Temporomandibular Joint Disorder (TMJD)


Temporomandibular Joint Disorder (TMJD)

Temporomandibular Joint Disorder (TMJD, TMJ or TMD), or TMJ syndrome, is a problem in the jaw and surrounding areas of the head and neck that causes pain, discomfort, and disability in millions of people each year. Many people suffer needlessly as they search in vain for relief from their pains. With the application of new technology and acquisition of proper training, dentists are able to diagnose and treat TMJ disorder. With all of this new information emerging, dentists will now be able to understand TMJ disorder and can become more productive in their treatment and prevention of it. Today, the medical profession is becoming more cognizant that dentistry plays a vital role in this process and more often seeks the expertise of dentists knowledgeable in this new field of treatment.







Bad bite” (Malocclusion) and the Temporomandibular Joint
- Your jaw joint, which holds your lower jaw in place, is suspended beneath your skull by an intricate system of muscles and tendons. The jaw joints, also known as the temporomandibular joints (TMJ), are some of the most complex in the body. The jaw joint, surrounding muscles, and the fit of your teeth are closely interrelated, each affecting the other as you make everyday jaw movements such as speaking and chewing.




The way your teeth fit together is called Occlusion. When your teeth are not in proper relation to each other and to your jaw joints, the jaw automatically shifts to a new position in an attempt to compensate for the misalignment of your teeth?a condition known as malocclusion (teeth do not fit together properly).

When malocclusion exists, even what looks like a good bite could be at the expense of putting pressure on other jaw joint areas as the jaw shifts to accommodate the teeth. Symptoms of misaligned teeth may be clenching, grinding, premature tooth wear, stress on the muscles and tendons, some of which may occur during sleep. Results of these symptoms are headaches and muscular aches and pains in the face, neck, shoulders and back, dizziness, earaches, ringing in the ears and many other problems.

In addition to these common conditions which often (but not always) relate to malocclusion and cause pain in and around the temporomandibular joint, there are other conditions which can affect the function and comfort of this joint and the total body health. These conditions include disease, nutritional deficiencies (e.g. gout, tumors, trauma and infections).


Diagnosing the problem

Before prescribing the proper treatment for your particular problem, a variety of diagnostic procedures may be necessary. A radiograph (x-ray) may be taken of your jaw joint. This provides a clear picture of your own particular TMJ anatomy and position of the various structures within the jaw joint.





The visual radiograph is also used as a means for detecting disease in the jaw joint.Jaw repositioners may be used. These appliances are worn for a given period of time. The appliance is refined and adjusted until it eliminates the bite disharmony and pain. In this way, the bite need not be permanently altered until the problem is accurately diagnosed via the splint and other procedures. Permanent treatment would then be prescribed to duplicate the effects of the appliance, e.g. equilibration or occlusal adjustment, orthodontics or restorative procedures such as crowns.


Treatment and Modalities
After diagnosing the problem, a variety of treatments may be recommended. initial phases of treatment are aimed to eliminate the TMJ pain the symptoms resulting from the actual problem. In the second stage, the actual treatment to correct the problem is implemented. Various TMJ treatments are explained briefly below.

I . Splint/Jaw Repositioner Appliances




II. Physical Therapy

J-5 Myomonitor TENS Unit – For muscle relaxation and
for establishing physiologic occlusion
No needle acupuncture


III. Occlusal Equilibration
Premature contacts, detected by the proprioceptive system and relayed through the central nervous system may not be tolerated, if the patient’s resistance to this interference is not adequate.  In this case, pathology will occur.  Treatment of this condition may require selective grinding to achieve occlusal stability.








IV. Craniodontics





V. Occlusal Restoration

 Before  After  Before  After


Occlusal restoration involves the replacement or reconstruction of teeth in addition to the reshaping procedures (which eliminate high spots on the teeth), thus allowing the face and jaw muscles to relax.

Signs & Symptoms
Self Evaluation Test – Check yourself if you are suffering from anyone of these signs & symptoms:
• Dizziness
• Facial pain
• Throat problem
• Migraines
• Hypersensitivity (non carious teeth)
• Pain down the arms radiating to the fingers
• Headaches
• Eye problems
• Insomnia
• Depression
• Ringing in the ears
• Forgetfulness
• Muscle pain
• Grinding/clenching of the teeth
• Limited jaw opening/Pain upon jaw movement
• Chronic neck, shoulder & backache (upper & lower)
• Post nasal drip
• Uncontrollable facial twitching

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