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Temporomandibular Disorders TMJ/TMD
The Right Time for Braces
Tooth Decay: A Preventable Disease
Women's Dental Health
Your Child's First Dental Visit
Your Child's Teeth and Gums: Tips for Parents

Temporomandibular Disorders TMJ/TMD
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What is the Temporomandibular Joint?

The temporomandibular joint (TMJ) is a joint that slides and rotates just in front of your ear, consisting of the temporal bone (side and base of the skull) and the mandible (lower jaw). Mastication (chewing) muscles connect the lower jaw to the skull, allowing you to move your jaw forward, sideways, and open and close.

The joint works properly when the lower jaw and its joint (both the right and left) are synchronized during movement. Temporomandibular Disorder (TMD) may occur when the jaw twists during opening, closing or side-motion movements. These movements affect the jaw joint and the muscles that control chewing.

What is Temporomandibular Disorder?

TMD describes a variety of conditions that affect jaw muscles, temporomandibular joints, and nerves associated with chronic facial pain. Symptoms may occur on one or both sides of the face, head or jaw, or develop after an injury. TMD affects more than twice as many women than men and is the most common non-dental related chronic orofacial pain.

What Causes TMD? **

Normal function for this muscle group includes chewing, swallowing, speech and communication. Most experts suggest that certain tasks, either mental or physical, cause or aggravate TMD, such as strenuous physical tasks or stressful situations. Most discomfort is caused from overuse of the muscles, specifically clenching or grinding teeth (bruxism).

These excessive habits tire the jaw muscles and lead to discomfort, such as headaches or neck pain. Additionally, abnormal function can lead to worn or sensitive teeth, traumatized soft tissues, muscle soreness, jaw discomfort when eating, and temporal (side) headaches.

What TMD Symptoms Can I experience?

• An earache without an infection

• Jaw pain or soreness that is more prevalent in the morning or late afternoon

• Jaw pain when you chew, bite or yawn

• Clicking when opening and closing your mouth

• Difficulty opening and closing your mouth. Locked or stiff jaw when you talk, yawn or eat.

Sensitive teeth when no dental problems can be found.

What Can I Do to Treat TMD? **

The majority of cases can be treated by unloading (resting) the joint, taking a non-aspirin pain reliever and practicing stress management and relaxation techniques. It's important to break bad habits to ease the symptoms. Most treatment for TMD is simple, often can be done at home, and does not need surgery. For example, control clenching or grinding during the day by sticking your tongue between your teeth. If you still experience pain, you may be grinding or clenching your teeth at night. So see your dentist for a nighttime mouthguard.

Most people will experience relief with minor treatment. More severe cases may be treated with physical therapy, ice and hot packs, posture training and orthopedic appliance therapy (splint). Eating soft foods and avoiding chewing gum also help relax the muscles.

Is TMD Permanent?

The condition is often cyclical and may recur during times of stress, good or bad. As the patient, you should be active in your treatment, by being aware of the causes of your jaw problems after seeing a dentist for a diagnosis regime. Make routine dental appointments, so your doctor can check TMD on a regular basis.

Created July 1998 Sources: Giblisco, Joseph A. DDS, Charles McNeill, DDS, Harold T. Perry, DDS.: Orofacial Pain: Understanding Temporomandibular (TMJ) Disorders. Quintessence Publishing Co., Inc., Carol Stream, Illinois. 1994, E. Mac Edington, DDS, MAGD, ABGD, NIDR: Temporomandibular Disorders, Bethesda, Maryland; Wilkinson, Tom, "New patterns of Dental Disease; Management of Temporomandibular Disorders." Australian Dental Association News Bulletin, No. 246, July 1997.

This information was compiled for you by the Academy of General Dentistry. Your dentist cares about long-term dental health for you and your family and demonstrates that concern by belonging to the Academy of General Dentistry. As one of the 35,000 general dentists in the United States and Canada who are members of the Academy, your dentist participates in an ongoing program of professional development and continuing education to remain current with advances in the profession and to provide quality patient treatment. Visit the AGD's website at www.agd.org. You have permission to photocopy this page and distribute it to your patients.

AGD IMPACT August/September 1998

**Editor's Note: It is pretty well accepted that problems with a patient's "bite" (a malocclusion) may cause, and, will at least contribute, to a patient's TMJ/TMD symptoms. Many patients have relief from symptoms after correction of their "bite" either through: 1. Crowns, Fillings, Grinding the Teeth; 2. Orthodontic Treatment (braces) provided by an orthodontist; 3. Orthognathic Surgery (jaw surgery) provided by an oral surgeon; OR,   4. All of the above: #1 & #2 & #3. In some ways this article presents a simplistic view of TMJ/TMD. With some patients the causes and treatment of the condition are relatively complicated.**

It is pretty well accepted that problems with a patient's "bite" (a malocclusion) may cause, and, will at least contribute, to a patient's TMJ/TMD symptoms. Many patients have relief from symptoms after correction of their "bite" either through: 1. Crowns, Fillings, Grinding the Teeth; 2. Orthodontic Treatment (braces) provided by an orthodontist; 3. Orthognathic Surgery (jaw surgery) provided by an oral surgeon; ,   4. All of the above: #1 & #2 & #3. In some ways this article presents a simplistic view of TMJ/TMD. With some patients the causes and treatment of the condition are relatively complicated.

Posted   October  1,  2000   [TCJ]

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