How TMD Affects the Individual
Temporomandibular joint disorder (TMD) is a common condition impacting the lives of millions of people. The temporomandibular joint (TMJ) is the hinge and sliding-action joint positioned on each side of the head, attaching the mandible (lower jaw bone) to the temporal bone of the skull and allowing for its movement. As the most extensively engaged joint in the human body, the TMJ is responsible for assisting a number of vital daily actions, such as eating, swallowing, speaking, yawning, sneezing and coughing – essentially any activity that involves movement in and around the mouth. Because of its role in performing these actions, the TMJ is in a precarious position to become overused or even damaged from a number of biological and environmental factors. TMD is a result of such factors, and is identified as a collection of conditions affecting the jaw joint(s) and surrounding muscle tissue.
The Impact of TMD Symptoms
While the exact cause of TMD is not quite understood, a number of triggers have been recognized. Jaw alignment, tooth positioning, bruxism (teeth grinding and clenching habits), autoimmune dysfunction, arthritis and parafunctional habits such as excessive gum chewing are all contributors to TMD, as are environmental influences like stress, anxiety, anger, frustration and trauma or injury to the face, head or jaw. Even sleep apnea exhibits a relationship with TMJ problems, as those with TMD often suffer from the sleep disorder as well. Part of addressing TMD is identifying the symptoms of the condition. Consider the following information concerning TMD symptoms.
Pain/Tenderness
When the muscles and facial tissue surrounding the TMJ become inflamed or injured, pain and tenderness often result. This discomfort can be felt in many areas, from the teeth, ears, head and neck to the back, arms and hands. Pain and tenderness may be felt when movement of the lower jaw is required, in a spontaneous nature or in a constant, dull pattern. TMD symptoms like pain and tenderness can be debilitating for a patient, depending on the severity and tolerance of the individual. Popping, clicking and grinding of the TMJ may induce discomfort in some patients.
Limited Mouth Expansion
When the jaw joint becomes damaged or the surrounding muscles inflamed, the ability to open and close the mouth fully may become impaired. A cartilaginous disc separates the bones within the jaw joint, providing a cushion for and protection of the bone structure when the joint is engaged. Degeneration or other form of damage to this disc may affect the ability of the jaw joint to function properly, often impacting the degree of mouth expansion. Painful, inflamed muscles surrounding the TMJ can also impede full expansion of the mouth, making talking, yawning and eating difficult for the individual.
Locked Jaws
Jaws that become “locked” may be the result of a problem within the jaw joint itself or the surrounding muscles and soft tissue. Muscle tissues may seize up, or “cramp,” preventing opening or closing of the mouth. Relief can often be achieved from the use of warm, moist compresses. Another reason for locked jaws is when the lower jaw (mandible) becomes subluxed, or displaced from its socket. Full or partial dislocation of the jaw often requires treatment from a specialist who gently moves the lower jaw bone back into proper position.
Joint Clicking
Joint clicking, popping and grinding are common TMD symptoms. These sounds may occur infrequently or nearly every time the mouth is opened or closed. Several factors can lead up to the incidence of joint clicking, such as bruxism, overuse of the TMJ or jaw injury, among others. However, the noise itself is the result of the disc lying within the joint popping in and out of place when opening or closing the mouth, or gas bubbles popping in the fluid within the joint in response to some activity.
Difficulty Chewing
TMD sufferers may have minor to serious difficulty chewing, depending on the severity of the condition. Jaw and facial muscle inflammation associated with the joint condition can make masticating food difficult and painful. Muscles may become fatigued easily, further lending to problems with chewing. The joint itself may present problems with the chewing function, particularly if the bone, cartilage disc or supporting ligaments suffer acute or chronic damage.
Bite Discomfort
Biting function depends largely on the ability of the TMJ to operate efficiently. When TMD is present, the action may become difficult for the patient due to inflamed or stiff jaw and facial muscles, dislocation of the joint disc or displacement of the lower jaw itself. When the lower jaw bone slides in and out of proper positioning, the teeth may not meet properly upon closing, placing undue stress on certain areas of the mouth. Such a result further impacts the bite, often causing discomfort that occurs while eating and potentially even some time after. Bite problems can lead to TMD, and conversely, TMD can lead to bite problems.
