If you have chronic jaw pain, you may be one of an estimated 10 million Americans suffering from temporomandibular joint disorders (TMD). If so, it's quite possible you're also coping with other health conditions.
TMD is an umbrella term for disorders affecting the temporomandibular (jaw) joints, muscles and adjoining tissues. The most common symptoms are limited jaw function and severe pain. Determining the causes for these disorders can be difficult, but trauma, bite or dental problems, stress and teeth clenching habits seem to be the top factors. Women of childbearing age are most susceptible to these disorders.
In recent years we've also learned that many people with TMD also experience other conditions. In a recent survey of TMD patients, two-thirds reported having three or more other health conditions, the most frequent being fibromyalgia, chronic fatigue syndrome, rheumatoid arthritis or chronic headaches. Researchers are actively exploring if any systemic connections exist between TMD and these other conditions, and how these connections might affect treatment changes and advances for all of them including TMD.
In the meantime, there remain two basic approaches for treating TMD symptoms. The most aggressive and invasive approach is to surgically correct perceived defects in the jaw structure. Unfortunately, the results from this approach have been mixed in their effectiveness, with some patients even reporting worse symptoms afterward.
The more conservative approach is to treat TMD orthopedically, like other joint problems. These less invasive techniques include the use of moist heat or ice to reduce swelling, physical therapy and medication to relieve pain or reduce muscle spasming. Patients are also encouraged to adopt softer diets with foods that are easier to chew. And dentists can also provide custom-fitted bite guards to help ease the stress on the joints and muscles as well as reduce any teeth grinding habits.
As we learn more about TMD and its relationship to other health conditions, we hope to improve diagnosis and treatment. Until then, most dentists and physicians recommend TMD patients try the more conservative treatments first, and only consider surgery if this proves unsatisfactory. It may take some trial and error, but there are ways now to ease the discomfort of TMD.
If you would like more information on the causes and treatments of TMD, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “Chronic Jaw Pain and Associated Conditions.”
Your temporomandibular joints (TMJ), located where your lower jaw meets the skull, play an essential role in nearly every mouth function. It’s nearly impossible to eat or speak without them.
Likewise, jaw joint disorders (temporomandibular joint disorders or TMD) can make your life miserable. Not only can you experience extreme discomfort or pain, your ability to eat certain foods or speak clearly could be impaired.
But don’t assume you have TMD if you have these and other symptoms — there are other conditions with similar symptoms. You’ll need a definitive diagnosis of TMD from a qualified physician or dentist, particularly one who’s completed post-graduate programs in Oral Medicine or Orofacial Pain, before considering treatment.
If you are diagnosed with TMD, you may then face treatment choices that emanate from one of two models: one is an older dental model based on theories that the joint and muscle dysfunction is mainly caused by poor bites or other dental problems. This model encourages treatments like orthodontically moving teeth, crowning problem teeth or adjusting bites by grinding down tooth surfaces.
A newer treatment model, though, has supplanted this older one and is now practiced by the majority of dentists. This is a medical model that views TMJs like any other joint in the body, and thus subject to the same sort of orthopedic problems found elsewhere: sore muscles, inflamed joints, strained tendons and ligaments, and disk problems. Treatments tend to be less invasive or irreversible than those from the dental model.
The newer model encourages treatments like physical therapy, medication, occlusive guards or stress management. The American Association of Dental Research (AADR) in fact recommends that TMD patients begin their treatment from the medical model rather than the dental one, unless there are indications to the contrary. Many studies have concluded that a majority of patients gain significant relief with these types of therapies.
If a physician or dentist recommends more invasive treatment, particularly surgery, consider seeking a second opinion. Unlike the therapies mentioned above, surgical treatments have a spotty record when it comes to effectiveness — some patients even report their conditions worsening afterward. Try the less-invasive approach first — you may find improvement in your symptoms and quality of life.
If you would like more information on treating TMD, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “Seeking Relief from TMD.”