TMJ Dysfunction

Used about 2,000 times each day during talking, chewing, swallowing, yawning, and snoring the temporal mandibular joint, or TMJ, is the most used joint in the body. Dysfunction in this joint can affect our daily habits from the food we eat to suffering from pain and tension. The TMJ is the joint just in front of our ears that allows our jaws to open and close. Normally we should be able to fit 3 of our own fingers vertically between the teeth when the mouth is opened as well as move the bottom row of teeth in front of and behind the top row with out any pain, clicking, or discomfort.

TMJ malposition can cause the cartilage disks that pad the TMJ to become worn or displaced, causing painful grinding of the jaw bone. Symptoms of TMJ Dysfunction (TMD) can appear gradually or suddenly. Sometimes disorders of the TMJ can be disguised as neck pain. The reverse can be true in situations where the jaw is painful, but the problem is rooted in the upper neck. Some of the signs of TMJ problems may include:

pain radiating to the face, neck, or shoulders
suboccipital muscle spasms
loss of motion or jaw locking
painful clicking or grating when opening or closing the mouth
a change in your bite
headaches, earaches, dizziness, hearing problems or difficulty swallowing
ringing in the ear or ear pain

TMJ symptoms are usually caused or triggered by the jaw being incorrectly aligned, overused, or traumatized in someway. Misalignment of the TMJ can be from the teeth needing to be physically aligned or from the joint needing to be functionally aligned. Ill-fitting braces, crowns, or dentures can lead to a poor occlusion of the teeth that can cause chronic strain or sprain. Either the teeth or the joint can be the cause to the problem. Usually both need to be checked by the time the patient has symptoms.

Subtle repeated traumas trigger TMD. When a patient has healthy dental occlusion and muscle and jaw function, overuse does not cause TMD. Stress and tension can awaken a quiet, asymptomatic TMJ or aggravate an existing temporomandibular condition. These cumulative stresses over time lead to the cartilage wear and tear. This wear and tear allows for dislocation of the joint indicated by popping and cracking when the jaw is opened or closed. This may negatively affect the jaw, face, and neck.

Trauma can lead to the rapid onset of symptoms. Major dental work, such as installing braces or a crown, where the mouth is open for a long period of time may cause the jaw to come out of its normal alignment, resulting in TMJ syndrome. Most dentists are sensitive to this and allow patient to take breaks if necessary. In infants, birth trauma can lead to a misaligned jaw. Arthritis can form in the joint after trauma and cause uncomfortable inflammation of the TMJ, adjoining tissues, ligaments and muscles. Sometimes the trauma that causes the TMD is unknown

Treatment Options
A thorough exam by your doctor (dental, chiropractic, or medical) is critical to determine the source of pain. Traditional dental or medical approaches to treat TMD include using muscle relaxants, anti-inflammatories, painkillers, bite plate, surgery, night guards or physical therapy. Chiropractors check to make sure the TMJ and neck are properly aligned so the jaw can heal and function properly as well as use physical therapy. Chiropractors usually work along side your dentist if there is need for teeth alignment or your medical doctor if medications are necessary.

Part of the healing process is breaking some bad tension-related habits such as clenching your jaw, grinding your teeth, or chewing on your lip. Maintaining good jaw posture can help. Keep your jaw muscles relaxed with the teeth slightly apart, the tongue lightly touching the roof of your mouth and resting directly behind your upper teeth. Eating soft foods, cutting food into small pieces, avoiding sticky or chewy food, and avoiding gum will minimize muscle use and may help alleviate pain until you are properly checked.

My philosophy, as is many other physicians, is to work least invasive to most invasive procedures. Chiropractic care has shown to be a safe and effective way of returning function to the TMJ. The best place to start is getting your TMJ evaluated by a chiropractor who will work along side your dentist before referring a patient for more invasive medical procedures.

By: Jill Aardema D.C.