Toothaches
Jaw pain and associated discomfort can give way to toothaches in a number of ways. Teeth grinding or clenching resulting from TMD stresses the tooth structure repeatedly, causing the sensation of a toothache in one or more locations. During these bruxism habits, the teeth, gums and underlying bone may become sore or bruised due to repeated grinding or clenching. Displacement of the lower jaw upon closing may cause the teeth to bite together improperly, an action that can also lead to tooth pain. TMJ-related toothaches may be more difficult to pinpoint to an exact area, and are often localized to a certain section of the mouth rather than a specific tooth. In the absence of any decay or damage to the teeth or their supporting structures, a toothache may be secondary to the condition of TMD.
Head/Neck Aches
Headaches, especially those chronic in nature, are often one of the prominent TMD symptoms. In general, headaches can be caused by any number of things, but a jaw joint that is not functioning properly or jaw muscles responding to TMJ issues often result in this common symptom. TMD-induced headaches are typically experienced behind the eyes or on either side of the head. Strain on the joint and surrounding tissues resulting from TMD often induce pain in the neck area, particularly the back portion where it meets the bottom of the skull. TMJ-related headaches and neck pain are often mistaken as tension headaches due to the location of the pain.
Upper Shoulder Pain
Some individuals are surprised to learn that the cause of their upper shoulder pain is TMJ-related. When strain or stress is placed on the jaw joint, the surrounding muscles and tissues respond in a painful, tense or stiff way. Many of the muscles supporting the head and neck originate in the upper shoulder and back area. While an off-balanced jaw or impaired biting function involves the facial and jaw muscles in the short-term, long-term strain trickles down into the neck and shoulder area, relying on these muscle groups to help disperse the repeated stress.
Dizziness
Lesser known of the TMD symptoms, dizziness is a TMJ-related issue for some individuals. The proximity of the jaw joint to the ear is the connection between this surprising symptom and TMJ problems. The inner ear controls a person’s balance, and when nearby muscles are firing in a spastic nature in response to stressful stimuli (especially on a repeat basis), the mechanism that helps maintain balance is thrown off, allowing dizziness to occur.
Earaches
Increased pressure from the nearby jaw joint along with strained muscles can lead to acute or chronic earaches. In some cases, pain is referred from the inflamed, injured muscles surrounding the TMJ to the ear area, rather than coming from the ear itself. In either case, the source of the pain is originating in or around the TMJ and is adversely affecting the delicate tissues of the ear canal and other auditory structures. Oral conditions such as bite problems and misalignment of the jaw that lead to TMD are common causes of ear pain and discomfort.
Hearing Problems
Those suffering from TMJ-related issues are at risk of experiencing hearing problems. When tissue around the ear becomes inflamed due to the effects of TMD, auditory functions may become impaired. Tissue blockage of the ear canal resulting from jaw joint problems leads to difficulty hearing and even hearing loss, in some cases. Typically a long-term effect, hearing problems caused by TMD often resolve once the condition is treated and tissue inflammation reduced or eliminated. Pain often accompanies hearing loss due to TMD.
Ringing in the Ears
The effects of jaw joint problems along with chronic TMD symptoms may cause a ringing sensation, or tinnitus, in the ears. Muscles within the ear are affected by the tension or inflammation of tissues surrounding the jaw joint, and become strained themselves when bruxism (a leading contributor to TMD) or biting problems occur. The major nerve responsible for assisting in jaw joint function also innervates the ear muscles, further lending to ringing in the ear and other ear dysfunction in conjunction with TMD.
Treatment Protocols for TMD Symptoms
When it comes to addressing TMD symptoms and treating the causes of the condition, a progression of solutions may be presented and effected. Efforts are often palliative at first, especially if TMD is on the mild side, and become less conservative the more complex the condition is. Treatment protocols for addressing TMD symptoms and the condition itself include the following:
- Warm, moist compress and/or ice application
- Anti-inflammatory or sedative medications
- Soft food dietary recommendations
- Avoidance of gum chewing or other excessive chewing
- Night-guard or similar occlusal splint
- Dental or orthodontic treatment to correct oral issues
- Injectables, such as steroids or Botox®
- Jaw joint surgery or replacement
One or more of these treatments may be recommended, with jaw joint surgery or replacement of the joint with an implant reserved as a last resort.
Receiving a TMD Diagnosis
Living with TMD symptoms can be life-altering, from suffering jaw and facial pain to experiencing debilitating hearing loss and dizziness. Any symptoms of jaw joint issues should be evaluated by a dentist or TMJ specialist to determine if TMD is present. Contact your dentist today for a consultation if your quality of life or health are being affected by TMD symptoms.