Temporomandibular Disorders (TMD) are a complex and poorly understood set of conditions characterized by pain in the jaw joint and surrounding tissues and limitation in jaw movements. Injuries 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, chew, swallow, make facial expressions, and even breathe. Also included under the heading of TMD are disorders involving the jaw muscles. These may accompany the jaw joint problems or occur independently. Scientists have found that most patients with TMD also experience painful conditions in other parts of the body. These comorbid conditions include chronic fatigue syndrome, chronic headache, endometriosis, fibromyalgia, interstitial cystitis, irritable bowel syndrome, low back pain, sleep disorders, and vulvodynia. They are considered comorbid because they occur together more often than chance can explain. In addition, the conditions share other features. These findings are stimulating research into common mechanisms underlying all of these comorbid conditions.
What Causes TMD?
Adding to the complexity of TMD is that there can be multiple causes as well as cases where no obvious cause can be found. Some known causes are the following:
- autoimmune diseases (in which the body’s
- immune cells attack healthy tissue)
- injuries in the jaw area
- dental procedures (even prolonged mouth opening)
- insertion of a breathing tube before surgery
- various forms of arthritis
Additionally, there are genetic, hormonal, and environmental factors that can increase the risk for TMD. Studies have shown that a particular gene variant increases sensitivity to pain, and this variant has been found to be more prevalent among TMD patients than among the population at large. The observation that jaw problems are commonly found in women in the childbearing years has also led to research to determine the role of female sex hormones, particularly estrogen, in TMD. Environmental factors such as habitual gum chewing or sustained jaw positions, such as resting a phone on yournshoulder, may also contribute to TMD. Singers and musicians, such as violinists, may also be susceptible to TMD due to jaw stretching or positioning the head and neck to hold the instrument.
The pain of TM disorders is often described as a dull, aching pain, which comes and goes in the jaw joint and nearby areas. However, some people report no pain but still have problems moving their jaws. Symptoms may include the following:
- 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, fullness, ringing in the ears (tinnitus)
- painful clicking, popping or grating in the
- jaw joint when opening or closing the mouth
- a bite that feels “off”
- vision problems
Keep in mind that occasional clicking or discomfort in the jaw joint or chewing muscles is common and is not always a cause for concern. Often, the problem goes away on its own in several weeks to months. However, if the pain is severe and lasts more than a few weeks, consult with your health care provider for a formal diagnosis. Once you've received a formal diagnosis make mention to your Neuromuscular Dentist the benefits of Bodywork and IntraOral Neuromscular Therapy which can be a profoundly effective treatment for TMD.