TMJ / TMD

Do you really have a TMJ problem?

Do you think the problem just went away?

What if you never had jaw pain in the first place?

Were earlier treatments unsuccessful?

Did you decide that fixing the problem costs too much?

Have you decided to just live with the pain?

Has someone told you that your only hope is surgery?

Do you know that the health of your whole body may be at risk?

 Life doesn’t have to be painful!

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The jaw joints, also known as temporomandibular joints (TMJ), are the most complex joints in our body. These joints are essential to all jaw movements such as eating, speaking, facial expressions and most importantly breathing. Unfortunately this joint is a common area for recurrent pain. Most individuals are aware that joint pain, popping noises, and headaches are common TMJ problems. Equally important, but often over looked, symptoms are: tooth loss, fatiguedmuscles, cracked, worn or broken teeth, the inability to open your mouth as wide as you used to, and fluctuation in the health of your gums. Less obvious, but just as important symptoms include ear congestion, dizziness, and neck and/or shoulder pain. Pain or abnormal function is Mother Nature’s way of telling you something is wrong. If left untreated these problems may become debilitating.

Muscles, Teeth and Joints

Dentistry is about more than just teeth; it is also about the role muscles play in the relationship between teeth, bones and the alignment of the jaw with the rest of the body. Physical and emotional stress can also be a factor on tight tense muscles, which reduce the adaptive capabilities of the jaws. Usually the patient cannot voluntarily relax the muscles that are held in constant tension. Depending on the individual circumstances, muscles may be in a constant state of hyperactivity. This is due to sub-conscious programming or because they are in the self-perpetuating “pain-spasm-pain” cycle.

Up to 75 percent of the population has at least one sign or symptom of temporomandibular (TM) dysfunction at any given time; and 34 percent of the population reports having a temporomandibular disorder (TMD). TMD is a common problem, but its effect on people’s lives is very serious. These conditions usually result in a progressive degeneration of the joint(s) with symptoms and pain becoming more and more severe.

If you have any of the above problems, or even just a concern about your jaw joints call us today. We can schedule an evaluation to determine if you have a true TMJ problem. This evaluation may include a series of radiographs; plaster models, diagnostic photographs, clinical analysis, and your symptom history.

Understanding Temporomandibular Dysfunction

TMJ stands for Temporo Mandibular Joint. These joints are made up of the Temporal bone of the side of the skull (T) and the Condyle or Mandible (M), the lower jaw. The joint (J) they form is the Temporomandibular Joint (TMJ) which connects your lower jaw to your skull. These joints are located in front of the ears and allow the jaw to open and close, move side-to-side and forward and backward. Unlike any other joints in the body, these joints move in unison. When one or both aren’t functioning properly, it is referred to as “dysfunction.”

TMJ problems are also referred to as TMD - Temporal Mandibular Dysfunction, CMD - Cranio Mandibular Dysfunction and MPD - Myofascial Pain Dysfunction along with other names.

Etiology of TMD

TMD result from the various types of trauma:

MACROTRAUMA (direct trauma) is injury due to impact or extensive stretching, twisting, or compression of the mandible (lower jaw). It is due to sudden force and may also result from indirect trauma such as acceleration-deceleration injury (also known as whiplash).

MICROTRAUMA occurs as a result of sustained and repetitious adverse loading or continued compression due to Para functional oral activities (clenching and grinding). This activity becomes a vicious cycle, a dwindling spiral: The clenching or grinding causes the teeth to wear unevenly and the jaw joints to deteriorate, often unevenly, which causes the muscles to contract unevenly and the whole cycle starts all over again. This can cause all of the symptoms mentioned above and more. The signs and symptoms vary from person to person depending upon their body’s particular ”weak links.”

The jaws are literally one end of the postural (skeletal) chain. When teeth do not fit together properly it can result in muscle tension of the face and jaws. This imbalance can be transmitted down this chain and result in neck or back pains and symptoms. Similarly, abnormal back and pelvic positions can upwardly contribute to jaw imbalances.

Forward head posture has been found to be a contributing factor that leads to joint strain and musculoskeletal pain including headache. Chronic forward head posture results in increased load. Correct head posture with the center of the ear sitting directly over the center of the shoulder results in a head that weighs approximately 10 pounds, producing a 10-pound load on the spine and its tissues. However, for each inch forward the load increases by 10 pounds. For example, a head posture that is three inches forward of normal would result in a 30-pound increase in the load on the spine and its tissues. Patients with chronic forward head posture are predisposed to headaches by nerve entrapments and increased load on the cervical (upper) spine.

Morning headaches or facial muscle pains are common symptoms of TMJ/TMD’s and obstructive sleep apnea (OSA), which is caused by a decrease in oxygen saturation. Scalloping of the tongue is also predictive of TMD’s and OSA. Patients with headaches and facial pain are frequently mis-classified. It is important that an assessment for OSA be included to distinguish between these disorders. 


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