Posts for tag: tmd
Have you noticed a clicking, popping, or grating sound when you open or close your jaw? As many as 36 million U.S. adults experience this phenomenon in one or both of the joints that connect the lower jaw (mandible) to the skull.
While the sounds may be disconcerting, there’s generally no cause for concern in the absence of other symptoms. They’re most likely caused by a harmless shift in the position of the disk inside each temporomandibular (jaw) joint, and it can diminish or disappear entirely over time. But, if you’re also experiencing persistent discomfort, severe pain, or limited function in your jaw (which can include getting it “stuck” in an opened or closed position), then you may be suffering from a temporomandibular joint disorder — part of a complex set of conditions affecting one or both jaw joints, muscles and/or other surrounding tissues. (You may have heard the condition called TMJ, which is actually the abbreviation for the temporomandibular joint itself. Health care professionals prefer TMJD or TMD.)
Depending on the severity, TMD can interfere with your ability to speak, chew and even make facial expressions. The cause is unclear, but genes, gender, environment, stress and behavior are believed to play a role. It can also be symptomatic of a larger medical problem, such as fibromyalgia, which can produce pain all over the body.
Management Options for TMD
TMD traditionally was viewed as a bite problem (malocclusion) requiring mechanical correction — e.g., through orthodontic braces or surgery. But the current therapeutic model approaches TMD as an orthopedic problem (joint inflammation, muscle soreness, strained tendons and ligaments, and disk damage) and favors a sequence of conservative, reversible procedures — hot or cold compresses in the jaw area, soft foods, physical therapy/massage, medication, and/or a bite guard to decrease pressure on jaw joints from tooth clenching and grinding — prior to more aggressive, irreversible treatment alternatives.
If you would like more information about TMD, please contact us or schedule an appointment for a consultation. You can also learn more about the subject by reading the Dear Doctor magazine articles “Seeking Relief from TMD” and “Chronic Jaw Pain and Associated Conditions.”
You’ve suddenly noticed a significant amount of pain radiating from your jaw, so severe you can barely bring your teeth together.
First things first: with this level of pain you should see us as soon as possible. There are a number of possible causes, but only a thorough examination will give us the correct diagnosis and answers we need to develop a plan to treat the cause and alleviate the pain.
With that said, here are a few possible causes for that severe jaw pain.
Injured or diseased teeth. Although the pain you feel seems to come from the jaw in general, the true source may be an individual tooth that’s been traumatized or infected. Because of the interconnectivity of nerves throughout the oral structure, the pain could be radiating from the teeth to the jaws. By effectively treating the affected tooth, we may in turn reduce the jaw pain.
Trauma around the joint. If you’ve taken a physical blow to the area around the jaw joint, the resulting swelling in the joint space is keeping the head of the jaw joint (the “condyle”) from seating in the space properly. You may also notice the upper and lower teeth in the back of your jaw won’t touch. As the swelling from the injury subsides (aided by anti-inflammatory drugs that also reduce pain), the joint should eventually return to its normal position.
Jaw fracture. The most common jaw fracture occurs in the area just below the condyle. The pain is usually much more severe than you might experience with indirect trauma. Fractures are normally treated by repositioning the broken bone and immobilizing the area to allow healing.
Joint dislocation. The injury you’ve sustained may have actually moved the condyle out of the joint space. If this is the case careful manipulation may be needed to reseat the condyle back into place, along with anti-inflammatory medication to reduce swelling.
TMJ or TMD. Muscle spasms can cause significant pain with similar symptoms, including limiting jaw movement. Only an examination with x-rays (to determine if it’s a soft tissue or bone-related injury) can narrow down the possibilities to the true cause. The sooner we make that determination and begin treatment the better you’ll feel — and the less likely the injury will result in irreversible damage.
If you would like more information on the causes of jaw pain, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “Jaw Pain — What’s the Cause.”
The term TMD means “Temporomandibular Disorder.” But if you suffer from this disorder, it means pain. The pain can be mild or severe, acute or chronic, and it can appear to be centered in different locations, making it difficult to diagnose.
People who clench or grind their teeth because of stress often experience the pain of TMD. They might not even know they are engaging in these habits, because they do them subconsciously, for example when driving in traffic or engaging in vigorous exercise. Another cause of TMD might be an injury such as a blow to the jaw.
You can feel your temporomandibular joints working if you place your fingers in front of your ears and move your lower jaw up and down. On each side the joint is composed of an almond shaped structure at the end of the lower jaw, called the condyle, which fits neatly into a depression in the temporal bone (the bone on the side of your skull near your ear). A small disc between the two bones allows the lower jaw to move forward and sideways. The joints are stabilized by ligaments and moved by muscles.
TMD pain is the result of a process that begins when a stimulus such as psychological stress or an injury to the joint causes spasms (involuntary muscle contractions) in the muscles that move the joint. Blood vessels in the muscle begin to accumulate waste products, causing chemical changes and lactic acid buildup in the muscle. Nerves in the muscle then signal the brain to stop the movement of the jaw by registering pain.
TMD pain can appear to originate from various locations in your jaw, head, or neck. This is why it's important to make an appointment with our office for a professional assessment and diagnosis.
Treatment aims to relieve the symptoms of pain and discomfort and to prevent them from recurring in the future. Treatment can include heat, mild painkillers, muscle relaxants, soft diet, and simple jaw exercises, as well as education regarding the causes of TMD. To prevent further pain you may be provided with a “bite guard,” or referred to relaxation training with a licensed therapist. A bite guard is designed to prevent the lower teeth from biting hard into the upper teeth. It is commonly worn at night, but can also be worn during the day if clenching and grinding are apparent.
If these simpler treatments do not solve the problem, we may recommend more complex procedures such as bite adjustment or, as a last resort, surgical treatment may be needed.