Temporomandibular Joint Disorder (TMD) is a term referring to a number of clinical problems involving the Temporomandibular Joints (TMJs) and associated muscles and structures of the jaw area. Several researchers have found clicking and popping noises in the jaw joints to be present in 40-60% of the general population.

What are the symptoms of TMD?

Common symptoms are:
• Pain about the face, head and neck regions
• Clicking, popping, and or grating noises in the jaw joints
• A limited ability to open the mouth wide or move it side-to-side
• Frequent headaches, often around the temple area
• Earaches, buzzing, or ringing noises in the ears
• Deep pain the jaw joint itself
• Soreness or pain in the cheek area
• Sticking or locking up of the jaw
• A sudden inability to find a comfortable bite position

Common causes of TMD

• Long-term strain on the TMJs caused by a sleep pattern of chronic grinding and/or clenching of the teeth (bruxism). This may lead to permanent damage to the teeth and TMJs themselves.
• Certain types of malocclusion (bad bites) can chronically over stress the TMJs and related structures every time the individual chews. This in turn can lead to TM joint damage.
• Accidents involving direct or indirect trauma to the head, face, and/or neck may lead to partial or total TMJ disc dislocation, stretched or torn TMJ ligaments, and impaired joint function.
• Extensive dental procedures that have over stressed the muscles, joints, ligaments, nerves, may also lead to TMJ ligament inflammation or damage. This in turn can lead to muscle spasms and/or TMJ disc dislocation.
• Arthritis may occur in the TMJs, particularly in patients with TM disc dislocations.
• Research shows that substances such as caffeine, nicotine, and sugar can significantly increase muscle tension and impair their performance.
• Studies have also shown a link between emotional stress and the frequency of teeth grinding at night. This chronic and prolonged nightly activity ultimately damages the TM joints or impair the body’s ability to heal a damaged joint.
• Some other reasons for TMD are less identifiable and may result from a combination of small events such as lying against a partially strained or damaged (but previously asymptomatic) TMJ while sleeping.

How are TMJ disorders diagnosed?

The first step in the management of TMJ disorders is to determine that the concern is not another type of medical or dental problem behaving as if it were a TMJ problem. A TMJ screening includes the completion of a thorough TMJ history, radiographic imaging of the teeth and jaw joints, and a preliminary clinical examination of the jaw joints, muscle system, bite, and teeth.Patients should seek a concurrent proper medical exam from a medical doctor (ideally an ENT) to rule out the presence of medical problems which may be occurring in combination with or disguising themselves as TMJ problems.

Following this, a preliminary diagnosis can be rendered. If the preliminary diagnosis is TMJ disorder, then further studies and tests will identify the exact nature of the disorder and assist the dentist in developing a treatment strategy for the patient’s specific health circumstances.

How are TMJ disorders treated?

Initial treatment for TMJ disorder can range from resting the joints, switching to a soft diet and prescribed medication to stabilization of the joints through the use of a specially designed and custom-adjusted hard acrylic orthotic appliance, also known as a “bite splint,” that fits on the top of the teeth. This appliance, when properly designed, redistributes the stresses on the TMJs, and muscle system while specifically guarding and guiding certain joint movements.

Does treatment work?

The vast majority of cases treated are successfully managed through the use of orthotic appliances and/or a combination of orthotic appliance and physical therapy to reduce symptoms and accelerate healing.

Do dentists need special training to treat TMD?

The diagnosis and treatment of TMJ disorders is best done by dentists who have advanced training in TMD and experience with it. Dr. Sanchez has been trained to recognize and treat TMD. If you think you may have TMD, schedule an appointment with our Tehachapi dental office and we can diagnose you.