Temporomandibular joint
The TMJ is the most complicated joint in the body. It includes a group of muscles that are responsible for the joint movement, allowing us to do things such as chew, talk, swallow and yawn. When the harmony of the muscles becomes disrupted and prevents them from working, it causes TMD (temporo mandibular disorder).
Signs and symptoms of having TMD
- Sore jaw muscles.
- Limited mouth opening.
- Noise in your TMJ when eating or opening your mouth.
Sore muscles: The muscles around your TMJ may be sensitive and sore. This pain may be heightened in the morning when you wake up, when you eat food or when you open your mouth.
Limited mouth opening:
It may be hard for you to open your mouth as usual. This means that your muscles are tired, tense or/ and inflamed, and need rest.
Headaches: You may experience headaches accompanied by a stiffness or pain in your neck. People with TMD also often experience back and shoulder pain.Therefore, if you have any pain in your TMJ it is important to be cautious of any other skeletal pains that you may have throughout your body. Multidisciplinary treatment will be required in these situations meaning you will have to treat your TMD as well as the other skeletal problems that you have.
Clicking sound in your TMJ:
You might hear a clicking or grinding noise when you eat or yawn. You may hear strange noises in your jaw, such as clicking or popping when you open and close your mouth, or crunching and grinding when you chew food..
Your symptoms will be discussed, and your dentist or doctor will look at your jaw. Your dentist will do some examinations such as:
- Feel your jaw when you open and close your mouth.
. ● Check your range of motion.
- Press on the area around your jaw In order to locate any areas of painor discomfort.
- Take X-rays to evaluate your teeth and the shape of your TMJ, or a CT scan of your jaw to get images of the joints and bones.
- MRI to identify the problems with the disc in the joint or the surroundingsoft tissue. This can be done by a specialist.
- Arthroscopy may be used by a specialist to have a better diagnosis inmore complicated cases. This is a tiny camera that goes into the area and shows its surroundings.
Your dentist may decide to refer you to a specialist to treat your issue. These specialists can be Oral Medicine Specialists or Oral Surgeons.
Causes Of TMD
-The most common reason for TMD is stress, as it commonly causes clenching and grinding of the jaw and teeth. There was a tremendous number of TMD’s during the pandemic. Patients are usually unaware that they are clenching or grinding, however your dentist will know by examining your enamel and soft tissues on your cheek.
-Asymmetrically missing a tooth may cause a TMD due to uneven alignment of teeth, especially patients who don’t have teeth in the back and don’t have a stable bite. Patients who don’t have a stable bite such as patients with ill fitting dentures (partial or complete) can have TMD.
-Some diseases such as arthritis can cause TMD’s. Any disease that affects joints and muscles can cause TMD.
-Injury to the jaw such as accidents might also cause TMD.
-There are some habits such as nail biting and chewing gum might be a reason for
TMD.
These causes are most common, however they are not the only ones.
Treatment
-Be aware of when you are clenching your teeth. It is important to know that at rest your teeth shouldn’t touch each other. If you are touching your teeth together when you are not eating this is called clenching. So during the day you can control your clenching by keeping space between your teeth at all times except when you are eating.
-Stay away from hard and sticky foods. You want to allow your TMJ to rest and the muscles around it to heal. Be aware to avoid chewing gum, biting your nails and biting on anything hard such as pencils. Avoid any hard foods for 2 to 4 weeks. Food such as nuts (especially almonds), raw carrots and any other hard food. Have a soft diet and cut food into small pieces since you don’t want to open your mouth very wide and big. Small pieces can help the muscles to rest. Also avoid opening your mouth too wide, especially when you yawn.
-Keep the area of concern warm. You can heat the area by holding warm water in your mouth and from outside you can use a warm damp towel on your muscles. Repeat using the warm damp towel as many times as you can. Be sure that you don’t go to a cold area after warming your muscles.
- Laser treatment is an option for treating TMD. This treatment is more common inEurope and not as much in North America.
-Wearing a night guard can help, as it fits over the biting surface of the teeth of one jaw so that you bite against the splint rather than your teeth. This helps your jaw joints and muscles to relax. Depending on your TMD there are different materials for night guards to use
- Painkillers and anti-inflammatories can be prescribed by your dentist as part of thetreatment. Ibuprofen is a common anti-inflammatory painkiller that is recommended to be taken for TMD in low doses for a period of time. Your dentist will decide the length and interval of that.
-Muscle relaxants can be prescribed by your dentist or Doctor.
-If you are in a period of stressful time in your life, medications that can control and help your stress and anxiety will help reduce the symptoms of TMD.
- Botox injections in Muscles that control the clenching and grinding can be extremelybeneficial for TMD.
Follow the instructions that were given to you by your dentist seriously. TMD is one of the problems that will take time to heal little by little, and the longer you postpone the instructions the worse your symptoms will become and healing will take longer.. This can become very overwhelming for patients at some points so please take the instructions seriously.
It is important to understand that sometimes TMD happens suddenly and if you address the issue immediately it will recover soon. Some TMD’s can be healed by themselves after a period of time, however this depends on the severity.
Your dentist may choose to refer you to a specialist or other health providers such as physiotherapists to help the pain.
If you have TMD contact your dentist and ask for their help and guidance.
