Many millions suffer from TMJ disorder, a condition that affects the function of the temporomandibular joint, or jaw joint.
Despite this fact, TMJ remains one of the most commonly misunderstood areas of dentistry.
For an answer to the question “What is TMJ?" and to learn more about the causes, symptoms, and treatments of this disorder, please read the sections below.
What is the Temporomandibular Joint, or TMJ?
The temporomandibular joints connect the jawbone to the skull. Located at the sides of the head near each ear, these joints play an essential role in eating, speaking, and making facial expressions. In fact, the temporomandibular joint ( TMJ) is one of the most frequently used and complex joints in the entire body.
TMJ Solutions can help you find a TMJ dentist in your area today.
TMJ disorder can develop when one or both of the temporomandibular joints stop functioning properly. This may happen due to any number of causes and may result in chronic ear pain, jaw stiffness and soreness, difficulty opening the mouth, jaw popping or clicking, and headaches. Sufferers of TMJ disorder may experience either sharp pain or a dull, constant ache. Because the causes and symptoms of TMJ disorder are so varied, the condition is typically classified into three main sub-categories:
Myofacial pain
Internal derangement of the joint
Inflammatory joint disease
These classifications help doctors develop more effective treatment options for sufferers of TMJ disorder, based on each patient’s unique symptoms and needs. For proper diagnosis and treatment of TMJ conditions, a patient may require evaluations from multiple medical specialists. In addition to general dentists, dentists trained in neuromuscular dentistry, primary care physicians, and otolaryngologists (ear, nose, and throat specialists) are typically sought for TMJ diagnosis and care. These health care professionals can provide more information on what causes the condition, how it is treated, and other TMJ topics.
TMJ Symptoms and Causes
TMJ refers to the temporomandibular joints on either side of the jaw. Often referred to as TMD (temporomandibular disorders), can lead to serious headaches or acute neck, ear, jaw joint and cheek pain. Depending on the causes of TMJ and the symptoms you are exhibiting, an experienced dentist can provide the treatment you need to reduce your discomfort.
TMJ and Tooth Pain
TMJ is most often linked to tooth pain in those patients who routinely clench or grind their teeth. The extreme pressure absorbed by the teeth and jaw joints while clenching or grinding can cause serious pain in the cheeks and damage in both areas.
Locate a TMJ Dentist Quickly
If you are experiencing any of the TMJ symptoms mentioned above, find a TMJ dentist who is experienced in TMJ disorders. A dentist will be able to diagnose TMJ dysfunction and possibly identify the specific causes of your TMJ-related pain.
TMJ syndrome is a condition that occurs when the temporomandibular joint (TMJ) that connects the upper and lower jaw is misaligned or stressed. This can cause pain in the jaw, the face, and in extreme cases, the neck and shoulders. The causes of TMJ syndrome require careful analysis. Once the causes have been determined, there are a multitude of TMJ treatment options available from dentists, including pain relief through the application of mouth guards, bite therapy, and TMJ exercises.
Treatment for TMJ Pain
TMJ treatment, referred to by some dentists as TMJ therapy, includes many options. The first step is to relieve the pain with the application of mouth guards, also known as dental splints. The next step in TMJ treatment is to apply bite therapy principles and tools to analyze the cause of the misalignment or stress that is causing the problem. If necessary, a routine of jaw exercises will be created to eliminate the clenching or grinding that is contributing to the stress on the lower jaw.
TMJ Mouth Guards for Pain Relief
TMJ mouth guards are soft plastic protectors that slip over the upper and lower teeth to prevent grinding of the teeth. Guards make it more difficult to clench the jaws, an important first step in TMJ pain relief. Your dentist will take a mold of your upper and lower teeth to custom-fit your TMJ mouth guards for maximum comfort and efficiency.
Jaw Exercises for TMJ
TMJ exercises are designed to relax the jaw and eliminate clenching, and also to help in the correction of alignment problems. After careful analysis, your dentist may provide you with an appropriate series of very simple exercises to be performed in front of a mirror. The use of a mirror in TMJ exercises helps you see the misalignment that is one of the factors in TMJ syndrome. Gradually, the exercises will teach you control of the jaw muscles and eliminate clenching.
TMJ Bite Therapy
A process known as TMJ therapy, or bite therapy, is used by dentists to help find the causes of TMJ syndrome and provide long-term pain relief. TMJ bite treatment begins with a careful, detailed analysis of your mouth and jaw to find the causes of your disorder. For some, the issue may be jaw clenching; this can usually be attributed to stress or simply a bad habit. For others, the teeth may not come together evenly, a condition known as malocclusion. This can cause uneven use of the jaw and result in muscle pain. Dentists have several tools at their disposal to measure bite pressure throughout the mouth and formulate a plan for dental work that will correct malocclusion and provide TMJ pain relief.
Unlike typical finger or vertebral junctions, each TMJ actually has two joints, which allows it to rotate and to translate (slide). With use, it is common to see wear of both the bone and cartilage components of it. Clicking is common, as are popping and deviations in the movements of the joint. Pain is the most conventional signifier of TMJ.
In a healthy joint, the surfaces in contact with one another (bone and cartilage) do not have any receptors to transmit the feeling of pain. The pain therefore originates from one of the surrounding soft tissues, or from the trigeminal nerve itself, which runs through the joint area. When receptors from one of these areas are triggered, the pain can cause a reflex to limit the mandible's movement. Furthermore, inflammation of the joints or damage to the trigeminal nerve can cause constant pain, even without movement of the jaw.
