Temporomandibular Joint Disorder (TMD)
Temporomandibular joint disorder (TMD) is a common cause of chronic head and facial pain. You may have heard of the term “TMJ.” TMJ actually stands for temporo-mandibular joint, which is the area affected by this condition. The temporomandibular joint connects the lower part of the jaw to the skull.Who Gets TMD?
Anyone can develop this condition, but it tends to be more common in women between the ages of 15 and 45.
What Are the Symptoms?
- Facial pain
- Earaches
- Headaches
- Increased pain with chewing
- Limited jaw movements
- Popping or grinding sensations
- Clicking
- Neck pain
- Locking of the jaw
What Causes TMD?
- Trauma
- Over-opening the jaw
- Excessive gum chewing or nail biting
- Repetitive jaw movements
- Tooth grinding at night
How Is it Diagnosed?
- Physical examination Your doctor will check the motion of the jaw and feel the musculoskeletal structures of the face and head. You will be checked for clicking and popping sounds when you move the jaw.
- X-ray A plain x-ray can evaluate for arthritic changes of the temporomandibular joint.
- MRI An MRI can evaluate the cartilage and disc at the temporomandibular joint.
What Are the Treatments?
- Medication Analgesics, anti-inflammatories and muscle relaxants may be prescribed.
- Rehabilitation Physical therapy may be recommended. Your therapist can apply cold, electrical stimulation and ultrasound and may try gentle stretching and massage. Your therapist will also teach you exercises that you can perform at home to decrease pain and improve the motion of your jaw. You may also be referred to a speech/language pathologist.
- Splints Your dentist may fabricate a special splint (also known as a bite plate) that you can wear in your mouth at night. The splint can alleviate symptoms due to painful clicking.
- Injections An injection into the temporomandibular joint or the soft tissue surrounding it can be helpful for some.
- Surgery Surgery is generally considered a last resort for the treatment of TMJ disorder.
Sources:
Walter R. Frontera, Julie K. SilverEssentials of Physical Medicine and Rehabilitation 2002
Marbach JJ “Temporomandibular pain and dysfunction syndrome. History, physical examination and treatment” Rheum. Dis. Clin. North Am.22(3):477-98