What are TMJ and TMD?
The TMJ, short for temporomandibular joint, is a synovial joint (a very common joint in our body that allows for the ball and socket to move against each other with greater mobility) that connects our upper jaw to our lower jaw. Everyone has a TMJ on both the left and right side. TMD, however, is something different (though related). TMD, or temporomandibular dysfunction, is something that encompasses a broad range of possibilities that deal with the signs, symptoms and dysfunction of the TMJ and surrounding muscles. These signs, symptoms, and dysfunction can be associated with the muscles of mastication, facial and trigeminal nerves, or in the joint itself.
How do you know if you have TMD and can we do anything about it?
Many people who suffer from TMD may come in to our office with signs and symptoms of sore teeth, ear aches, shoulder and neck pain, sore muscles in the face, clicking in the joints in front of the ear, ringing in the ear, ear ache, an inability to open or move their jaw adequately, headaches, fatigue and pain around the eyes (to name a few). Some of the individuals who present symptoms such as these would benefit from active treatment, while others do not. The best route for treatment is dependent on the individual and this can be discussed to optimize results.
The TMJ is like a number of joints in our body: it can degenerate and breakdown. There are many different differential diagnosis’ for TMD, however I will focus on a couple of the more common categories. These will encompass the majority of patients we see who suffer from TMD.
1) Occlusal Muscle Dysfunction (ie. Bite problems)
- i) Sleep parafunction (nocturnal clenching and bruxism)
- ii) Sleep clenching/bruxism associated with some form of airway resistance
iii) Daytime parafunction (diurnal clenching/bruxism)
At Braeside Dental Centre, we have good, predictable treatments that can help a lot of our patients who have dysfunction of the TMJ muscles. These methods are able to help maintain oral health in both the short and long term.
2) TMJ structural changes/damage
- i) Damage to the condyle or fossa (bony changes)
- ii) Damage to the ligaments or fibrocartilage disc (soft tissue changes)
There are treatments for TMJ structural damage as well, but it is important to note that studies report upwards of 85% of damaged joints adapt favourably on their own and require no active treatment. Sometimes the joint does not adapt well, but fortunately this is not as common.
Along with these two categories, a combination of the two occurs commonly as well.
Is TMD serious?
It can be a significant problem, but most of the time it can be managed to reduce long term damage. The TMJ may also adapt favourably on its own.
Does TMD go away?
Many times, the body will naturally adapt in the joint or the symptoms may resolve on their own. However, there are some simple things that can help. Just like with any injury, we can do things on our own to help with the process of healing by resting, cold compression, reducing strains and function, NSAIDS, reducing life’s stress, and having a healthy diet and lifestyle.
Does TMD hurt?
Yes, it can range from little pain to very significant pain. This will depend on what the problem is and whether it is in the chronic, acute, healing or in a stable stage.
Does TMD require surgery?
As a general rule, surgery would be one of the last resorts and is generally reserved for severe cases (ones that result in significant debilitation or disfigurement).
What are some treatments considered for TMD once palliative care and lifestyle modifications have been tried?
Depending on the problem, we may employ things such as an anterior deprogrammer, occlusal splint therapy, sleep analysis, bite adjustment, massage, physiotherapy, chiropractics, dieticians, medications and surgery.
What is the significance of structural changes in the TMJ?
The TMJ is the reference point between the upper and the lower jaw. To maintain long term health of our teeth (for both function and aesthetics), it is very important that the TMJ be stable and healthy. If the TMJ changes and remodels, then all of the teeth and muscles of mastication will have to adapt and adjust in concordance to continue to function adequately.
In our modern society, TMD can be a problem quite often. If there is something that we can help with, please let us know and we will do our best to provide the appropriate guidance. If we are not able to help, then we make our best effort to direct you in the right direction.