Temporomandibular Joint Disorder (TMJD)

Temporomandibular joint disorder includes the human jaw joint, the temporal bone extending from the skull to the ears and the jaw muscles. It is the most complex joint in human body. The lower jaw opens as a hinge, slides forward and even side to side. This facial area helps in chewing, biting and other jaw movements such as talking and yawning. Temporomandibular joint disorder (TMJD) can thus hinder all of these movements. Jaw alignment disorders are common and can be treated easily. However, sometimes the problem is complex and the infrastructure of the joint is not right lengthy measures have to be taken to resolve the problem. TMJD is a sub-part of myofascial pain dysfunction or craniomandibular dysfunction.

Symptoms:
• Pain around ears, in the jaw, shoulders, tooth and face.
• The jaw clicks and pops whenever moved. The irregular sounds produced by the jaw indicate TMJD.
• Hindrance in opening the mouth within the normal range with pain or without pain.
• Patients continuously grind their teeth.
• Excessive pain is experienced in the head and neck area. This can be either occasional or persistent depending upon the severity of the disease.
• Patients may even face severe migraine headache attacks.
• The ears start ringing (tinnitus).
• Snoring and sleep apnea may occur.

Occurrence of any of the preceding symptoms indicates presence of TMJD. Patients may be perplexed about how they got the disease. The causes of TMJD are thus listed below.

Causes:
1. Bruxing: This is excessive grinding of the teeth subconsciously as a habit or during sleep. This indicates psychological stress and can be investigated by a doctor looking at the wear and tear on the patient's teeth.

2. Uneven bite: Sometimes the rows of teeth are not in a straight line. Some are higher than others. This irregularity exerts different amounts of pressure on the temporal joints when chewing. One joint might be compensating for the other as more pressure is being exerted on it.

3. Trauma/stress: This can be a major contributing factor towards TMJD. The brain can be overworked that causes the muscles to stiffen or stress leads to bruxing.

4. Dental work: Braces or other dental procedures can also cause TMJD. Braces could cause TMJD initially as the teeth may be slowly being pulled back. This causes the muscle to flex and the jaw to remain under stress.

5. Accident: Accidents may lead to a slightly or seriously dislocated jaw that causes TMJD.

6. Inflammation: Diseases may cause muscle inflammation that will inflame the jaw muscle

Besides the reasons mentioned above, Patient with arthritis and fibromyalgia have higher probabilities of developing TMJD.

Treatment:
Treatment of TMJ depends on the cause of the disease. In simpler cases, doses containing painkillers may suffice. In other cases, however, the jaw structure may have to be worked upon.

- Treatment for Bruxing: For patients with TMJD caused by bruxing, the grinding of the teeth has to be stopped. Doctors may recommend various relaxation techniques. A night guard can also be placed. It prevents contact between the upper and lower jaw.

- Stabilizing the bite: To adjust the bite, orthotic can be prescribed. This aligns the bite and maximizes comfort.

- Reconstructing the bite: In some cases where stabilization does not seem enough, the bite may have to be reconstructed. Placing a permanent orthotic is one alternative. Other ways include reshaping your teeth using crowns/on lays or moving your teeth to adjust properly.