Understanding TMJ/TMD

Do you have pain in your face, jaw or teeth? Trouble chewing? Frequent headaches? Does your jaw make clicking or popping noises? …These symptoms can be caused by temporomandibular disorders (TMD). This term describes a group of problems related to the temporomandibular joint (TMJ) and nearby muscles.

The TMJ is the most complicated joint in the body. Though you only have one lower jaw, there are two joints on either side which connect the jaw to your skull. Unlike your knees or elbows, these two joints must function in harmony to avoid complications. If there is a problem on one side, it will most likely affect the other. These joints are part of a large group of muscles, ligaments, and bones that work together as a system.

When the System Works

When the system is healthy, you can talk, chew, and yawn in comfort. Muscles contract and relax to open and close the joint. Between each joint there is a small disk, or fibrous pad, which absorbs pressure in the joints and allows them to open and close smoothly. In a healthy TMJ, the fibrous pad remains between the two bones, preventing them from ever making contact. Ligaments support the joint and tether the fibrous pad in place, connecting the lower jaw to the skull.

Normal Jaw

Click the picture below to see an enlarged view

Causes of TMD

The TMJ and its nearby muscles, tendons and ligaments make up a complex, closely connected system. Because of this, a problem in one part of the system can affect the other parts. We often find that patients with a TMJ problem have issues with their cervical spine as well.

Common TMD problems include tight muscles, inflamed joints, and damaged joints. In some cases, symptoms may be related to the teeth or bite, also whiplash or a previous accident may be the culprit. Over time the following bad habits can lead to a frustrating battle with pain and TMJ disorders.

  • Bruxism (grinding your teeth side to side)
  • Clenching (biting down on your teeth)
  • Malocclusion (when the teeth or bite is out of alignment)

Tight Muscles

The muscles surrounding the TMJ can go into spasm (tighten) and cause pain.

Referred pain occurs in a part of the body separate from the source of the problem. For example, pain in the face or teeth could be coming from a problem in TMJ.

Myofascial pain occurs in soft tissues, such as muscle. Trigger points in these pain areas often cause referred pain. You may feel jaw, neck, or shoulder pain.

Inflamed Joints

Inflammation may include pain, redness, heat, swelling, or loss of function.

Synovitis occurs when certain tissues surrounding the TMJ become inflamed. It causes pain that increases with jaw movement.

Inflamed ligaments can be caused by strain or injury. When this happens, the ligaments are unable to support the joint.

Rheumatoid arthritis is a joint disease. It leads to inflammation in the TMJ.

Damaged Joints

Many people hear clicking when their jaw moves. If you feel pain along with the noise, the joint may be damaged.

Impingement occurs when the disk slips out of place (displacement). This causes the jaw to catch. As the disk slips, you may hear a clicking sound.

Locked jaw occurs when the disk gets struck in one position. As a result, the jaw locks open or closed.

Osteoarthritis is a joint disease. It causes the TMJ to wear away (degenerate). This leads to pain during movement.

Click on picture for enlarged view

Did You Know?

During sleep we can clench with hundreds more pounds of pressure than during the day and not even know it! Many times, this is the reason for waking up with a headache.

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