What are TMJ or TMD?
Temporomandibular disorders (TMD) is a term used to include a number of disorders characterised by pain in or around the jaws joints. The problems are thought to be quite common, although only a small proportion of patients seek treatment. Adolescents and young adults are most commonly affected, though the symptoms can occur at any age.
Tooth clenching or grinding, especially at night, can also lead to its development. Some patients, however, are unable to identify any particular cause. Anxiety, stress and depression can also be significant factors in the development and progression of TMD.Symptoms
How we diagnose the problem
Sometimes the way you bring the problem to us makes the diagnosis quite straight forward. However there may be cases where it is important to have a thorough examination, which should include assessment of the muscles of the head and neck and jaw, measurement of jaw movements and evaluation of any joint noises. A dental cause needs to be excluded. The teeth should be examined to identify any wear caused by grinding or any tooth interferences which might be affecting the bite. X-rays are useful in case of degenerative conditions of the joints and any other pathology in the jaws.
Physiotherapy and jaw exercises can be helpful. Counselling and/or medication are indicated if anxiety, stress or depression are involved. Life-style changes which include relaxation, regular exercise and yoga are helpful for some patients. Other less commonly used treatments include acupuncture and biofeedback. Changes to the teeth and bite are not generally helpful unless an obvious bite interference or poor bite relationship are present. If back teeth are missing and causing a loss of jaw support, this is an indication for their replacement. Rarely, if pain and jaw limitation are persistent and there is clear evidence of degenerative changes on X-rays, joint surgery
Ways to minimise problems with TMJ and promote healing
Injuries to jaw joints and muscles are quite common and usually resolve with rest. Often the condition resolves spontaneously. It is very difficult to voluntarily rest jaw joints and muscles, especially as jaw movements often occur during sleep. During waking hours, however, it is possible to minimise activity and the simple guide-lines below allow you to avoid those jaw movements which might re-injure your joints, muscles or ligaments. Just as you would rest and support a twisted ankle, so it is necessary to reduce the load placed on your chewing muscles and joints.
An occlusal splint is a custom-made mouthguard-like device which is worn over the upper or lower teeth at night. It is particularly helpful when a clenching or grinding habit is present. The splint may need to be worn for several months and may be helpful indefinitely if a long-term grinding habit is present.