Temporomandibular Disorder (TMD)
Millions of Americans suffer from chronic head, neck, and jaw pain as well as severe, recurring headaches. In many cases, this pain is due to a temporomandibular disorder (TMD)
Your temporomandibular joints, or TMJs, connect your lower jawbone to your skull. These joints get a lot of use throughout the day as you speak, chew, swallow, and yawn. Pain in and around these joints can be unpleasant and may even restrict movement of your lower jaw.
What is the distinction between TMJ, TMD, and CMD?
TMD is an acronym for temporomandibular disorder or disorder of your Jaw joints. Common usage outside of the dental profession refers to these problems as TMJ.
TMJ is an acronym for the temporomandibular joint or jaw joint in front of your ear. It is the articulation, or joint, between the temporal bone of your skull and your mandible or lower jaw. Your lower jaw below is separated by a cartilage disk from your temporal bone in the skull above. This joint allows you to open, close, protrude, retract, and move your lower jaw side-to-side.
MPD is an acronym for myofascial pain disorder. MPD is a myofascitis or inflammation of your chewing muscles and its fascia, the fibrous membranes covering, supporting, and separating muscles. Fascia may be superficial, covering your muscles and permitting free movement of your skin, or may be deep, enveloping and binding your muscles.
CMD is an acronym for craniomandibular disorder. CMD describes a complex chronic and progressive disorder involving your skull, lower jaw, neck or cervical vertebrae, and the muscles that support these structures. CMD broadens the holistic scope of TMD treatment to include the neck. The F-S Index developed by Dr. Lawrence A. Funt and Dr. Brendan Stack, shows the chronic, progressive increase in the signs and symptoms of Craniomandibular pain disorder.
The incidence of TMD is highest in females between the ages of 20 and 44
Millions of Americans suffer from undiagnosed TMD. Epidemiologic studies report the incidence is highest (37 to 63% depending on the study) in women between the ages of 20 and 44. The incidence is 7:1 to 17:1 times higher in females than in males. Joint laxity due to estrogen may be the cause.
What are the common symptoms of a TMJ disorder?
Often, the first sign of TMD is a joint vibration, clicking, or popping sound originating in your jaw joint(s), especially when you open widely. It is the sound of your articular cartilage disk(s) slipping in and out of position.
As your disorder progresses, frequent pain or soreness occurs in and around your jaw joint(s). The initial clicking will decrease or even stop if your disk(s) remain out of position. This is not a sign of recovery! Your condition has worsened. Your ability to open decreases as your effort to open widely is met with increased strain and discomfort.
In advanced stages, your cartilage disk(s) are permanently displaced. Ligaments stabilizing your jaw joint(s) are stretched then perforated. Traumatic osteoarthritis occurs as your jaw and skull surfaces, now in contact, wear against each another. Irreparable damage to your disk(s) and ligaments may result in permanent disability.
The symptoms of TMD, MPD, and CMD often include:
- frequent headaches or neck aches
- jaw joint clicking, popping, crunching, or grating
- pain or soreness in or around the jaw joints
- pain behind the eyes, facial pain, and tooth pain
- locked jaw or limited opening of the mouth
- pain, ringing, or stuffiness in the ears
- clenching or grinding of teeth
- neck, shoulder, or back pain
- numbness in fingers and arms
- dizziness or vertigo
- difficulty swallowing
- sleep apnea
- difficulty sleeping
- muscle spasms in the jaw area
- a change in the alignment of top and bottom teeth
Left untreated, these symptoms increase in number and severity with age. Finally, there is irreparable damage and permanent disability.
What should I do if I suspect TMD, MPD, or CMD?
If you notice that you are experiencing any of the above symptoms, call us at (248) 282-7298 for a FREE no-obligation evaluation. Dr. McAnnally can help determine if you have a TMD, MPD, or CMD. He will present his diagnostic findings, discuss treatment options with you, and create a customized plan to help relieve your symptoms.
See Schedule an appointment with Dr. McAnnally and Getting Started.
Misaligned teeth and jaws are a major cause of TMD, MPD, and CMD.
We invariably close into the safest fit of our teeth. If our teeth are not in their correct positions, our teeth can force the jaw out of its correct position. The lower jaw will shift to protect our teeth from traumatic collision and fracture. This jaw shift, in turn, may cause problems in your jaw joints, head, neck and jaw muscles, and the connective tissues covering and separating muscles.
Neutral splints – a diagnostic aid but rarely a corrective device
Splint wear separates the teeth. Neutral diagnostic splint wear insures that jaw comfort, neither disengaged teeth nor splint, guides the trajectory of jaw closure. The jaw now closes along a trajectory dictated by jaw joint and muscle comfort alone. Once this trajectory is established, the bite can be adjusted to stabilize the jaw along the new splint-derived trajectory of comfort.
Splints are diagnostic aids and rarely corrective devices. When a splint is discontinued, the dental interferences or tooth contacts that deflect your jaw from a normal, pain-free trajectory of closure, once again exert their deleterious effect.
Bite splints occasionally help unload the jaw joints while short-term, sudden onset joint injuries or transient sprains heal. Don’t expect splint wear to correct chronic, progressive pathology caused by the constant microtrauma associated with long-standing bad bites. Long-standing problems generally require bite adjusting, orthodontic, prosthetic, or dentofacial orthopedic solutions.
Muscle tension Headaches
An estimated eighty percent of headaches are due to muscle tension in the masticatory or chewing muscles. Though the pain seems to originate within the cranium, the pain is actually originating in the muscles that control the movements of the jaw, and/or neck and shoulder muscles that balance the head on the spinal column. This type of pain is called "referred pain" since it originates in one place, the muscles of the head, neck, and jaws, and seems to emanate from another place, the cranium.
If you have frequent headaches (over two headaches a month), or suspect that you might have a temporomandibular disorder, you should be screened for clinical signs or symptoms of MPD, TMD, or CMD. Call us at (248) 282-7298 for an evaluation.
Until you are seen, there are many steps you can take that may alleviate or prevent discomfort.
- Relax your facial muscles - Keep your lips lightly together with your teeth slightly apart.
- Avoid clenching and grinding your teeth.
- Avoid gum chewing.
- Avoid hard foods
- Avoid opening your mouth wide - Limit the range of your jaw movements.
- Don't sit with your chin resting on your hand.
Upper left: Treatment of a TMJ Disorder - A Testimonial; Upper right: TMJ Diagnostic Splint Therapy; Lower left: The Diagnosis and Management of TMJ Disorders; Lower right: TMD and Muscle Tension Headaches - A Testimonial