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Occlusion & TMD Specialist
Temporomandibular Disorders (TMDs)
Temporomandibular Disorders are conditions that affect the jaw
joints (Temporomandibular joints or TMJs) and the muscles that move
the jaws. These conditions can create pain, stiffness, clicking
and cracking sounds in the jaw joint and may be associated with
headaches, ear ache, dizziness or ringing in the ears.
The Temporomandibular joints are the two joints located just in
front of the ears which connect the mandible (lower jaw) to the
temporal bone (base of the skull). The joint is a 'ball and socket
joint' with a meniscus or disc between the two bones which allows
the mouth to open and close smoothly in chewing, speaking, yawning,
etc.
TMD patients commonly complain of pain in the jaws, ear or side
of the head. There may be limitation of jaw motion, locking or sticking
of the jaw. Popping, clicking, or cracking of the jaws may also
be present. Some patients experience soreness or sensitivity of
the teeth.
The causes of TMD are not understood completely but there are many
potential causes of TMD symptoms. Most commonly people clench, grit,
grind or tap their teeth together. These habits can occur at night
when people are unaware of the habit. Excessive clenching or grinding
is called Bruxism. Sometimes disordered sleep habits are associated
with these symptoms. Trauma to the jaw can also damage the delicate
joint mechanism. Some people with Rheumatoid or Osteoarthritis also
have degenerative changes in their jaw joints.
The treatment of a TMD depends on its cause so your dentist may
decide to refer you to an Oral and Maxillofacial Surgeon who has
training in the evaluation and treatment of TMDs. After taking an
examination of the jaws and mouth, the appropriate treatment may
be include:
- A night guard-this is like a retainer that is worn after Orthodontic
treatment and is worn at night to rest the jaws and prevent damage
to the teeth due to bruxism.
- Medications such as muscle relaxants or prescription anti-inflammatories
may be necessary for the severe phase.
- Behavioral Medicine techniques such as Stress management, Relaxation
exercises and Biofeedback can all be helpful.
- Physical Therapy can help to relax the muscles, reduce pain
and improve range of jaw motion. Improvement in the posture of
the upper back, neck and shoulders can also be valuable.
- Surgery is indicated in a small number of patients.
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