TMJD Basics – From The TMJ Association
What Are Temporomandibular Disorders?
Temporomandibular Disorders (TMJD), commonly called TMJ, are a complex and poorly understood set of conditions characterized by pain in the jaw joint and surrounding tissues and limitation in jaw movements. Injury and other conditions that routinely affect other joints in the body, such as arthritis, also affect the temporomandibular joint. One or both joints may be involved and depending on the severity, can affect a person’s ability to speak, eat, chew, swallow, make facial expressions, and even breathe.
Also included under the heading of TMJD are conditions involving the jaw muscles. These may accompany the jaw joint problems or occur independently. They are often confused with jaw joint problems because they produce similar signs and symptoms.
Comorbid (Overlapping) Conditions
Researchers have found that temporomandibular disorders often occur along with other – often painful- conditions in other parts of the body, prompting studies in search of a common factor underlying them all. Among these conditions are chronic fatigue syndrome, chronic headache, endometriosis, fibromyalgia, interstitial cystitis, irritable bowel syndrome, sleep disorders, and vulvodynia. Moreover, certain medical conditions such as Ehlers-Danlose syndrome, dystonia, Lyme disease, and scleroderma may affect the temporomandibular joint.
Who is Affected?
Approximately 35 million people in the United States suffer from TMJ problems at any given time. While both men and women experience these disorders, the majority of those seeking treatment are women in their childbearing years. The ratio of women to men increases with the severity of symptoms, approaching 9 to 1 for patient with major limitations in jaw movements and chronic, unrelenting pain.
Although the cause of most of these disorders is not known, there are some known contributing factors to the development of these disorders.
Among them are:
• autoimmune diseases
• injuries to the jaw area
• dental procedures
• stretching of the jaw as occurs with inserting a breathing tube before surgery
• various forms of arthritis
Genetic, hormonal, and environmental factors can also increase the risk for TMJD. Studies have shown that a particular gene variant increases sensitivity to pain and this variant has been found to be more prevalent among TMJD patients than among the populations at large. The observation that TMJD are commonly found in women in their childbearing years has also led to research to determine the role of female sex hormones in these disorders. Environmental factors such as habitual gum chewing or sustained jaw positions may also contribute to TMJD.
Diagnosis of TMJ Disorders
At present, there is no widely accepted, standard diagnostic test to identify all TMJD. Because the exact cause and symptoms are not clear, identifying these disorders can be difficult and confusing. The American Association for Dental Research recommends that a diagnosis of TMJD or related orofacial pain conditions should be based primarily on information obtained from the patient’s history and a clinical examination of the head and neck.
In addition to a detailed history and a careful clinical examination, imaging studies of the teeth and jaws may sometimes be helpful as a diagnostic tool. These include: routine dental x-rays and panoramic radiographs, computed tomography (CT or CAT scan), Magnetic Resonance Imaging (MRI), and Scintigraphy (Bone scan).
Blood tests are sometimes recommended to rule out possible medical conditions as a cause of the problem.
Before undergoing any costly diagnostic test, it is always wise to get an independent opinion from another health care provider of your choice and one not associated with your current provider.
Symptoms of TMJ Disorders
The Pain of TMJD is often described as a dull, aching pain which comes and goes in the jaw joint and nearby areas. Some people, however, report no pain, but still have problems using their jaws.
Symptoms can include:
• pain in the jaw muscles
• pain in the neck and shoulders
• chronic headaches
• jaw muscle stiffness
• limited movement or locking of the jaw
• ear pain, pressure
• painful clicking, popping or grating in the jaw joint when opening or closing the mouth
• a bite that feels “off”
Less common symptoms include: ringing in the ears (tinnitus), dizziness, and vision problems.