TMJ Pain and TMD (Temporomandibular disorder)
The temporomandibular joint connects the upper and lower jaw on each side of the head. Rounded condyles of lower jaw fit into sockets in upper jaw with a cartilaginous disc situated between the two to absorb forces that cross through the joint. Pain or dysfunction in the TMJ on either side is known as TMD or temporomandibular disorder.
The following is a list of symptoms associated with TMD:
- Migraines and other headaches
- Tinnitus or ringing in the ears
- Lock jaw or difficulty opening or closing the jaw
- Dull achy pain around the jaw and ear
- Pain when chewing, talking or yawning
- Popping or crepitis in the joint with motion
- Neck and shoulder pain
The following is a list of possible causes of TMJ pain:
- Chewing predominately on one side
- Chewing gum, taffy or objects like a pencil
- Teeth grinding often associated with emotional stress
- Trauma such as a blow to the jaw or a car accident
- Osteoarthritis in the joint for prior trauma or mechanical stress
- Dental malocclusion
- Depression and anxiety can contribute to the pain
Diagnosing disorders involving the TMJ consists of taking a good history and a physical exam that includes range of motion tests. Imaging using an MRI or CT scan may be indicated for more severe cases. It is important to determine if the dysfunction is from inflammation in the joint, a congenital abnormality, ligament laxity or a mechanical cause such as an anteriorly displace disc.
The first choice in treatment is to leave the jaw alone and let it rest for a period of time. Avoid all activities that may aggravate it such as playing a wind instrument or chewing gum. Try eating soft foods for several weeks. If the condition fails to improve with a trial of avoidance and activity modification, it may be appropriate to try a natural anti-inflammatory such as an omega 3 fish oil supplement. Chiropractic adjustments using an instrument known as the activator may be helpful to reposition an anteriorly displaced disc within the joint. Some research indicates the alignment of the upper vertebrae in the neck may influence the TMJ and the TMJ may influence the alignment of the upper cervical spine. Therefore chiropractic adjustments to the upper neck if indicated are useful.
Other treatment options include ultrasound, cold laser, ice compresses and massage to a muscle inside the joint called the medial pterygoid and muscles outside the joint called the temporalis and masseter muscles. Exercises such as opening the jaw against resistance and biofeedback may help. Magnesium citrate taken prior to going to bed may help reduce muscular tension around the joint.
People that have a tendency of grinding their teeth can benefit from a mouth guard or a device that fits over the front teeth and inhibits the muscles of mastication. Braces and dental work to better align the bite are useful for cases involving dental malocclusion. Surgery is reserved only for obvious cases involving malformation or degenerative arthritic changes. These cases are estimated to be less than 1% of all TMD cases.
If you are suffering with TMD, call our office for a full consultation regarding your specific condition. We hope to help you get back to a healthier life or refer you to the appropriate specialist. Our chiropractic office is located in Frisco, TX.