What are temporomandibular disorders (TMDs)?

Temporomandibular disorders (TMD) is the name given to several problems with jaw movement and pain in and around the jaw joints .

You may also hear TMD called TMJ or TM problems.

The jaw joints, or temporomandibular (TM) joints, connect the lower jawbone (mandible) to the skull. These flexible joints are used more than any other joint in the body. They allow the jaw to open and close for talking, chewing, swallowing, yawning, and other movements.

Many people have problems with jaw movement and pain in and around the jaw joints at some time during their lives. These joint and muscle problems are complex. So finding the right diagnosis and treatment of TMD may take some time.

What are the symptoms?

Temporomandibular disorders (TMD) can affect the jaw and jaw joint as well as muscles in the face, shoulder, head, and neck . Common symptoms include joint pain, muscle pain, headaches, joint sounds, trouble with fully opening the mouth, and jaw locking.

In most cases, symptoms of TMD are mild and don't last long. They tend to come and go without getting worse and usually go away without a doctor's care.

Some people who have TMD develop long-lasting (chronic) symptoms. Chronic pain or difficulty moving the jaw may affect talking, eating, and swallowing. This may affect a person's overall sense of well-being.

What causes temporomandibular disorders?

The most common cause of TMD symptoms is muscle tension, often triggered by stress. When you are under stress, you may be in the habit of clenching or grinding your teeth. These habits can tire the jaw muscles and lead to a cycle of muscle spasm, tissue damage, pain, sore muscles, and more spasm.

TMD can start when there is a problem with the joint itself, such as:

• An injury to the joint or the tissues around it.
• Problems with how the joint is shaped.
• Joint diseases, such as osteoarthritis or rheumatoid arthritis.
• The articular disc that cushions the joint shifts out of place.

How is a temporomandibular disorder diagnosed?

Although there is no one way to identify a TMD, your doctor can most likely check your condition with a physical exam and by asking questions about your past health. In some cases, an X-ray, CT scan, or MRI is also used to check for bone or soft tissue problems related to symptoms of TMD.

How is it treated?

TMD symptoms usually go away without treatment. Simple home treatment can often relieve mild jaw pain. There are things you can do at first to reduce pain.

• Rest your jaw joint.
• Use medicines for a short time, to reduce swelling or relax muscles.
• Put either an ice pack or a warm, moist cloth on your jaw for 15 minutes several times a day if it makes your jaw feel better. Or you can switch back and forth between moist heat and cold. Gently open and close your mouth while you use the ice pack or heat.
• Eat soft foods. And avoid chewy foods and chewing gum.

Getting physical therapy and learning ways to reduce stress may also help to reduce pain and TM joint problems. Continue to use some of these methods over time to prevent and manage symptoms that might come back. If your pain is chronic or severe or is caused by problems with how the joint is shaped, your doctor may recommend other treatments.

Splints, also called bite plates, are a common dental treatment for TMDs. Splints are usually clear pieces of plastic that fit between the upper and lower teeth. They help reduce grinding and clenching. Splints are used for a short time so that they do not cause permanent changes in the teeth or jaw.

Before you try treatments such as surgery or reshaping or shaving down the teeth, think it over. These treatments cannot be reversed and can even damage the TM joint.

For most people, surgery is not used to treat TMDs. Surgery has few benefits, and there is the chance of causing more serious problems. You and your doctor can carefully weigh a decision to have surgery. Talking with another doctor to get a second opinion can also help you make your decision.

Chronic pain can lead to depression, anxiety, and other problems. If you have chronic pain, talk to your doctor about medicine and mental exercises to manage the pain. Give special attention to treating any related anxiety or depression.

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