Temporomandibular joint (TMJ) disorders are a common condition that affects millions of people worldwide. On average, 5 to 12% of adults have TMJ. Although this condition is not much discussed, it brings a lot of difficulties and complications in carrying out our everyday activities like chewing or speaking, affecting our overall quality of life.
Whether you’re experiencing TMJ-related issues or seeking preventive care, understanding this condition is the first step toward effective management and relief. This blog will provide a comprehensive guide to understanding TMJ disorder. Our dental specialists and orthodontists share insights about its causes, symptoms, diagnosis, treatment, and effective management of TMJ.
What is TMJ Disorder?
The TMJ (temporomandibular joint) is located on either side of the head. It is the joint connecting the jaw to the skull. While some use TMJ and TMD (temporomandibular disorder) interchangeably, they are not the same.
TMJ typically refers to the actual joint that connects the jaw to the skull. In contrast, TMD recognizes the disorders or conditions affecting the TMJ and the surrounding muscles, causing pain, dysfunction, or other symptoms that hinder the quality of life.
TMD is often referred to as TMJ disorder, as it involves issues with the TMJ.
Types of TMJ Disorders
Disorders of Jaw Joints
This type of TMJ disorder refers to problems in the area or ligament connecting your jawbone to your skull. Internal derangement, arthritis, and trauma are some of the common conditions experienced here.
Disorders of Chewing Muscles
This covers the muscles that control the jaw movement and cause pain or related dysfunction. Disorders of chewing muscles are often linked to stress or overuse, and key issues include myofascial pain syndrome and muscle spasms.
Headaches From TMJ Disorder
Common causes for headaches from TMJ include pain in the jaw area due to muscle tension or misalignment. Although they are taken as accompanying symptoms of TMJ disorders, these headaches can bring major inconvenience to overall well-being and in carrying out routine tasks.
The onset of TMD can also be linked to traumatic events such as whiplash injuries, jaw misalignment, or a direct impact on the head.
TMD Can Overlap with Other Conditions
TMJ disorder or temporomandibular joint disorder (TMD) can sometimes closely mimic other medical or dental conditions.
Headaches, facial tenderness, and jaw pain can resemble the symptoms of serious health issues such as vascular disorders, brain tumors, cervical spine problems, or even oral and throat cancers.
This is another crucial reason why accurate diagnosis is essential to direct targeted TMJ treatment. To support this, make sure you share any changes in your medical history or conditions with our dentist to ensure a comprehensive evaluation.
Common Causes of TMJ Disorder
Temporomandibular joint disorder mimics the symptoms of many other conditions, and its cause is often unknown or unclear. There is also no single cause of TMD. Rather, it can be a result of many other factors or a combination of causes.
Some of the most common causes of TMJ disorder include:
Jaw injury (like a broken or dislocated jaw).
Teeth grinding or clenching (bruxism).
Arthritis in your jaw joint.
Malocclusion (when your teeth don’t fit together exactly as they should).
Stress.
Painful TMJ disorders can also occur if:
The disk erodes or moves out of its proper alignment
The joint's cartilage is damaged by arthritis
The joint is damaged by a blow or other impact
Understanding Early Indicators
Most temporomandibular joint disorders often begin during childhood development stages. Some of the common early indicators include narrow dental arches, improper tongue posture, and mouth breathing. These can disrupt facial growth, resulting in problems such as vaulted palates, deep bite syndrome, and compromised nasal breathing. Over time, these developmental irregularities can affect the bite, jaw alignment, and the stability of the head, neck, and overall posture.
Factors That Can Worsen TMJ Disorder
While it is difficult to control factors that cause TMJ disorder, there are certain habits that can aggravate the pain and related symptoms. Some of them include the following:
Using the teeth as a tool to tear clothing tags
Poor posture.can put stress on the neck, shoulder, and facial muscles, increasing pain.
Chewing on pens, pencils, or other items is a common “nervous habit” behavior
Chewing on ice or excessively chewing gum
Taking big bites of food makes the jaws overwork
Daytime teeth clenching or grinding
Sleeping on your stomach
Diagnosis of TMJ Disorder
TMD or TMJ disorders often exhibit complex symptoms, which cause the root cause to go undiagnosed or untreated.
For individuals who experience persisting symptoms without proper TMJ treatment, the possibility for the condition to evolve into chronic pain with other physical and emotional consequences is high.
Misdiagnosis or conflicting opinions from various specialists can further complicate the path to recovery. This is why it is important to get an accurate diagnosis and proper intervention for the primary cause of TMJ disorders.
Your orthodontist can diagnose TMJ disorder during a dental checkup or physical examination. They will:
Observe the range of motion in your mouth when you open and close your mouth.
Press on your face and jaw area to find areas of pain or discomfort.
