What are Temporo-mandibular-disorders?

Fun fact: Did you know that a snake can completely dislocate its TMJ (intentionally) and put it back in place, trying to eat its prey ???

NO. Humans can’t do that.

Temporo-mandibular-disorders or TMD for short are the disease processed directly or indirectly affecting the TMJ. Any pathological process affecting the muscles surrounding the TMJ or attaching to it, which include the facial muscles used for chewing, speaking etc., the bony part of the joint, or the ligaments and discs attached to the joint comprises the TMD.

Some things that can cause or contribute to TMD are:

• An unfavorable bite causing overuse of muscles
• Change in bite, that is unfavorable
• Nocturnal grinding 
• Clenching
• Obstructive sleep Apnea 
• Upper airway resistance syndrome
• A square facial structure
• Female Gender
• Conditions that cause increased flexibility like Ehlers-Danlos Syndrome
• Diseases like Arthritis 
• Certain auto-immune conditions

Symptoms of TMD range from simple pain, to intense pain, sometimes appearing to come from teeth. Dull or stabbing pain around the ear, a snap while opening or closing, a hyper flexible joint, inability to close the mouth back, stiff jaws, inability to open the mouth etc.

As with anything else, early recognition of risk, investigation of cause, and management of contributing diseases or risk factors can prevent progressive pain and loss of function and deterioration of quality of life.

A doctor well trained in recognizing TMD, will include a thorough evaluation and ruling out other causes. Further management depends on if the condition is acute (highly painful) or chronic (going on for a long time), and may include treatment with analgesics (pain killers) and muscle relaxants as well as prescription of bite splints or mandibular advancement devices. Chronic TMD management includes incorporating physical therapy (known as myo-functional therapy) to prevent further deterioration as well as reverse early to moderate conditions by incorporating regular exercises. Extreme management of very severe cases include Botox therapy (results are widely varying in scientific studies) and possible consideration of surgery (again, the results of which are highly variable, unlike a knee surgery). In most cases, early recognition and management including treatment of diseases like Obstructive Sleep Apnea (80% of patients with OSA have some form of TMJ Disorder), prevents further progression and in many cases reverses symptoms to improve the quality of a patient’s day to day life.

Know anyone who might need help for TMJ disorders? Call our office, we are here to help!