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Treatments > Temporomandibular Joint Disorders

TMJ is the short version of Temporomandibular Joint – or jaw joint – and the surrounding muscles. TMD is a group of disorders and can be quite painful. Many times the symptoms of TMD can be mistaken for migraines! TMD symptoms could present as neck and shoulder pain, and a host of other symptoms. In addition, TMJ problems (or TMD) can make it difficult to eat, swallow, and yawn. TMJ problems can be difficult to diagnose, so if you think you have a problem, please give our office a call.

For some people, the disc within the jaw joint slips out of position during sleep, he says. “All of a sudden, they’ll wake up in the morning and they can’t open their mouth more than 10 millimeters and a normal opening is 50 millimeters or so. So imagine you’re trying to eat breakfast and you can’t open your mouth wide enough to get the toast in there. That can be very panicking.”

Signs of Trouble

When symptoms of TMD surface, they might include:
  • Pain in the chewing muscles or jaw joint
  • Pain in the jaw, neck, or face
  • Stiff jaw muscles
  • A jaw that locks or has limited movement
  • Painful clicking, popping, or grating in the jaw joint
  • Changes in the fit between upper and lower teeth
TMD may affect more than 10 million Americans, according to the National Institutes of Health. Women are affected more often than men.

Who Treats TMD?

In fact, patients who experience popping, clicking, or pain in the jaw joint will often call their dentist first.

To check for TMD, a dentist will ask about symptoms, take a medical and dental history, and examine the head, neck, face, teeth, and jaw.

But some people go to their primary care doctor if they have less obvious TMD symptoms, such as headaches, neck pain, ringing in the ear, or a sense of fullness in the ear that makes them suspect an ear infection,

Two Categories of TMD Patients

The large majority of temporomandibular disorders stem from jaw muscle problems that cause pain and tightness. “Luckily, most... are muscle spasm problems,”

In contrast, only a small minority of cases stem from problems within the jaw joint itself, he says. These include a disk that moves out of proper position, strained ligaments, osteoarthritis, and other joint-related conditions, .

“If we’re concerned that there’s an internal problem in the joint itself, the patient may be recommended to have either an MRI or a CAT scan of the joint,”

Nonsurgical Treatments

Fortunately, “the vast majority of [TMD] will not require surgical intervention.”

Instead, most patients can try nonsurgical treatments, which don’t cure TMD, but help to relieve pain and improve function. Experts tell WebMD that it’s crucial to try these methods before resorting to surgery or other treatments that result in permanent changes to the jaw or teeth.

Nonsurgical treatments include:

Stabilization or bite splint: This main treatment for jaw muscle pain and tightness involves using a plastic guard that fits over the upper or lower teeth. “It allows the teeth to slide smoothly against each other, which lets the jaw muscles relax,” . Splinting helps to prevent clenching and grinding of the teeth. Most people wear the splint only at night, but in severe cases, “the patient may be wearing the splint 24 hours a day, except when they’re eating.”

Physical therapy: “Physical therapy involves muscle relaxation and increasing the range of motion in the joint,” . These methods may includebiofeedback, stretching exercises, or ultrasound treatments. Applying warm compresses to the side of the face during exercises may be useful, too.

Yoga, meditation, acupuncture, and stress management can also help ease symptoms, Messina says. “Stress doesn’t cause [TMD], but it certainly makes it worse,”

Drug therapy: These treatments include anti-inflammatory medications to relieve pain and prescription muscle relaxants. “If there are some severely inflamed muscles that have restricted motion because they’re in spasm -- the muscles are excessively contracted or hyperactive -- we can use some muscle relaxants,”

Comparing Nonsurgical and Surgical Treatments

Experts agree that nonsurgical treatments should be tried first -- unless there’s a compelling reason for immediate surgery, such as a tumor in the jaw joint.

Temporomandibular joint surgeries carry risks, “Post-surgically, some pain in the joint tends to be fairly common.” Other surgical complications include nerve damage, bleeding, infection, and scarring of the joint.hence sorted as a last measure.

 
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