Temporomandibular Disorders
Many people who suffer from such seemingly disparate symptoms as headaches, earaches, tenderness of the jaw muscle, or dull, aching facial pain often share a common problem. These people, numbering close to 10 million Americans, all suffer from what has come to be known as temporomandibular (TM) disorders. TM disorders can have a variety of causes. Generally, TM disorders are believed to result when the chewing muscles and jaw joints do not work together correctly. In many cases, TM disorders can be successfully treated by your dentist.
Five pairs of muscles allow you to open and close your mouth. They also control forward, backward, and side-to-side movements of the lower jaw. Also involved in these movements are the TM joints. Each of these important joints has two sections, connected by a disk, that make possible the hinge action and gliding action needed to open the mouth widely. Any problem that prevents this complex system of muscles, joints, ligaments, and bones from working together properly may result in a TM disorder.
Signs and Symptoms of TM Disorders
- Pain in or around the ear. This pain often spreads to the face
- Tenderness of the jaw muscles
- Clicking or popping noise when one opens or closes the mouth
- Difficulty in opening one's mouth
- Jaws that "get stuck", "lock", or "go out"
- Pain brought on by yawning, chewing, or opening the mouth widely
- Certain types of headaches or neck aches
Your dentist can determine the cause of your symptoms by conducting a series of diagnostic tests.
Remember that TM disorders often result when the chewing muscles and the temporomandibular joint (TMJ) do not work together correctly. When this occurs, the muscles will often go into a spasm (cramp). This spasm can then become part of a cycle that results in tissue damage, pain, and muscle tenderness.
Factors of TM Disorders
Although accidents such as injuries to the jaw, head, or neck, or diseases such as arthritis may result in some TM problems. Factors relating to the teeth and bite are also believed to be common causes of TM disorders. Among these factors are the following:
- Oral habits such as clenching the teeth or grinding the teeth (bruxism). These habits can tire the muscles and cause them to go into spasm. The spasm causes pain, which in turn causes more spasm. The end result of this cycle may eventually be a TM disorder.
- Problems in the way the teeth fit together or bite. Improperly aligned teeth can sometimes place the chewing muscles under stress and cause them to go into spasm thus setting off the harmful cycle described earlier. frequently, oral habits and problems with the bite work together to cause TM disorders.
Methods of Treating TM Disorders
- Elimination of spasms and pain. This can be done by applying moist heat to the face, using prescribed muscle relaxants or other medications, massaging the muscles, and eating soft, non-chewy foods. Bite plates or occlusal (bite) splints can also be made. This treatment helps to eliminate the harmful effects of clenching or grinding the teeth.
- Counseling or biofeedback/relaxation training. Many times, counseling is used along with other forms of treatment, if emotional stress is the factor that causes clenching or grinding of the teeth, that stress should be reduced or eliminated. Biofeedback, a relaxation technique that teaches people to control tension throughout various parts of the body with the aid of an electronic monitoring device, can also be helpful in reducing muscle tension in the jaws.
- Correcting the way the teeth fit together. If your bite is incorrect or uneven, it can be adjusted by selective grinding of the teeth. Orthodontic appliances (braces) and other dental procedures may also be used to reduce the problems caused by incorrect tooth contact (improperly aligned teeth).
- Surgery. If muscle spasms have occurred for long periods, the TMJ itself may have become injured or arthritic. In addition, the bones and the soft tissues of the TMJ may slip out of normal position because of trauma, such as a blow to the head, or due to some other cause. Occasionally in severe cases such as these, surgery may be needed to correct the TMJ problem.
Your dentist and other health professionals who provide treatment for TM disorders care about your health and comfort. Follow the recommendations they give you and discuss with them any concerns you have. Remember, in many cases the pain, headaches, and other symptoms associated with TM disorders can be successfully and readily treated.
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