Temporomandibular Disorders (TMD): A Complete Guide

When visiting the dentist you might have heard of the acronyms TMD and TMJ. But, you still might be wondering what is TMD in dentistry and what is TMJ dental? Put simply, Temporomandibular Disorders (TMD) are a group of conditions that affect the Temporomandibular Joint (TMJ) and the surrounding structures.

According to research, the prevalence of TMDs can vary, with some studies reporting an average prevalence of 31% of adults and 11% of children. What is temporomandibular joint? The TMJ is a synovial joint that connects the lower jaw to the skull. The TMJ allows for up-and-down, side-to-side, and forward-and-backward movements of the jaw which is necessary for chewing, speaking, and making facial expressions. In this article we dive into important details you need to know about TMD vs TMJ.

Understanding the Causes of TMD

There are several potential causes of TMD. A combination of factors may play a role, which can make identifying a specific cause challenging. Common causes of TMD include injury or trauma to the TMJ, genetic predisposition, teeth grinding and clenching, stress and anxiety, medical conditions (i.e. arthritis, neuralgia, lupus), and misaligned bite and teeth. In many cases, the exact cause of TMD is unknown.

Recognizing the Symptoms of TMD

There are several common TMD symptoms to recognize. This includes:

Jaw pain or tenderness: Many people report jaw pain or tenderness with natural daily activities like talking and chewing. The pain may present as an aching or throbbing sensation.
Headaches and facial pain: Migraines or headaches may occur, as the TMJ and surrounding facial muscles may become strained.
Clicking or popping sounds in the jaw: In some cases, clicking or popping sounds of the jaw may indicate that the TMJ is damaged or not functioning properly.
Jaw locking or limited movement: Trouble opening, closing, or moving the mouth can be a sign of TMJ issues. The jaw may even become locked, known as tetanus, in which the jaw muscles have a hard time allowing the mouth to open or close.
Earaches and tooth sensitivity: Since the TMJ is located near the ears and jaws, pain may radiate to the ear canals and teeth.

What complications can arise from TMJ dysfunction?

TMJ dysfunction could cause various complications. Common complications from TMJ dysfunction include teeth grinding or clenching, lock jaw, headaches, earaches, facial pain, tinnitus, dizziness, and difficulty chewing and speaking, and sleep issues.

Diagnosis of TMD

TMDs can be diagnosed by dentists or healthcare providers through a comprehensive evaluation. Diagnosis often involves evaluation of your dental and medical history, a clinical examination, and imaging such as X-rays, MRI, CT scans to evaluate the TMJ and surrounding tissues and muscles. The clinical examination may involve testing how far you can open and close your mouth, palpation of the TMJ and surrounding muscles, and listening for abnormal sounds during jaw movement. Your existing signs and symptoms will also be evaluated and other possible conditions will be discussed.

Treatment Options for TMD

There are both non-surgical and surgical treatment options for TMD. Your dental or medical professional will determine the best TMD treatment option based on your dental needs.

Non-Surgical Treatments

Physical Therapy Techniques: Manual therapy techniques and exercises can help improve TMD symptoms such as muscle stiffness and pain. This includes exercises focused on improving jaw movement and strength and is guided by your healthcare professional.
Self-Management and Behavioral Strategies: Methods aimed to reduce stress can improve TMD symptoms. You may be recommended to try mindfulness meditation, practice deep breathing exercises, or massage therapy. Other lifestyle adjustments such as maintaining good posture, getting regular exercise, sleeping for an adequate amount of time, and following a healthy diet can be helpful.
Medications for Pain Relief: Your healthcare provider may recommend and prescribe medications like nonsteroidal anti-inflammatory drugs (NSAIDs), muscle relaxants, or corticosteroids to help reduce inflammation and pain. In TMD cases associated with nerve damage, anti-epileptic medication like Gabapentin may be prescribed to manage pain.
Intraoral Appliances: Intraoral appliances such as night guards may be used to alleviate TMD symptoms and protect the jaws and teeth from harm. Nightguards are designed to cover the surfaces of your teeth to prevent teeth grinding and clenching. Other appliances may be used to stabilize the jaw in a more ideal position and prevent stress on the TMJs.
Complementary Treatments: Complementary treatments like acupuncture and TENS (Transcutaneous Electrical Nerve Stimulation) may help manage TMD symptoms, although greater research is needed to determine their effectiveness in comparison to more standard TMD remedies. Acupuncture involves thin needle stimulation to reduce pain and inflammation in the jaws. TENS therapy delivers electrical impulses to relieve pain from TMDs.

