The TM joints are made up of the temporal bone of the skull (T) and the mandible (M) the lower jaw. The joint (J) they form is the Temporomandibular Joint which connects the lower jaw to the skull. These joints are located in front of the ears and allow the jaw to open and close, move side to side, forward and backwards. Unlike other joints of the body, these joints move in unison. When one or both are not functioning properly, it is referred to as “dysfunction.”
Malfunction of one or both of the TM joints can be caused by trauma, malocclusion, poor posture, teeth grinding, stress, head and muscle imbalance, chronic mouth breathing, arthritis or skeletal malformation. According to American Dental Association, 34% of population has at least one sign or symptom of TMD.
While medical profession is knowledgeable in treating all other joints in the body, it is the responsibility of the dental profession to treat the temporomandibular joint (jaw joint or TMJ). After many years of study, doctors have found that problems associated with TM joints are usually progressive. Each person’s TMD problems are unique and not the same as what someone else may experience. An accurate diagnosis by a TMD dentist is imperative and the key to receiving successful treatment.
Diagnosis of TM Dysfunction
To help understand how the jaw joint works, gently place your little fingers in each ear canal while you open and close your mouth. You will be able to feel the motion created. Is it a smooth movement you feel or is there a popping, grating or cracking feeling? Another test is how wide you can open without pain. If there is no structural problem within the TMJ, you should be able to open approximately 50 mm, which means you should be able to fit three fingers in between the upper and lower front teeth without hurting. If you hear a clicking or pooping sound when you perform this exercise, it’s a warning that you have TMD. A normal TMJ is noiseless and painless.
Treatment of TM Dysfunction
Internal Derangement of TMJ (Intracapsular).
The clinical signs would be clicking or popping noise when you open or close. The cause is an anteriorly displaced disc. When you open, the condyle moves forward on to the anteriorly displaced disc causing the clicking noise. The cause of the problem is that the lower jaw is located too far back when you bite on the back teeth. The solution is to use a lower repositioning indexed splint to be worn during the daytime to move the lower jaw forward.
External Derangement (Extracapsular).
Extracapsular problems can be caused by occlusal interferences or parafunctional habits such as clenching or bruxing. The solution is to wear an upper appliance called an anterior deprogrammer at night to help to eliminate the parafunctional habits. Anterior deprogrammer prevents posterior teeth from occluding. This helps prevent the clenching and grinding at night as well as the headaches upon awakening.
What happens if you don’t get treatment?
Unfortunately, TM dysfunction isn’t a disorder that can be ignored. Without treatment, you may begin to notice more grinding/ clenching of your teeth, more headaches, neck problems and facial or ear pain. For your own good, please don’t delay. The sooner you get help; the least expensive treatment will be for you – not to mention how your health will improve. Forty million people in North America suffer from symptoms of TMD. That’s why the goal of treatment is to alleviate symptoms and make you more functional at this same time!