear infections.
- Face Pain or swelling
- Neck and shoulder or upper back pain
- Difficulty or pain in eating, talking or yawning
- Bite Problems
- Tooth pain when teeth are healthy
- Difficulty to swallow
- Morning jaw pain
When to seek help?
If TMJ pain starts affecting your way of life – making it difficult to eat, to talk, to yawn or to sleep – then it is time to seek help or advice of professional. An Orofacial Pain Consultant Dentist will be in a position to review and assess the medical history, conduct a thorough exam and make a diagnosis, and recommend treatment.
What are the treatment options?
The majority of TMJ problems respond well to non-invasive treatments. The treatment plan can consist of exercises, physiotherapy, habit correction, posture correction.
As all the cases are not caused by similar conditions the plan can not be generalized. It has to be worked out as per the individual patient. It is important to share the accurate history with your doctor so that specialist can understand and get to the bottom of the reason causing TMD and find an effective treatment.
Some of the common treatments are:
Medications: Some medicines can be used to provide transient relief or control the acute condition. They do not correct anything but help get rid of the symptoms. For eg, many people take pain killers for pain relief and they may help get rid of the symptoms(pain) of the problem (TMD), but the problem will still continue to degrade and over time may well be harder to deal with adequately.
Moist Heat and /or cold packs: The use of gentle heat and cold packs can help relieve pain symptoms, but the cure can be found by working on eliminating the underlying cause altogether.
Soft Diet: Hard, crunchy foods irritate an already painful joint . So, this is again a temporary measure to provide the healing period to the joint.
Relaxation Techniques: Stress and tension are not the root cause of your TMD; however you may be experiencing stress and tension because of it. It is advisable to try some relaxation techniques to ease the tensions and stress. Yoga, meditation, exercise, massage, and guided imagery are all stress-relief techniques to consider.
Side sleeping: Some TMD is caused by what you do when asleep. Try sleeping on your side with pillows between the shoulder and neck for support. If your sleep is getting affected with your bite concerns, make sure to discuss it with your doctor and work on a plan to sleep well.
Jaw exercises: True, thinking of exercises with jaw is not on your mind, but gentle jaw exercises can actually help. Try yawning while holding your chin on your fist. Try small O’s with your mouth, gradually making them larger. Try pulling down on your lower jaw just until it hurts, then holding it for 30 seconds and letting go. Repeat this 3 times. Do this after every meal and then again at night before bed. If doing these exercises is a challenge then you need to see the TMD Dr at the earliest.
Habit correction: Sometimes bad habits are the root cause of TMD. Therefore, some bad habits that can lead to TMD are listed here:
- Clenching your teeth when angry or stressed.
- Working your jaw when angry or stressed.
- Chewing gum.
- Grinding your teeth.
- Holding the phone between shoulder and ear.
- Resting your chin on your hands
- Tilting your head to one side when reading or watching television
- Improper posture when sitting at a desk or computer
- Allowing stress to build up instead of dealing with it and relieving it
- Sleeping on your stomach or back
Jaw Splints or appliances: There are many different types of jaw appliances or splints. The most commonly used appliances at our practice are custom made out of hard acrylic. These can be easily inserted and removed from the mouth and can be fit on the upper or lower teeth. These appliances are designed to improve the function of the jaw joint or TMJ by changing the joint mechanics and increasing potential mobility or movement.
Mouth guards are different, they are not custom made and are soft and flexible and fit over the teeth to protect them and other structures in the mouth from the damage caused by trauma, especially during contact sports.
DR. RUCHIKA SOOD
(FIOFP U.S.A.) MDS (U.S.A.)
TMJ DISORDERS Specialist