Temporomandibular Joint Dysfunction (TMD)

Temporomandibular Joint Dysfunction (TMD) is a silent disorder that affects the proper functioning of the mandible.

In order to guarantee a successful recovery, it is vital that individuals suffering from TMD receive medical attention from specialists in temporomandibular disorders.

Contact Grupo Gil to receive a diagnosis and effective treatment for your TMD.

What is temporomandibular joint dysfunction?

TMD, also known as temporomandibular joint dysfunction or Costen Syndrome, is a disorder that affects the temporomandibular joint that is responsible for jaw function and movement. 

It is located in front of the ear on both sides of the head. Its function is to permit proper use of the mouth – opening, closing, chewing and speaking.

The temporomandibular joint involves several anatomic structures of the stomatognathic system. If it is not functioning correctly, the person will have bothersome symptoms that will affect their quality of life.

Symptoms of temporomandibular joint dysfunction

According to the American Academy of Orofacial Pain and the NIH, temporomandibular joint dysfunction encompasses over 30 pain producing conditions, including dysfunction of the mandibular joint and the muscles that control jaw movement. 

Therefore, when analyzing a patient’s symptoms, it is necessary to first identify which type of TMD the patient presents and then review the complete symptomology. 

The types of TMD are:

  • Joint disorders, including those of the articular disc.
  • Disorders of the muscles of mastication.
  • Headaches associated with TMD.

How do I know if I have temporomandibular joint problems?

Symptoms may include:

  • Pain on both sides of the jaw.
  • Mild or severe bruxism.
  • Headaches or migraines.
  • Neck pain.
  • Earaches or ear pain.
  • Buzzing in the ears.
  • Difficulty moving the jaw.
  • Rigidity in the jaw.
  • Clicking or popping sounds when moving the jaw.
  • Malocclusion or bite problems.
  • Muscular spasms in the jaw area.

Causes

Temporomandibular joint dysfunction can be caused by a number of things:

  • Trauma such as a blow to the jaw or head or a sharp, prolonged stretching of the jaw.
  • Jaw clenching or teeth grinding.
  • Frequent nail biting.
  • Chewing gum for extended periods of time.
  • A misaligned bite or malocclusion.
  • Emotional or physical stress.
  • Anxiety or depression.
  • Medication that affects brain and muscular functions.
  • Arthritis.
  • Costen Syndrome diagnosis. This disorder causes pain and restricted movement of the maxillary joint and its surrounding muscles. 

It is important to mention that in the majority of cases, it is a combination of factors that provoke the onset of TMD. Therefore, intervention by a specialist in this disorder is critical in order to determine the direct and indirect causes.

Risk factors

If the symptoms of TMD are not treated in a timely fashion, the patient can experience chronic orofacial pain that can impede normal movement of the jaw. 

Lack of treatment can aggravate other symptoms as well. These include headaches, locking of the jaw and persistent migraines. 

Factors that increase the risk of developing TMD include daily habits, medical conditions and emotional factors. The most common of these include:  

  • Unhealthy habits. Frequent clenching and relaxing of the jaw, grinding your teeth while asleep, chewing ice or gum for prolonged periods of time.
  • Medical conditions. Some medical conditions can increase the risk of developing TMD. These include:
    • Jaw or facial deformities.
    • Malocclusion or bite issues.
    • Degenerative joint diseases (such as osteoarthritis and rheumatoid arthritis).
    • Inflammation of the temporomandibular joint (more commonly known as synovitis).
    • Jaw fractures or dislocations. 
  • Age. Individuals between 30 and 50 years of age are more likely to suffer from TMD. 
  • Sex. Women have a greater risk of developing TMD than men.
  • Dentures. Ill-fitting dentures or dentures that have worn out over time. 

For more information, we suggest you read the section on prevention of TMD in order to identify those habits that can improve the first symptoms and to prevent the development of this disorder in patients who suffer from other conditions such as bruxism.

Diagnosis

During the diagnosis, the specialist will conduct a detailed evaluation of your symptoms in order to determine the cause of your TMD as well as the ideal treatment for you. The diagnosis can be carried out in the following ways:

  • Medical history. Review of the patient’s physical, dental and psychological conditions.
  • Analysis of symptoms. This is carried out in order to detect conditions such as joint pain, limited movement, ear aches, pain when chewing, etc.
  • Physical examination. Examination beginning with the head and neck, mandible and mouth, and cranial nerves and muscles.
  • Additional tests. These can include X rays, computed tomography, magnetic resonance imaging, lab tests, diagnostic injections among other tests.

