TMJ/TMD – A Detailed Overview
TMJ or Temporomandibular Joint is a joint that connects the skull and the bottom jaw. It actually comprises of two joints that are on either side of your jaw to enable slide and rotation. Here, we will be using the phrase “joint jaw” to discuss about the temporomandibular joint to simplify reading.
TMD or Temporomandibular Disorder is an inflammation in the temporomandibular joint.
We will use TMD to refer to TMJ here to simplify reading as TMJ is commonly used in place of a temporomandibular joint disorder. This is a chronic or acute inflammation in the key joint that connects the skull and the bottom jaw, or of surrounding muscles around the jaw. The disorder can cause discomfort or pain in this joint and in the surrounding area. It can also cause earaches and might be a reason for the occurrence of bruxism. A study depicted that 11% of teenagers undergo the experience of TMJ pain.
Symptoms and Signs of TMJ/TMD
The different symptoms and sign of TMJ are classified as well as briefly explained below.
Clicking or popping sounds made by the temporomandibular joint – It is normal to hear clicking and popping sounds made by the joint, which is an indication of wearing of the bone as well as the joint cartilage. This is a mild TMJ symptom.
Abnormal jaw movement while opening – The two classic TMJ symptoms are when a jaw ‘deviates’ (shifts slightly sideways on opening the mouth) or ‘deflects’ (shifts sideways, then shifts back into its normal position on opening the mouth).
Opening jaw becomes difficult – A common TMJ sign is the difficulty you face in opening your jaw wide normally (for instance, while yawning or eating).
Pain in jaw muscle – People suffering from TMJ are liable to experience tenderness or pain in the jaw joint or in the muscles surrounding it if these points are pressed, palpitated or massaged. It is a common symptom to experience pain in those areas while eating, clenching or speaking.
Facial pain or pain in neck, ears or shoulders – Tissue inflammation around the areas of the joint can cause earache and is a symptom of TMJ.
Anxiety, stress, troubled sleep and depression – Various studies show that sufferers of TMJ are more liable to experience anxiety, stress, troubled sleep or depression.
Malocclusion – Your jaw may slightly get misaligned due to TMJ (when it deflects or deviates, as mentioned in the text above) which means that your contact between the upper and lower jaws is irregular.
Wobbly Teeth – Malocclusion or irregular contact puts more pressure on a few teeth causing them to eventually become mobile – move or loosen.
Loss of Teeth – Severe malocclusion occurring on wobbly or loose teeth can result in the teeth completely falling out.
Bruxism – A study claims that in case of increased intensity of bruxism, there will be more symptoms and signs of TMJ. Bruxism is a common cause of this disorder. To read more about bruxism, click here.
Diagnosis of This Disorder and Its Confirmation
As a matter of fact, all the symptoms mentioned above can be linked to various other factors. However, if you think you are suffering from TMJ or bruxism, you should first be sure of its existence before starting any kind of treatment. Only your doctor or dentist can give you confirmation of its existence. They may recommend a bite strip. This is a little appliance that is worn on your cheek above the joint and surrounding muscles. It consists of an electrode that is sensitive to the severity of the tension in the jaw muscle and records instances of tension. You doctor will analyze the data received and use it to diagnose you.
A few websites suggest having a hair analysis test. This method is used to analyze the nutritional deficiencies and mineral imbalances of the hair. In Your Daily Diet, you will notice a relationship between bruxism and magnesium deficiency (it includes names of foods which are rich in magnesium that you can add to your daily diet). Though you can ask about the hair analysis test from your doctor, if you require confirmation regarding the existence of bruxism, the doctor may have various other reliable methods to do so.
The Main Reasons for TMJ
Bruxism – A study claims that in case of increased intensity of bruxism, there will be more symptoms and signs of TMJ. A reason for this can be that severe or extended bruxism can result in teeth damage or teeth malocclusion. This can in turn obstruct the joint from functioning properly. Another link between TMJ and bruxism is that it can cause weariness and pains in the face muscles (specifically to the muscles that are utilized while masticating, surrounding the joint). As you can clearly see under the detailed overview of TMJ/TMD; unneeded contractions of temporomandibular muscles result in pain and inflammation of the muscles causing jaw pain or TMJ. Broadly said, excessive clenching due to any reason can cause TMJ pain.
Unnecessary biting, gnawing and chewing – Chewing on your fingernails or on gum or gnawing on a pen will cause exertion in the jaw muscles as it requires them to contract repeatedly which cramps or fatigues them. Therefore, it is commonly seen that chewing stiff foods like beef jerky or toffee cause pain.
Jaw Strain – Did you shout a lot recently or had an unusually tall sandwich in your meal? These activities involve extreme jaw opening and can put a strain on the jaw joints. (In case your answer to the initial question was a ‘Yes’, read the text about stress under Treatments).
Injury – In case you suffered a bash on your jaw while participating in a sport or from falling, it may have knocked some teeth on your bottom jaw causing misalignment. A jaw that is misaligned usually has deviated (read under ‘Symptoms and Signs of TMJ’) or displaced (lost teeth) teeth which have an effect on your jaw’s occlusion.
Bipolar Disorder – A study illustrates the relationship between TMJ and bipolar disorder.
Complications and Risks of Not Treating TMJ
Why should you never leave your disorder untreated:
Jaw Dysfunction – A usual reflex action of being a victim of TMJ is the limited ability in opening your jaw. This means you will not be able to talk or chew properly.
Related pain in shoulders, ears, neck and facial muscles – Inflammation of joints or of the surrounding soft tissue can cause pain which is sometimes shifts to adjoining areas like the ears, facial muscles, shoulders and neck muscles.
The methods of Biofeedback (read about bruxism treatments) have been tried on patients of TMJ disorder by positioning electrodes above the masseter or jaw muscles to monitor muscle tension. Bruxism patients are awake during the trial of the method of biofeedback. The electrodes, on sensing a certain intensity of masseter muscle strain, trigger a stimulus to alert the patient of their muscle strain and teach them to ease the tension. A research paper on these tests mention in its concluding remarks that such this treatment method, along with cognitive behavioral therapy (guiding the mind to alter their thoughts and reactions in a more favorable manner), is quite effective for TMJ treatment. Click here to learn more.
You can purchase painkillers from a general store like anti-inflammatory and analgesics medications.
It is interesting to note that Botox is seen as an effective hypertrophy treatment for masseter muscles. Nonetheless, Botox is an expensive treatment and requires to be repeated after every few months, the effect of which weakens at every visit.
The repositioning of splints or occlusal guards is a fine treatment for TMD as it guides the jaw alignment and jaw occlusion when users try opening and closing their mouths.