Surgical and Other Medical Procedures

Occlusal Treatments: The goal of most occlusal treatments is to correct the bite to address symptoms like pain and jaw movement issues. This includes occlusal splints/bite guards and adjustments. There is some controversy among dental professionals on the efficacy of occlusal treatments for TMD, as some believe there is not enough research.
Botulinum Toxin Injections: Botulinum Toxin (Botox) injections may be used to induce jaw muscle relaxation. By helping the muscles relax around the jaw, headaches, pain, tension, and other symptoms may be reduced.
Prolotherapy: Prolotherapy may be recommended to treat TMDs. It involves injecting a sugar solution into the TMJ or muscles to promote tissue regeneration and reduce TMD symptoms.
Arthrocentesis: Arthrocentesis involves rinsing the TMJ with a solution to remove debris that cause joint stiffness, pain and inflammation. The procedure typically involves general anesthesia and the use of two needles and a sterile solution that is injected and drained from the TMJ.
Arthroscopy: Arthroscopy may be used to diagnose and treat problems in the TMJ. An arthroscope, or small lighted camera, is inserted into the joint through a minimal incision to inspect and treat the TMJ.
Surgical Interventions: Other surgical procedures like open joint surgery, disc repositioning, or total joint reconstruction may be recommended depending on the severity of the TMD. As with any surgical procedure, complications may occur in some instances including infection, bleeding, and nerve damage.
TMJ Implants: TMJ implants, also referred to as total joint replacement, can be used to treat severe TMD. This treatment is often considered when all other non-surgical and surgical treatments have not worked.

Practical Tips for Managing TMD

There are several practical tips for managing TMD which involve simple lifestyle changes and activities.

Dietary changes: TMDs can be managed by making small adjustments to your diet. Aim to eat soft foods that don’t require intense chewing, and avoid hard or crunchy foods which can strain the TMJ.
Jaw exercises: Your dentist may recommend physical therapy for your jaw to help manage symptoms. You may be shown a variety of stretching and strengthening exercises for the jaw muscles to aid in pain relief and improve jaw function and mobility.
Stress management techniques: Do your best to limit stress, which may negatively impact your TMJs. Practice stress-reducing habits like meditation, yoga, and deep breathing exercises.

How Great Lakes Family Dental Can Help with TMD Care?

What is TMJ dysfunction? Great Lakes Family Dental is here to answer all of your questions about TMJ dysfunction or TMD. Our exceptional team of TMD/TMJ specialists will evaluate your symptoms, diagnose, and create a treatment plan to manage your individual dental needs. Call us to schedule an appointment today.

Conclusion

Temporomandibular Disorders are complex and require the help of dental and healthcare providers to evaluate, diagnose and treat. Both children and adults may be affected by TMD, and there are a number of different possible causes. A healthy TMJ is needed for important daily tasks such as speech and eating. If you believe you may suffer from TMD, contact a dental or medical professional.

Frequently Asked Questions

What are the common signs that I might have TMD?

Common signs of TMD include tooth sensitivity, jaw or facial pain, clicking or popping sounds when moving the mouth, trouble opening or closing the mouth, headaches, earaches, and bite and teeth misalignment. It is important to speak with your dental professional if you notice any of these signs or symptoms for evaluation and treatment.

Are there any foods I should avoid if I have TMD?

To avoid jaw stress and strain, inflammation, and muscle tension, certain foods should be avoided for individuals with TMD. Avoid hard, crunchy, and chewy foods such as candy, nuts, popcorn, raw hard vegetables, and tough meats. Sugary and acidic foods should also be consumed cautiously to help limit inflammation.

How long does it typically take to treat TMD?

Treatment times for TMD can vary from individual to individual. Depending on the severity, underlying causes, overall health and lifestyle habits, and treatment approach, for instance, TMD treatment may take weeks to months or possibly longer.

Can stress cause TMD?

Stress and anxiety have been linked to TMD according to research. Stress may lead to muscle tension, teeth grinding or clenching, joint misalignment, pain, and discomfort.

Is surgery always necessary for TMD?

No, surgery is not always necessary for TMD. Many cases are treated non-surgically, which is often the first life of treatment before opting for surgery. Your dentist will determine the best course of action based on your personal case.

Where can I find a specialist for TMD treatment?

To find a TMD specialist, ask your primary care physician and dentist for recommendations in your area. You can also search online directories through dental organizations such as the American Academy of Orofacial Pain (AAOP), the American Board of Orofacial Pain (ABOP), and American Association of Oral and Maxillofacial Surgeons (AAOMS).