TMJ and TMD explained
The Temporomandibular Joint is the joint connecting the lower part of the jaw with the skull. In actual fact, it comprises two joints, which allow for sliding and rotating actions.
TMJ and TMD are simply shortened terms that refer to Temporomandibular Joint Disorder, which occurs when the temporomandibular joint becomes acutely or chronically inflamed. This can cause considerable discomfort, earaches and a clicking or popping sound in the jaw. It is often the direct result of a bruxism habit. It is estimated that more than 10% of teenagers suffer from TMJ/TMD.
TMJ is the more common term of the two, and is the one that we tend to use on this site when discussing disorders of the temporomandibular joint.
Signs and symptoms of TMJ
Below, we have listed various TMJ symptoms, with brief explanations of each:
Clicking or popping sounds in the jaw joint – Clicking and popping in the jaw joint is a very common sign of wear to the cartilage and bone of the joint. It can be quite mild, and is often an indicator of TMJ.
Deviation or deflection in the jaw upon opening – Two common TMJ symptoms are ‘deviation’ (a slight movement sideways) or ‘deflection’ (a movement sideways and then a return to the normal, central position) of the jaw when the mouth opens.
Jaw becomes difficult to open – Another common indication of TMJ is an inability to open your jaw fully when you yawn or eat.
Muscle pain in the jaw – TMJ sufferers often experience tenderness or pain in the jaw joint and its surrounding muscles. This is particularly noticeable when the area is pressed, palpitated or massaged. Pain can also arise in the area during speaking, clenching or eating.
Ear, neck, facial or shoulder pain – Referred pain in any of these areas can occur as a result of inflamed tissue surrounding the jaw joint.
Troubled sleep, stress, anxiety and depression – Numerous clinical studies indicate that people suffering from TMJ have a greater susceptibility to disturbed sleep, stress, anxiety and depression than the general population.
Malocclusion – Malocclusion is the official term for dental misalignment. TMJ often puts the jaw out of normal alignment (this occurs when it deflects or deviates, as explained above), which creates irregular contact of the upper and lower teeth.
Loose teeth – Malocclusion (as explained above) puts an uneven amount of pressure your teeth, causing some of them to loosen or shift.
Loss of teeth – Uneven pressure applied continually to previously loosened teeth may eventually cause them to collapse or fall out.
Bruxism – Those with severe teeth grinding habits have a strong likelihood of suffering from TMJ as well. Bruxism is known to cause disorders of the jaw.
Of course, any of the symptoms outlined in the previous sections can occur as a result of factors having nothing to do with TMJ. However, if you have begun to suspect that you have TMJ or bruxism, consult a dentist or doctor for confirmation so that you can begin treating it.
To arrive at a confirmed diagnosis, your dentist or doctor may require that you use a bite strip. This is a small, adhesive strip that is worn on the outside of the cheek. It has an electrode that can detect and record instances of muscle tension in your jaw. Your health professional will use this information in their diagnosis.
Another test for TMJ is hair analysis. It is now possible to analyze strands of hair for nutritional imbalances and deficiencies. As you will find outlined in Your Diet, a relationship exists between bruxism and dietary magnesium deficiency. The article also provides examples of magnesium-rich foods you should consume, in order to prevent deficiency.
Common TMJ Causes
Bruxism – Clinical studies suggest that symptoms and signs of TMJ appear increasingly more as your bruxism intensifies. This is because the dental damage brought about by bruxism prevents proper mouth closure, increasing the tension in the jaw. This eventually stops the jaw opening and closing as it should. In addition to this, the strain and fatigue that bruxism places on the muscles of the face can easily exacerbate TMJ. Generally speaking, any kind of excessive clenching is likely to contribute to TMJ symptoms.
Other unnecessary biting, chewing or gnawing actions –Every time you chew your fingernails, gnaw on a pen or even chew gum with too much gusto, you risk over-exerting the muscles of the jaw. Any movement that requires repeated muscular contractions will eventually cause cramping and fatigue. If you are experiencing TMJ symptoms already, tough foods like beef jerky or toffee should definitely be avoided.
Jaw strain – Even shouting for too long at a sports match or eating an overly tall sandwich can exacerbate your symptoms, if you already have TMJ. These kinds of activities require you to open the jaw to its maximum capability, and are not a good idea if the joint is already inflamed.
Injury – Any kind of blow to the jaw (resulting, for example, from a sporting mishap or fall) knocks the lower jaw out of its normal alignment. This can cause deviation and displacement, as previously discussed. If you have a jaw injury, please have it checked by a professional to prevent any long-term consequences from occurring.
Bipolar disorder – A clinical study published in the Turkish Journal of Biological and Medical Research (1991) shows a correlation between TMJ and bipolar disorder.
Complications and risks arising from untreated TMJ
The following undesirable outcomes may arise, if you leave your TMJ unchecked and untreated:
Jaw dysfunction – If your condition limits your ability to open and close your jaw properly, it will impede your ability to chew and speak.
Referred pain in the neck, ears, shoulders and facial muscles – When the TMJ joint becomes inflamed, this also affects the soft tissue surrounding it. Pain very often spreads to the surrounding muscles of the face, and can even extend as far as the ears, shoulder muscles and neck.
Current TMJ Treatment Methods
One extremely effective method of managing and reducing the symptoms of TMJ is known as biofeedback (See also the article on bruxism treatments). This is a method in which small electrodes are attached to the outside of the cheek, in order to monitor tension levels in the jaw. When they sense a high tension level in the masseter muscles, a stimulus (usually a small beep) alerts the subject to the fact that they are clenching inappropriately. Over time, this trains them to relax their muscles, eventually eradicating the habit that caused the disorder in the first place. For more information on the biofeedback headband that is currently available, click here. Visit Website.
Painkillers and anti-inflammatory drugs such as ibuprofen will of course help to manage your symptoms in the short term. It is vital, however, that you still address the underlying cause of your TMJ.
Botox is a protein that, when injected, binds to specific receptors in a muscle and causes hypertrophy. This can be highly effective in treating TMJ. The downside is that it is quite an expensive treatment and needs to be repeated up to four times a year.
Splints or guards can also assist in repositioning or realigning the jaw. They prevent deviation and displacement when opening or closing the mouth.