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TMD: Tempromandibular Disorder

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What is a TMD?

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TMD, or temporomandibular disorder, is often referred to as TMJ syndrome. This term refers to any pain, discomfort, dysfunction, or tension related to the jaw. According to the American Academy of Craniofacial Pain, TMDs are a group of maladies that can affect the temporomandibular joints and the associated muscles of the jaw, face, and neck. It may also include related neurological and vascular structures.

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What is the tempromandibular joint (TMJ)?

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The temporomandibular joint connects the mandible (lower jawbone) to the skull temporal bones in front of the ear. Within the joint formed by these two bones, there is a tiny disc of cartilage. The masseter and temporal muscles provide power to the joint, making it one of the most used joints in the body. The temporomandibular joint is very complex. It needs to move up and down, forward and back, and side to side to allow us to speak, chew, and yawn. It also has to be versatile enough to make the subtle movements required for speech as well as being able to open very wide and to generate enough force to deal with tough, hard to chew foods

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What are the

symptoms of a TMD?

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The symptoms of a TMD can include:

Jaw and facial pain, tension, and stiffness
Pain and tension that radiates into the neck, shoulders, and upper body
Earache
Hearing difficulties
Tinnitus (ringing in the ears)
Headaches

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Toothaches
Clicking or grating sounds when opening the mouth, yawning, or chewing
Clenching and grinding of teeth
Difficulty opening the mouth wide or yawning
Difficulty chewing
Locking open of the jaw
Dizziness

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What are

contributing factors?

The causes of temporomandibular disorders can be hard to pinpoint because a number of factors may be contributing. Anything that affects the functionality or structure of the temporomandibular joint can lead to dysfunction, pain, tension, and a wide range of other symptoms. These factors may be a combination of:

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Genetics
Epigenetic changes
Trauma
Age-related degeneration
Autoimmune conditions such as arthritis and rheumatoid arthritis
Nutritional and dietary issues
Chronic stress
Postural and structural issues
Tongue-tie

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Teeth clenching and grinding or bruxism
Improper chewing or swallowing patterns
Incorrect tongue resting posture and mouth breathing
Malocclusion or poorly aligned teeth
Persistently sleeping on one side
Oral Habits
Certain medications
Sleep-disordered breathing

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How are TMDs

treated?

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Many symptoms of TMJ disorders can respond well to home remedies such as:

Ice or cold packs to the area of the joint
Over-the-counter (OTC) nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen (Advil, Motrin) or naproxen (Aleve), and other pain relievers, including aspirin (Ecotrin) and acetaminophen (Tylenol)
Eating soft foods and avoiding chewing gum
Massage or gentle self-stretching of the jaw and neck muscles
Relaxation techniques and stress management and stress reduction
Some sedative essential oils (such as lavender, chamomile, sweet marjoram, and clary sage) may provide temporary relief from the pain and discomfort of TMJ.

When home remedies are not effective, medical treatment options may be necessary. These most common treatments include the following:

A dental splint (occlusal splint or stabilization splint or bite guard), which is a dental appliance placed in the mouth that keeps the teeth in alignment and prevents tooth grinding.
A medical professional may use Botox to relax the muscles of the jaw.
Physical therapy with jaw exercises can strengthen muscles, improve flexibility, and range of motion.
Behavioral management (biofeedback, cognitive-behavioral therapy)
Acupuncture
Prescription strength medications.
In severe cases, surgery on the jaw or dental surgery may be necessary.

How can

myofunctional therapy

help treat TMD?

Myofunctional therapy can strengthen and retrain oral and facial muscles to treat oral myofunctional dysfunction. It can also correct dysfunctional swallowing and chewing patterns, restore nasal breathing, and get the tongue to rest in the correct place.

As this study from Brazil shows, myofunctional therapy can make a significant difference in the treatment of TMDs, helping to restore the temporomandibular joint to correct functionality and reduce pain. The study indicated improvements in pain levels, increased mandibular range of motion, and a reduction in related signs and symptoms.

The contributing factors involved can be so complex, managing and treating TMJ pain and other TMD symptoms often requires a skilled multi-disciplinary team. A good myofunctional therapist can also help find the right doctor, dentist, orthodontist, or bodyworker for patients with TMJ-related issues depending on their individual needs.

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References

https://www.aacfp.org/

https://www.researchgate.net/publication/47631841_Effects_of_Orofacial_Myofunctional_Therapy_on_Temporomandibular_Disorders

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