Temporomandibular joint dysfunction (TMD or TMJD) is a condition, in which the hinged connection between the upper and lower jaw joint is not functioning properly. This is one of the most complex joints in the body, responsible for the forward, backward and sideways movement of the lower jaw. TMD often feels as though the jaw snaps or clicks or just gets stuck for a while.
Cause
TMD hinders this complex system of muscles, tendons, discs and bones to function as it should. According to current knowledge, there is no single cause for developing and/or maintaining TMD, but there is often a combination of several factors. One could think of:
- Wrong mouth habits (for example clamping and/or teeth grinding).
- Mental stress and personal characteristics.
- Trauma, for example after a blow or punch.
- Shift of the disc in relation to the jaw head (condylar displacement).
- A disturbed muscle activity.
Symptoms
Some of the most common signs and symptoms of TMD are:
- Headache (often similar to migraine), earache and pain or pressure behind the eyes.
- A clicking or snapping sound when opening or closing the mouth.
- Pain when yawning, chewing or opening the mouth wide.
- Jaws which get stuck, block or slip.
- Sensitivity to the jaw muscles.
- A sudden change in the way in which the upper and lower teeth fit together.
Diagnosis
Upon presuming temporomandibular joint dysfunction, the dentist can help in making a proper diagnosis by reviewing the complete medical history of the teeth. Sometimes, additional examination is needed to determine the diagnosis, such as X-rays, CT scan, MRI, taking dental impressions or laboratory examination.
Treatment
The dentist may advise one or more of the following treatments in order to reduce the symptoms of TMD drastically:
- Eliminate muscle spasms and pain by applying moist heat or by taking medication, such as muscle relaxants, anti-inflammatories, aspirin or other painkillers.
- Eliminate the harmful effects of clamping or grinding by wearing a dental guard. The dental guard is custom-made to fit into the mouth and is applied to the upper teeth, so that they cannot touch the lower teeth and thus prevent grinding.
- Learn relaxation techniques to help control muscle tension to the jaws. The dentist may suggest to follow therapy to help reduce stress.
- When the jaw joints are affected and other treatments are not successful, oral surgery may be recommended.
Prognosis
The prognosis of TMD depends on the cause of the problem. In many patients, TMD can be successfully treated with home remedies, such as changing posture or reducing stress. If the condition is caused by a chronic (long-lasting) disease such as arthritis, the prognosis is not so good. Arthritis eventually leads to destruction of the joint and more pain. In these cases, a more aggressive treatment, such as surgery, can be needed.
Considerations
- Never clamp or press the teeth together while in a state of rest.
- When eating, swallowing and speaking, simply place the teeth together.
- Avoid prolonged load on the jaw joint system by habits, such as nail-biting, clamping teeth, chewing gum, sucking or biting lips. Don’t use the teeth as a tool, for example, to hold a pen or nail or to bite threads.
- Avoid extremely wide opening of the mouth while eating, but also when yawning or laughing. Support the lower jaw as possible, so that the mouth can open less wide.
- Avoid incorrect posture of the head and neck at work, during hobby, sleep and telephone calls.
- Avoid draught and cooling of the chewing muscles by using a shawl and/or facial massage.
- Avoid using the front teeth to bite something.
- Don’t take too hard foods, such as chewy meat, nuts, apples, raw carrots, baguette, old cheese, etc. Sometimes it’s better to (temporarily) only eat soft food, such as minced, mashed potatoes, applesauce, bread without crust or food milled with a hand blender.
- It’s important for any dental treatment or when undergoing anesthesia, to inform the dentist or doctor about the symptoms. One shouldn’t open the mouth wide for too long.