When should you consult your doctor?

It is time to consult a medical professional if the patient is suffering from recurrent symptoms such as jaw pain, frequent headaches, excessive bruxism, limited movement of the jaw or persistent migraine headaches. If these symptoms are present, the patient should be evaluated by a specialist in orofacial pain in order to receive the appropriate treatment.

Schedule a consultation with our orofacial pain specialist now! 

Treatment

The treatment recommended to improve the symptoms of TMD is based on alleviating pain, improving jaw function and reducing the negative impact this disorder has on your day to day life.

Because TMD can have several causes, it can be treated in the same way that other articular and muscular problems are treated. Distinct therapies can be used, including:

Non surgical treatments

This type of treatment is recommended for patients who require the use of dental appliances in order to improve jaw movement and to relieve pain and pressure in the jaw. 

This treatment can be used in conjunction with physical therapy and dental treatments. For example, in cases in which orofacial pain is present, a dentist who is specialized in orofacial pain is an excellent option for treating TMD.

Surgical treatments

If surgical intervention is necessary, the specialist will determine which type of treatment is needed according to the patient’s medical history. The specialist should also take other options into consideration and determine the benefits and risks of those options, among other factors.

Generally speaking, the treatment for TMD can also include medication as well as evaluations of the patient’s physical, physiological and emotional health in order to determine the cause of his pain. The treatment may also include alternative procedures such as:

  • Intraoral appliances.
  • Physical therapy.
  • Temporomandibular therapy.
  •  Muscle punctures.

How can your dentist help?

Because of his training in various areas of medicine including neurology, psychology, physiotherapy and orofacial pain, a dentist who is specialized in orofacial pain can treat patients with TMD.

Prognosis

Once a diagnosis has been made and adequate and timely treatment is received, the TMD patient should be given a favorable prognosis. 

It is important to mention that during the diagnosis phase, it is vital for the patient to complete all of the relevant checkups in order to determine the correct treatment. If not, it is likely that the symptoms will worsen over time. In the majority of cases, when patients with TMD receive treatment during the six months after symptoms first occur, they experience a higher treatment success rate.

Prevention

The following basic care measure are recommended in order to prevent symptoms of temporomandibular joint dysfunction:

  • Avoid hard food or food that is difficult to chew.
  • Avoid chewing gum.
  • Reduce stress levels.
  • Adopt techniques that alleviate muscular tension in the mandible.
  • Avoid falls or any injuries that may cause fractures or dislocations in the affected area.  
  • Improve your posture when sitting, especially when sitting for long periods of time.
  • Avoid clenching your teeth. If you suffer from bruxism, see a specialist in order to receive adequate treatment.
  • Use massage in order to mitigate discomfort.

Frequently asked questions regarding temporomandibular joint dysfunction (TMD)

Does bruxism cause problems related to TMD?

Yes. Although bruxism is not the only cause of temporomandibular problems, it is a risk factor for TMD. The pressure exerted on the TMJ causes the joint to malfunction which causes the symptoms to worsen. 

If I don’t correct my bite, can my TMJ become damaged?

If your TMD is caused by malocclusion, or bite problems, a specialist can determine which treatment will be most effective for you. It is important to point out, however, that there is no evidence to prove that correcting bite-related problems will improve TMD.

What happens if temporomandibular joint dysfunction is not treated?

If not treated, the patient will suffer symptoms such as pain when chewing, stiffness in the jaw, joint blocks, arthritis in the joint, chronic headaches, bite problems and other symptoms that can negatively affect the patient’s quality of life.

Can TMD cause permanent ear damage?

Due to the connection of the temporomandibular joint, the symptoms of TMD can cause discomfort in the ears. However, there is no evidence that TMD can cause damage to the ears. 

What happens if I don’t receive treatment for my TMD?

Without treatment, the patient will suffer chronic pain in the jaw area as well as other persistent symptoms such as headaches, jaw stiffness, buzzing and/or ringing in the ears and other adverse issues. 

If you are experiencing any of these symptoms, schedule an appointment at the Clinica Gil as soon as possible!

Written by: Grupo Gil Dental 

Reviewed by: Dr. Andrés Cervantes

Published on: 26 february, 2024