Temporomandibular joint disorder, or TMD, is not just one condition but a group of them. Often painful, TMB affects the jaw joint, making it difficult to chew, open the mouth wide, yawn, or generally use the jaws. Pain or soreness in the frontal region of the ear, along the jaw muscle, cheek, teeth, or the temples may also accompany TMD. Sometimes, the jaws also make audible noises.
Pain or discomfort in the jaw muscles or joints are often temporary, occurring in cycles. Once the affected person stops moving the area, the pain also tends to stop. In some cases, however, TMD can develop into chronic symptoms. A doctor of chiropractic can determine whether jaw pain is due to TMD or another condition, and can provide an appropriate line of treatment.
Signs of Temporomandibular Joint Disorder can include locking of the jaw or restricted jaw movement, pain in the neck, face, or shoulders, a painful grating or clicking when the mouth is opened or closed, pronounced change in how the upper and lower teeth fit together, and earaches, headaches, dizziness, swallowing difficulties, or hearing problems.
- Discomfort or pain in the jaw, neck and shoulder muscles, known as myofascial pain
- A jaw dislocation or a displaced disc
- A degenerative joint disease, such as rheumatoid arthritis
TMD is commonly attributed to severe jaw injury. An injury during a sporting activity, or jaw overuse such as excessive gum chewing, may lead to TMD. In addition, physical and emotional stress can lead to TMD.
Formerly, the practice of sitting in a dentist’s chair for a prolonged period with a wide open mouth may have contributed to TMD. Nowadays, however, dentists allow for breaks during dental work, and screen patients for jaw-structure conditions. Susceptible patients may also receive medications during the dental procedure in order to reduce any injury potential, and physical therapy following treatment may be recommended. For less serious cases, home exercises following dental procedures may be suggested.
Emotional stress may also exacerbate TMD symptoms. Although stress is not a cause of TMD, the way stress manifests in the body can have a direct effect on TMD. Patients who experience psychological stress may also clench their teeth, an activity that is directly related to TMD.
Women are four times more likely to be afflicted with TMD than men. Different factors contribute to this ratio, particularly improper posture and high-heel use. However, some other activities, such as regular gum chewing, orthodontic treatment, and non-painful clicking of the jaw, does not cause TMD.
The Diagnosis and Treatment of TMD
To diagnose TMD, your doctor of chiropractic may ask you to put three fingers in your mouth and bite down on them. You may also be asked to open and close your mouth, and chew repeatedly. At this time, the doctor will monitor your jaw joint dimensions and the balance of the muscles.
If you are easily able to perform these activities, TMD may ruled out as the cause of your symptoms. Your chiropractic doctor will then search for signs of an inflammation and/or abnormalities. Special imaging in the form of an x-ray or an MRI may also be necessary to confirm or dismiss the diagnosis.
If you are diagnosed with TMD, your chiropractic doctor may suggest the employment of chiropractic manipulation, massage, heat/ice therapies and especially designed exercises. In the majority of cases, the initial aim is to alleviate the symptoms.
Assuming your chiropractic doctor determines that you require special appliances or splints to offset teeth grinding, he or she will refer you to an orthodontist or other specialist to coordinate the care of your symptoms and treatment.
Your doctor of chiropractic may also help you by:
- Applying ice or heat treatment to counter the pain. Ice is helpful to alleviate the pain, especially after the injury has occurred. In later healing stages, heat should be applied, especially in the case of recurring discomfort.
- Suggesting the avoidance of harmful joint movements, such as eating large sandwiches. Large sandwiches may cause the mouth to open too wide, and thus, destabilize the jaw.
- Recommend specific exercises. Your doctor of chiropractic may recommend strengthening or stretching exercises. Stretching exercises loosen tight muscles, whereas strengthening exercises tighten muscles. In addition, special sensors in the jaw can be retrained.
Once a diagnosis has been made, your doctor of chiropractic will design an appropriate course of treatment for your TMD.