TMJ means temporomandibular joint (jaw joint).
When the lower jaw opens and closes, the disc stays between the condyle and the glenoid fossa of the temporal bone at all times. When this happens, this is a normal healthy TMJ and the patient can open wide without any discomfort and without any noise. With a normal opening, the patient should be able to get three fingers between the upper and lower front teeth when the mouth is open as wide as possible. In cases where the TM joint is functioning normally with the disc in the proper position, the muscles of the head, neck and shoulders function relatively pain-free.
Factors That Contribute To TMJ
The main cause of TMJ disorder is usually some type of trauma. The symptoms of TMJ disorder are the result of problems with the joint and/or the muscles surrounding the joint.
Known factors that contribute to TMJ include:
- Sleep Apnea
- Bruxism, or teeth grinding
- Extraction/Retraction orthodontics
- Loss of teeth
- Poor nutrition
- Rheumatoid Arthritis
- Digestive problems
What is TMD?
The position of your teeth can affect the position of your jaw joints. Each jaw joint is a ball and socket joint. When functioning properly, the ball and socket do not actually touch because a thin disc of cartilage rides between them. The disc acts as a cushion and allows the joint to move smoothly. Each disc is held in place and guided by muscles and ligaments. If your bite is not right, as in cases where the following may occur: deep overbite, lower jaw too far back, narrow upper jaw or upper front teeth crooked and tipped backwards, this can cause the jaw to become dislocated. Typically the disc is pulled forward. The lower jaw then has a tendency to go back too far and the top of the lower jaw, which resembles a ball (condyle), presses on the nerves and blood vessels at the back of the socket and causes pain.
Usually, the protective disc (cartilage) is displaced forward and no longer serves as a cushion between the condyle (lower jaw) and the bony socket (skull) and eventually this can lead to the condyle rubbing against the bony socket. This can cause a problem called osteoarthritis.
Mild displacements cause a clicking or popping sounds in the jaw joint. When the disc becomes displaced, this is what causes the various noises within the jaw joints such as clicking and popping sounds. Patients must be aware that any noises or pain that occur during the opening and closing of the jaw is an indication that the jaw joints have become dislocated. Patients are advised to seek treatment as soon as possible to avoid allowing the problem to get worse.
More severe displacement can be very painful and eventually can cause permanent damage to the joint. An unstable bite can cause both jaw joint displacement and muscle strain and pain. Many seemingly unrelated symptoms results, which are collectively known as craniomandibular dysfunction. These symptoms include headaches, neck aches, ringing in the ears, stuffiness in the ears, pain behind the eyes, ear pain, shoulder and lower back pain, dizziness and fainting, difficulty swallowing, and tingling of the fingers and hands. These symptoms include:
- Ear pain
- Neck aches
- Shoulder and lower back pain
- Ringing in the ears
- Dizziness and fainting
- Stuffiness in the ears
- Difficulty swallowing
- Pain behind the eyes
- Tingling of the fingers and hands
Once a thorough diagnosis has been made, Dr. Wall will begin a personalized treatment program. Patients benefit from the non-surgical, conservative treatment our office provides. Individualized therapy will include muscle spasm reduction treatments in conjunction with an easy to wear, comfortable dental orthotic, referred to as a splint. The orthotic covers the lower teeth holding the jaw in proper alignment, reducing tension in the muscles of the jaw joint, allowing healing to take place. Once pain is controlled and the jaw joint is stabilized, the bite is balanced so the teeth, muscles and joints all work together in harmony.
It is important to assess the posture of each patient to determine whether or not the shoulders, pelvis and hips are level. Photos are taken of each patient to check for the above as well as to check for forward head posture. If there is a problem with the shoulders, hips or pelvis or if one leg is longer than the other, then a referral to a chiropractor would be necessary.
To solve the problem of forward head posture which can cause cervical (neck) problems, referral to a dentist or orthodontist who uses functional jaw orthopedic appliances should be made. These appliances such as the Twin Block, MARA or Herbst Appliance successfully reposition the lower jaw forward and eliminate the forward head posture.
1.Phase I Diagnostic – Temporary Solution
2.Phase II Stabilization – Permanent Solution – four options:
- Orthodontic correction
- Prosthetic correction
- Weaning from the orthotic
- Continuing orthotic wear as needed
There are several symptoms that you may be dealing with that are signs of TMD. Don’t suffer for another day and contact us to schedule your consultation.