Check and feel the area around the jaw joints while you open and close your mouth.
For accurate diagnosis, sometimes they may also take imaging tests to get a closer look at your jaw joints and the structures around them. Your dentist may request any of the following tests:
Dental X-rays
CT (Computed Tomography) scans
MRI (Magnetic Resonance Imaging)
TMJ arthroscopy (for diagnosis and treatment)
Treatment Options for TMJ Disorder / TMD
The exact treatment approach for TMJ will depend on many factors concerning your specific condition. Orthodontists generally opt for noninvasive options as their first line of treatment through medications or non-surgical procedures. Surgery is considered the next best alternative only if your symptoms don’t improve or if other treatment initiatives do not give the expected results.
Medications
There are many over-the-counter and prescription medications that can help ease TMJ disorder symptoms. This includes:
Pain relievers like acetaminophen.
Nonsteroidal anti-inflammatory drugs (NSAIDs) like ibuprofen and naproxen.
Muscle relaxers, especially for people who clench or grind their teeth.
Antidepressants that can relieve how your body interprets pain.
Be sure to consult your orthodontist or healthcare provider about the risks, benefits, and other health conditions you may be experiencing before using any medications.
Non-Surgical Options
Mouth guards
Dental appliances like mouth guards and oral splints can keep your jaw in a favorable position, reducing the effects of grinding and clenching. You can get them over the counter, but it's best to get one customized.
Physical therapy
Practicing jaw exercises will help stretch and strengthen the muscles around these joints.
Trigger point injections
Trigger point injections are another non-surgical option to manage TMJ. It involves dry needling or administering substances like corticosteroids or botulinum toxin into painful muscle areas or knots in the jaw to relax them.
Ultrasound therapy
Ultrasound therapy uses sound waves to deliver heat deep into the tissues, increasing blood flow and relaxing the muscles.
Transcutaneous electrical nerve stimulation (TENS)
TENS uses low-level electrical currents to relax your jaw muscles.
Behavioral changes
Changing behaviors and routines like improving posture, avoiding chewing on ice, or biting hard food can help ease the symptoms of TMJ.
Surgical Options
Surgery is the last resort to treat TMJ disorders if the medications and other therapeutic interventions do not deliver the desired results. Types of TMJ surgery include:
Arthrocentesis
Arthrocentesis surgery tries to find out why your jaw is sore. Your orthodontists or surgeon will also extract fluid from the joint to ease the symptoms and pain.
TMJ Arthroscopy
Also known as a keyhole surgery, TMJ Arthroscopy involves making a small opening in front of the ears to insert a thin tube that has light and a camera attached. This allows your dental surgeon to insert surgical instruments through the tube to reshape bone, remove scar tissue, or reposition the disk in your joint.
Open-joint surgery
Open-joint surgery is the next best option or alternative to TMJ arthroscopy. However, it is a more complex procedure where your dental surgeon will need to create a long incision that will allow them to access your jaw joint directly.
Treatment Process for TMJ Disorders
01. Initial Diagnosis
On your first visit, one of our TMJ specialists will take a close look at your jaw. We’ll talk with you about any discomfort or issues you’re experiencing to determine if you’re dealing with TMJ disorders (TMD). To aid our assessment, we might take X-rays or use other imaging methods, ensuring we get a comprehensive view of what’s going on inside.
02. Personalised TMJ Treatment Planning
Once we have diagnosed the problem, the next step is to chalk out a treatment strategy specifically for your TMJ issue. Your unique plan could encompass various treatments. These might range from pain relievers and physical therapy sessions to specific devices for your mouth geared towards alleviating pain and getting your jaw back to its natural movement.
03. Customized TMJ Therapy
A common therapy for TMJ disorders involves a custom-made oral device designed to be worn while you sleep. But this isn’t just any device. Our expert dental practitioners will create a mold of your teeth to ensure that this appliance fits perfectly. This precise fit aims to diminish jaw discomfort and foster proper alignment, offering you relief.
04. Consistent Check-ups for Optimal Results
After starting your customized therapy, our TMJ specialists will schedule regular check-ups to review your symptoms, assess how effective the procedure has been, and adapt your TMJ treatment plan if needed. At Invisalign Center, our goal is to ensure you achieve the best possible outcome and long-term relief from jaw pain.
Preventing TMJ Disorders
The complexity of TMJ disorder (TMD) lies in the fact that its causes are often unknown, and many of its risk factors are unavoidable. Regardless of this, there are certain things that you can do to reduce the risk.
Some of them include:
If you clench or grind your teeth, wear a mouthguard at night
Wear a mouthguard while playing contact sports to avoid pressure and injuries
Practice good posture
Practice meditation, mindfulness, or other lifestyle changes that can reduce stress
