Word of the Day: Temporomandibular

Temporomandibular refers to the joint that essentially is a hinge that connects your jaw to the temporal bones of your skull in front of each ear. This joint lets you move your jaw up and down and side to side, so you can talk, chew, and yawn. We call him TMJ for short. If you have problems with your jaw and the muscles in your face that control it, then your dentist may diagnose you with temporomandibular disorders (TMD), but you may hear it wrongly called TMJ, after the joint.

So how do you know if you have TMD? Common symptoms include:

• Pain or tenderness in your face, jaw joint area, neck and shoulders, and in or around the ear when you chew, speak, or open your mouth wide
• Problems when you try to open your mouth wide
• Jaws that get “stuck” or “lock” in the open or closed mouth position
• Clicking, popping, or grating sounds in the jaw joint when you open or close your mouth or chew. This may or may not be painful.
• A tired feeling in your face
• Trouble chewing or a sudden uncomfortable bite — as if the upper and lower teeth are not fitting together properly
• Swelling on the side of your face
• You may also have toothaches, headaches, neck aches, dizziness, earaches, hearing problems, upper shoulder pain, and ringing in the ears (tinnitus).

In other words, TMD symptoms can be very vague and generic. To figure out what’s causing yours, the dentist will ask about your health history and conduct a physical exam. He’ll check your jaw joints for pain or tenderness and listen for clicks, pops, or grating sounds when you move them. He’ll also make sure your jaw works like it should and doesn’t lock when you open or close your mouth. Also, he’ll test your bite and check for problems with your facial muscles. He’ll probably take X-rays to rule out other problems and in rare cases may even order a CT or an MRI to aid is his diagnosis.

What causes TMD? Who knows? Injury to your jaw, the joint, or the muscles of your head and neck — like from a heavy blow or whiplash — can lead to TMD. Other causes include grinding or clenching your teeth, arthritis, and stress.

Is TMD really that big a deal? Actually, it can be. TMD can lead to other medical conditions. First, the pain itself can be crippling for some individuals and can lead to chemical dependencies. This constant pain, combined with the tendency of some people with TMD to grind their teeth in their sleep, can lead to a pattern of sleep disturbance and insomnia as well. TMD symptoms may also contribute to depression. Not treating your TMD could also lead to malnutrition or even eating disorders, as patients attempt to avoid the problem by eating only soft foods, liquids, or not eating altogether. Many TMD patients show signs of premature wear and tear from grinding or clenching their teeth, often without knowledge. This can lead to fractured teeth and worn down enamel. The tendency of sufferers is to favor one side of the jaw over the other which can create swelling on one side of the face and unsymmetrical muscle growth over time. This can give the patient a lopsided appearance. Since the joint in question is located directly underneath the ears, many TMD sufferers contend with pain in their ears. Eventually, TMD disorder may lead to tinnitus or even permanently compromised hearing. Inner ear problems can also produce difficulties with balance and recurring dizziness (Vertigo). Similarly, even vision can be compromised by untreated TMD symptoms. TMD can also lead to serious jaw problems. For instance, the jaw may become permanently “stuck” open (locked jaw) requiring a trip to the emergency room to forcibly open or close the mouth. In addition, the breakdown of the cartilage in the jaw over time not only leads to pain and unpleasant grinding sounds – it can also result in the dislocation of the jaw.

No one should have to suffer in silence, particularly since TMD can be treated permanently through safe, non-surgical means. If you think you may have TMD, don’t wait for it to escalate – contact us at Apple Dental today. We are skilled diagnosticians and very well equipped to treat your TMD at any stage.