Temporomandibular (TMD)

Temporomandibular (TMD)

Your temporomandibular joint is a hinge like connection between your jaw to the temporal bones of your skull, which are in front of each ear.

This allows you move your jaw up and down and side to side, so you can talk, chew, and yawn.

When one has problems with the jaw and the muscles in the face that control it, it is called temporomandibular disorders (TMD). But you may hear it wrongly called TMJ, after the joint.

What Causes TMD?

We actually do not know what causes TMD. Some dentists believe symptoms arise from problems with the muscles of your jaw or with the parts of the joint itself. An injury to your jaw, the joint, or the muscles of your head and neck — like from a heavy blow or whiplash — can lead to TMD.

Other causes of TMD include:

  • Grinding or clenching your teeth, which puts a lot of pressure on the joint
  • Movement of the soft cushion or disc between the ball and socket of the joint
  • Arthritis in the joint
  • Stress, which can cause you to tighten facial and jaw muscles or clench the teeth

What Are the Symptoms of TMD?

TMD often causes severe pain and discomfort. It can be temporary or last many years. It could affect one or both sides of the face. Interestingly more women than men get it, and it’s most common among people between the ages of 20 and 40.

Common symptoms include:

  • Pain or tenderness in the face, jaw joint area, neck and shoulders, and in or around the ear when chewing, speaking, or opening the mouth wide.
  • Problems when trying to open the mouth wide, the jaws that get “stuck” or “lock” in the open- or closed-mouth position.
  • Clicking, popping, or grating sounds in the jaw joint when opening or closing the mouth or chewing. Which may or may not be painful.
  • A tired feeling in the face.
  • Trouble chewing or a sudden uncomfortable bite — as if the upper and lower teeth are not fitting together properly
  • Swelling on the side of the face
  • One may also have toothaches, headaches, neck aches, dizziness, earaches, hearing problems, upper shoulder pain, and ringing in the ears (tinnitus).

How Is TMD Diagnosed?

There other conditions that cause similar symptoms — like tooth decay, sinus problems, arthritis, or gum disease. To determine if you have TMD, Dr. Linterman will ask about your health history and conduct a physical exam. He’ll check your jaw joints for pain or tenderness and listen for clicks, pops, or grating sounds when you move them. He’ll also make sure your jaw works like it should and doesn’t lock when you open or close your mouth. Plus he’ll test your bite and check for problems with the facial muscles. He may take full face X-rays to view your jaws, temporomandibular joints, and teeth to rule out other problems.

A Few Ways to Help TMD:

  • Take over-the-counter medications. Nonsteroidal anti-inflammatory drugs (NSAIDs), like naproxen or ibuprofen, can relieve muscle pain and swelling.
  • Use moist heat or cold packs. Apply an ice pack to the side of your face and temple area for about 10 minutes. Do a few simple jaw stretches (if Dr. Linderman OKs them). When you’re done, hold a warm towel or washcloth to the side of your face for about 5 minutes. Perform this routine a few times each day.
  • Eat soft foods. Add yogurt, mashed potatoes, cottage cheese, soup, scrambled eggs, fish, cooked fruits and vegetables, beans, and grains to your menu.
  • Cut foods into small pieces so you chew less.
  • Skip hard, crunchy foods (like pretzels and raw carrots), chewy foods (like caramels and taffy), and thick or large bites that require you to open wide.
  • Avoid extreme jaw movements.
  • Keep yawning and chewing (especially gum or ice) to a minimum and don’t yell, sing, or do anything that forces you to open wide.
  • Don’t rest your chin on your hand.
  • Don’t hold the phone between your shoulder and ear.
  • Practice good posture to reduce neck and facial pain.
  • Keep your teeth slightly apart as often as you can. This will relieve pressure on your jaw.
  • Put your tongue between your teeth to control clenching or grinding during the day.
  • Learn relaxation techniques to help loosen up your jaw.
  • Dr. Linderman can prescribe higher doses of NSAIDs if you need them for pain and swelling. He might suggest a muscle relaxer to relax your jaw if you grind or clench your teeth. Or an anti-anxiety medication to relieve stress, which may have brought on the TMD. In low doses they can also help reduce or control pain. Muscle relaxants, anti-anxiety drugs, and antidepressants are available by prescription only.
  • A splint or night guard. These plastic mouthpieces fit over your upper and lower teeth so they don’t touch. They lessen the effects of clenching or grinding and correct your bite by putting your teeth in a more correct position. You wear night guards while you sleep. You use a splint all the time.

There are other options that would need to be discussed with Dr. Linterman