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Symptoms | Causes | How Diagnosed | Treatment | FAQ

Temporomandibular Joint Disorder (TMD) is a collective term referring to a number of clinical problems involving the Temorormandibular Joints (TMJ's) and associated muscles and structures of the areas.

TMD is though to be fairly common as several researchers have found clicking and popping noises in the jaw joints to be present in 40-60% of the general population. Considering that normal healthy TMJ's are completely silent at all times, the 40-60% figure is a rather staggering one to consider. The good news is that TMD symptoms are quite variable in nature, with most being a mild annoyance. However, a small percentage of patients with TMD have symptoms which degenerate into crippling chronic pain and limited jaw mobility. A recent National Institute of Health study indicates that over nine million Americans suffer from TMJ pain on regular basis.

Symptoms

• Pain about the face, head and neck regions
• Clicking, popping, and or grating noises in the jaw joints
• A limited ability to open the mouth wide or move it side-to-side
• Frequent headaches, often around the temple area
• Earaches, buzzing, or ringing noises in the ears
• Deep pain in the jaw joint itself
• Soreness or pain in the cheek area
• "Sticking" or "catching" or "locking up" of the jaw
• A sudden inability to find a comfortable bite position

Causes

Click on each subject

Long-term strain

Long-term strain on the TMJ's caused by a sleep pattern of chronic grinding and/or clenching of the teeth (bruxism). This may lead to permanent damage to the teeth and TMJ's themselves
Certain types of malocclusion (bad bites)
Certain types of malocclusion (bad bites) can chronically overstress the TMJs and related structures every time the individual chews. This in turn can lead to TM joint damage.
Trauma
Accidents involving direct or indirect trauma to the head, face, and/or neck may lead to partial or total TMJ disc dislocation, stretched or torn TMJ ligaments, and impaired joint function.
Extensive Dental Procedures

Extensive dental procedures which have overstressed the muscles, joints, ligament inflammation or damage. This in turn could lead to muscle spasms and/or TMJ disc dislocation.
General anesthesia procedures

General anesthesia intubations which strain weak TM joints or damage healthy TM joints by overextending the joint while the patient is asleep.
Arthritis

Arthritis of the TMJ's particularly in patients which TM disc dislocations.
Systemic Diseases

Systemic diseases such as gout, lupus, scleroderma, and fibromyalgia may also contribute to TML - like symptoms or problems.
Growth disturbances

Growth and / or developmental disturbances of the structures of the face and TM joints may cause malformation of the TM joint structures and than thus dysfunction.
Other causes
Some other reasons for TMJ are less identifiable and may result from a combination of small events such as lying against a partially strained or damaged (but previously asymptomatic) TMJ while sleeping.
Other reasons include irritability of facial muscles due to an inadequate diet, muscle tension due to caffeine, nicotine, and sugar. Lastly, studies have also shown a link between stress and the frequency of teeth grinding at night. This chronic and prolonged nightly activity ultimately damages the TM joints or impair the body's ability to heal a damaged joint.

How Diagnosed

The first step in the management of TMJ disorders is to determine that the concern is not another type of medical or dental problem behaving as if it were a TMJ problem. This determination is made following an initial TMJ Screening Visit that includes the completion of a thorough TMJ history form, screening x-rays of the teeth and jaw joints and a preliminary clinical examination of the jaw joints, muscle system, bite, and teeth. We also advise patients to seek a concurrent proper medical exam from a medical doctor (ideally an ENT) to rule out the presence of medical problems which ar occurring in combination with or disguising themselves as TMJ problems.

Following a TMJ Screening Examination, a preliminary diagnosis can be rendered. If the preliminary diagnosis is TMJ disorder, then further test will be indicated to identify the exact nature to assist in developing a treatment strategy.

Treatment

Initial treatment for TMJ disorder can range from resting the joints, switching to a soft diet and prescribed medication to stabilization of the joints through the use of a specially designed and custom adjusted hard acrylic orthotic appliance that fits on top of the teeth. This appliance, when properly designed, redistributes the stresses on the TMJ's and muscle system while specifically guarding and guiding certain joint movements.

FAQ

How long until I see results from treatment?
Results will vary by individual, however approximately 95% of our patients will experience significant relief, within a treatment timeframe ranging from a few days to 6-8 weeks.
What happens to the 5% of patients who are not successfully treated via professionally designed and maintained orthotic appliances?
These patients are typically sent to one of the few highly trained and experienced TMJ surgical specialists in the world. Dr.Mark Piper in St.Petersburg, Florida. Dr.Piper evaluates each patient for the value of surgical interventions. To learn more about Dr.Piper and TMJ, you can visit his website at : www.piperclinic.com.

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