Temporomandibular disorder or TMD is a broad term referring to problems with the jaws and their functioning. It is commonly referred to as "TMJ".This system is very complex and problems are caused by a variety of factors. This information sheet will attempt to give you a general overview of TMD so you can better understand the problems you have been having.
Symptoms and signs of TMD can include some or all of the following....
- Jaw pain and/or stiffness
- Headaches, usually at the temples and side of head
- Vague tooth soreness or toothaches which often move around the mouth
- Sensitive teeth
- Painful or tender jaw joint
- Difficulty opening jaw
- Pain and fatigue when eating hard or chewy foods
- Clicks, pops, or grinding sound in jaw joint
- Ear pain
- Cervical neck tension and pain
- Tooth wear
- Awareness of grinding/clenching teeth while sleeping or awake (Bruxism)
- A pattern of breaking or cracking teeth with no other cause, i.e. tooth decay or trauma
- History of medically diagnosed migraine headaches (common incidence of concurrent TMD)
Causes of TMD
Temporomandibular disorders rarely have a single cause. Any one of the following factors may contribute to TMD. Each patient presents with an individual combination of factors that are determined during history taking and clinical exam.
Trauma - Acute trauma to the jaws such as a car accident, a fall, a punch, etc. can cause damage to the muscles and/or joint. The acute pain and loss of function is usually responsive to conservative treatment. Sometimes trauma to the joint can cause chronic damage which may eventually contribute to a TMD problem at a later time.
Bruxism - Bruxism refers to a non functional grinding and clenching of the teeth. Some do this while awake but more often it is done while sleeping. Most people grind their teeth while sleeping to some degree. For whatever reason some people do this very hard to the point where they wear the enamel from their teeth. This bruxing is done by the jaw muscles and by the morning they can be painful due to fatigue. This constant pressure also can damage the TMJs over time. Bruxism is the most common factor found in TMD.
Malocclusion - This term means "bad bite". Sometimes when the teeth do not bite together in harmony with the shape and position of the joints it can place pressure on the joints. Missing teeth can sometimes contribute to this as well. The misalignment can also put strain on the jaw muscles. This factor can be mild to severe. Though the bite is an important part of the whole system it is only altered after conservative measures and only if it is felt improvement will result. Treatment of the bite for TMD is usually not needed but its contribution to the whole must be examined.
Emotion - Emotional stress often plays an integral role in the development of TMD. This occurs due to two basic reasons. Stress increases both the severity and duration of bruxism while asleep. Also, many will subconsciously clench and/or grind their teeth more while awake during times of stress. The other way stress contributes to TMD is that during times of stress your adaptability and pain threshold will go down. As a result you are more likely to experience symptoms of TMD if other factors already exist (bruxing, joint damage, etc.).
Emotional conditions beyond daily life stress can contribute to TMD as well. Depression, anxiety disorders, and the like can often have TMD problems arise. These conditions are quite stressful and it is not hard to imagine why TMD would develop.
Ergonomic - Your job and how you do it can contribute to TMD and related problems. If you work at a computer all day, for example, you may be holding your head in such a way that places strain on your TM system.
