Temporomandibular disorders (TMD)

Overview

Temporomandibular disorders (TMD) occur as a result of problems with the jaw, jaw joint and surrounding facial muscles that control chewing and moving the jaw. The Temporomandibular joint (TMJ) is the hinge joint immediately in front of the ear that connects the lower jaw to the skull. The joints are flexible, allowing the jaw to move smoothly up and down and side to side. Muscles attached to the jaw joint control the position and movement of the jaw.

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Causes

What Causes TMD?

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

Symptoms

What Are the Symptoms of TMD?

  • People with TMD can experience severe pain and discomfort that can be temporary or last for many years.
  • Pain or tenderness in the face, jaw joint area, neck and shoulders, and in or around the ear.
  • Clicking, popping, or grating sounds in the jaw joint when opening or closing the mouth (which may or may not be accompanied by pain).
  • Other common symptoms of TMD include toothaches, earaches, neck and shoulder pain, and ringing in the ears (tinnitus).

Treatments

Basic Treatments for TMD:

  • Apply moist heat of cold packs. Apply an ice pack to the side of your face and temple area for 10 minutes. Do a few simple stretching exercises for your jaw. After exercising, apply a heating pad to the side of your face for about 5 minutes. Perform this routine a few times each day.
  • Eat soft foods. Eat soft foods such as yogurt, mashed potatoes, cottage cheese, soup, scrambled eggs, fish, cooked fruits, vegetables, and grains. In addition, cut foods into small pieces to decrease the amount of chewing required. Avoid hard and crunchy foods (like apples, popcorn, raw carrots), and thick and large foods that require your mouth to open wide to fit.
  • Take medication. Nonsteroidal anti-inflammatory drugs (NSAIDSs), such as ibuprofen or Aleve, relieve muscle pain and joint inflammation. During a flare of TMD, high doses of NSAIDS for short periods of time are appropriate (800 mg ibuprofen three times daily for 5 days, or Aleve, 2 tablets twice daily for 5 days), then lower doses can be used as needed.
  • Don’t rest your chin on your hand or hold the telephone between your shoulder and ear. Practice good posture to reduce neck and facial pain.
  • Keep your teeth slightly apart as often as you can to relieve pressure on the jaw. To control clenching or grinding during the day, place your tongue between your teeth.
  • Wear a night guard. Night guards are plastic mouthpieces that fit over the upper and lower teeth, which lessens the effects of clenching or grinding the teeth. They also correct the bite by positioning the teeth in their most correct and least traumatic position.
  • Undergo corrective dental treatments. Replace missing teeth; use crowns, bridges, or braces to balance the biting surfaces of your teeth or to correct a bite problem.