The two temporomandibular joints are located in front of the ears and connect the lower jaw (mandible) to the temporal bone of the skull. Temporomandibular joints are complex, moving both up and down and side to side which allows for chewing, yawning and talking. The joint area involves numerous components: muscles, nerves, tendons, ligaments, bones, connective tissue, and teeth. As a joint, the TMJ is subject to other joint aliments like arthritis; but a more complex problem is TMJ Disorder which is commonly called TMJ or TMJ Syndrome.
TMJ Symptoms Mimic Other Health Issues
Many symptoms patients with TMJ suffer are similar or actually mimic symptoms of other health issues. This makes diagnosing TMJ difficult and can be time consuming and frustrating for the TMJ sufferer. Other health issues have to be ruled out before a TMJ diagnosis is considered. TMJ patients may end up seeing a multitude of providers including primary doctors, specialists such as Ear, Nose and Throat Doctors, chiropractors and dentists before a diagnosis of TMJ is made. Some symptoms are periodic; some improve over time while others can worsen. Symptoms of TMJ include:Credit: Source: Microsoft Office
- Pain in the shoulders or neck
- Migraines or chronic headaches
- Stiffness of the jaw muscle
- Limited movement of the jaw or locking of the jaw
- Painful clicking jaw
- Popping, or grinding of the jaw when opening or closing the mouth
- Ear pain such as pressure or ringing in the ears
- Decreased hearing
- Dizziness or vision problems
Animation of how the temporomandibular joint works
Causes and Treatments for TMJ
The causes of TMJ in general remain a mystery. It is known genetic, hormonal, and biological factors can influence the development of TMJ disorder. Also, some behaviors, such as clenching or grinding the teeth or biting nails can cause TMJ. Other possible factors that can contribute to developing TMJ are an injury to the area, infections, previous dental treatments, or auto immune disease. In addition, most TMJ patients report a hypersensitivity to pain.
Credit: Source: Microsoft Offie
Due to the lack of basic or clinical science TMJ is not recognized as a specialty in either the American Dental Association (ADA) or the American Medical Association (AMA). Furthermore, most insurance companies won’t cover treatment for TMJ because there is no standardized method of treatment. Adding to the difficulty of treatment is currently there is no empirical evidence TMJ can be prevented by any treatment method. The good news is there are some methods of treatment that do seem to help diminish TMJ pain.
The National Institute of Health (NIH) suggests the following treatments:
- Self-care practices. These include behavior changes such as eating soft food to reduce the chewing motion; avoiding extreme movements of the jaw such as yawning; avoiding repetitive movement such as chewing gum or eating toffee or caramels; and applying moist heat or cold to the area.
- Avoidance of treatments that cause permanent change to the bite or jaw. This would include having dental work such as crowns, bridges, grinding down of teeth.
- Avoidance of surgery on the teeth or jaw area.
- Replacement of the temporomandibular joint. This should be considered only as a last resort.
The most widely used treatment is the Mandibular Repositioning (MORA) Device. This is fitted Credit: Source: Microsoft Officeto the patient’s “bite” to help realign and relax the muscles in the jaw. Though this option is the most prevalent of treatments (other than self-practices); the scientific validity of the device is unproven. Some patients experience over time some symptoms go away without any treatment while others see temporary improvement with some self-care practices.
A stabilization splint is another method of treatment. This is a nightguard fitted to the patient’s teeth. The nightguard or splint is used as a deterrent to teeth grinding. Over-the-counter bite guards may shift a patient’s teeth and actually increase pain; thus are not recommended as an option of treatment for TMJ.
Some patients take over-the-counter pain or anti-inflammatory medications for temporary relief of TMJ pain. Others require doctors and dentists to prescribe stronger pain or anti-inflammatory medications or muscle relaxants.
The copyright of the article Causes and Treatments for Temporomandibular Joint Disorder (TMJ) is owned by Cheryl Weldon and permission to republish in print or online must be granted by the author in writing.
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