What Are Temporomandibular Disorders

Fun fact: Did you know that a snake can completely dislocate its TMJ (intentionally) and put it back in place when trying to eat its prey?

No. Humans can’t do that.

Temporomandibular disorders, or TMD for short, are conditions that directly or indirectly affect the TMJ. Any pathological process affecting the muscles surrounding the TMJ or attaching to it, including the facial muscles used for chewing and speaking, the bony part of the joint, or the ligaments and discs attached to the joint, comprises TMD.

Some things that can cause or contribute to TMD are:

• An unfavorable bite causing overuse of muscles
• A change in bite that is unfavorable
• Nocturnal grinding
• Clenching
• Obstructive sleep apnea
• Upper airway resistance syndrome
• A square facial structure
• Female gender
• Conditions that cause increased flexibility, like Ehlers-Danlos syndrome
• Diseases like arthritis
• Certain autoimmune conditions

Symptoms of TMD range from simple pain to intense pain, sometimes appearing to come from teeth. These include dull or stabbing pain around the ear, a snap while opening or closing, a hyper-flexible joint, inability to close the mouth, stiff jaws, and inability to open the mouth.

As with anything else, early recognition of risk, investigation of cause, and management of contributing diseases or risk factors can prevent progressive pain, loss of function, and deterioration of quality of life.

A doctor well-trained in recognizing TMD will conduct a thorough evaluation and rule out other causes. Further management depends on whether the condition is acute (highly painful) or chronic (long-lasting), and may include treatment with analgesics (painkillers) and muscle relaxants, as well as the prescription of bite splints or mandibular advancement devices. Chronic TMD management includes incorporating physical therapy (known as myofunctional therapy) to prevent further deterioration and reverse early to moderate conditions by incorporating regular exercises. Management of very severe cases may include Botox therapy (results vary widely in scientific studies) and possible consideration of surgery (results are highly variable, unlike knee surgery). In most cases, early recognition and management, including treatment of diseases like obstructive sleep apnea (80% of patients with OSA have some form of TMJ disorder), prevent further progression and, in many cases, reverse symptoms to improve the quality of day-to-day life.

Know anyone who might need help for TMJ disorders? Call our office. We are here to help!