Due to the proximity of the ear to the temporomandibular joint, TMJ pain can often be confused with ear pain The pain may be referred in around half of all patients and experienced as otalgia (earache). Conversely, TMD is an important possible cause of secondary otalgia. Treatment of TMD may then significantly reduce symptoms of otalgia and tinnitus, as well as atypical facial pain.[ Despite some of these findings, some researchers question whether TMD therapy can reduce symptoms in the ear, and there is currently an on going debate to settle the controversy.
The dysfunction involved is most often in regards to the relationship between the condyle of the mandible and the disc. The sounds produced by this dysfunction are usually described as a "click" or a "pop" when a single sound is heard and as "crepitation" or "crepitus" when there are multiple, rough sounds.
Disorders of the teeth can contribute to TMJ dysfunction. Impaired tooth mobility and tooth loss can be caused by destruction of the supporting bone and by heavy forces being placed on teeth. The movement of the teeth affects how they contact one another when the mouth closes, and the overall relationship between the teeth, muscles, and joints can be altered. Pulpitis, inflammation of the dental pulp, is another symptom that may result from excessive surface erosion. Maybe the most important factor is the way the teeth meet together: the equilibration of forces of mastication and therefore the displacements of the condyle. Many report TMJ dysfunction after having their wisdom teeth extracted.
There are many external factors that place undue strain on the TMJ. These include but are not limited to the following:
Over-opening the jaw beyond its range for the individual or unusually aggressive or repetitive sliding of the jaw sideways (laterally) or forward (protrusive). These movements may also be due to parafunctional habits or a malalignment of the jaw or dentition. This may be due to:
Bruxism (repetitive unconscious clenching or grinding of teeth, often at night).
Malalignment of the occlusal surfaces of the teeth due to dental defect or neglect.
Jaw thrusting (causing unusual speech and chewing habits).
Excessive gum chewing or nail biting.
Size of food bites eaten.
Degenerative joint disease, such as osteoarthritis or organic degeneration of the articular surfaces, recurrent fibrous and/or bony ankylosis, developmental abnormality, or pathologic lesions within the TMJ
Myofacial pain dysfunction syndrome
Lack of overbite
Patients of TMJ often experience pain such as migraines or headaches, and consider this pain TMJ-related. There is some evidence for this in that more than 50% of people who use nighttime biofeedback to reduce nighttime clenching experience a significant reduction in migraines and headaches as well as a reduction in direct TMJ pain.
TMJ disorder is a cause of migraines and headaches, other causes should also be considered.
Aligning the temporomandibular joint and placing the jaw into its optimal position through neuromuscular dentistry can alleviate most headache problems related to TMJ, muscle, nerve and joint disorder.
Many millions suffer from migraine headaches, a type of headache that can often be debilitating. There are 3 times as many women sufferers as men. While any headache can uncomfortable, migraine headaches will often cause incapacitation.
People will often experience a warning know as an aura. These are usually sensations such as flashing lights, blind spots or tingling in the extremities.
In addition to the pain of a headache, migraine symptoms can also include nausea, vomiting, and extreme sensitivity to sound and light.
The only relief many can find is by retreating to a dark quiet room for hours or even days. When left untreated, a typical migraine can last anywhere from 4 hours to days.
There is a lot that is not understood about headaches. Some researchers believe that migraines may be the result of changes in the trigeminal nerve system, which is a major pathway in the cranial nervous system. It is felt that changes in brain chemicals such as serotonin affect the pain messages running along this pathway.
When a headache occurs, the level of serotonin in the brain drops. Scientists believe that this causes the trigeminal nerve to release a protein which travels to the brain's outer covering. This protein causes the blood vessels of the outer covering to become dilated and inflamed. This results in a headache.
The type of migraine varies from person to person. Most people don't experience the aura before their headache. Those that do are experiencing what is known as a Classic Migraine. Whether you experience an aura or not, many people have sensations or premonitions before the headache actually occurs.
These symptoms may include: elation or intense levels of energy, craving for sweets, drowsiness, irritability, depression or thirst.
Migraine headache triggers
There are a number of things that may trigger a migraine:
• Hormonal changes. The exact mechanism between headaches and hormones is not fully understood. Changes in estrogens and progesterone seem to cause migraine in a number of women. Women who have a history of migraines report there occurrence right before or after their periods. Those women who take contraceptives or hormone replacement therapy often report migraines.
• Foods. Many people develop headaches after eating certain food. The most common food causes include: alcohol, especially red wine; aged cheeses; chocolate; fermented, pickled or marinated foods; aspartame; caffeine; monosodium glutamates; certain seasonings; and many canned and processed foods.
• Stress. Stress is often cited as a major contributor to migraines. Whether it occurs at home or work, the body can react to stress with a headache.
• Sensory stimulus. Bright or flashing lights and glaring sun can causes headache pain. Certain smells such as perfume and flowers, and unpleasant odours, such as paint thinner and cigarette smoke.
• Physical factors. Heavy manual work or exercise can set off a headache. Also, changes in sleep habits including too much or too little sleep can trigger a headache.
• Changes in the environment. Changes in the weather, such as rain storms or changes in altitude, such as going to the mountains, can result in a headache. A change of weather, season, altitude level, barometric pressure or time zone can prompt a migraine headache.
• Medications. Certain medications can aggravate migraines - Neuromuscular migraine dentistry is a more permanent option
All of these factors can contribute to the occurrence of a migraine headache.
But the biggest factor is a poor bite relationship.
When the upper and lower jaw are not aligned properly, it results in the muscles being in a constant state of contraction.
These muscles cause the jaws to come together 2000-3000 times every day during chewing and swallowing.
After a while, the muscles get tired and go into spasm. There is a build-up of lactic acid and other waste metabolites due to increased blood pressure in the muscles, which prevents normal blood flow. This is the primary cause of migraines which can often be relieved through neuromuscular migraine dentistry