If you are reading this right now chances are that you were either told that you have “TMJ” or have heard about “TMJ” and think that it may be the cause of your problems. So what is TMJ? TMJ is actually an acronym for the name of the joint between your lower jaw (mandible) and your skull. TMJ is not a diagnosis. The term TMJ does not imply pathology or dysfunction. The term TMD (an acronym for temporomandibular dysfunction) is used when there is pain, and dysfunction of the TMJ and related structures. So, TMDs are a group of maladies which can affect the temporomandibular joints (TMJs), associated muscles of the jaw, face and neck, as well as neurological and vascular structures. Broadly speaking TMD is considered to be either extracapsular or intracapsular in nature. Examples of extracapsular TMDs are: protective co-contraction, myospasm, myositis, or muscle contracture of the muscles of mastication and associated muscle groups. Examples of intracapsular TMDs are: disc displacement, disc dislocation with or without reduction, adhesions, inflammation, and degenerative changes of the articulating surfaces. It is not uncommon for someone to have both extracapsular and intracapsular TMD at the same time.
Common signs and symptoms associated with TMD are as follows:
- Generalized facial pain
- Pain in front of the ear
- Facial muscle stiffness
- Ear symptoms such as: ringing, buzzing, congestion, and pain
- Neck and shoulder pain
- Jaw joint symptoms such as: clicking, grating noise, locking of the joint, limited jaw opening, and pain with function.
- Teeth don’t touch together when you bite
- worn teeth
- Grinding and/or clenching of the teeth.
Many of the patients we see for TMD report a long history of TMJ problems such as clicking or popping of the joint, yet other patients present with an acute onset of their problems often associated with a specific event. In either case, often these patients will end up with numerous visits to many different practitioners before finding their way to our office. Dr. Gold is a fellow of the American Academy of Craniofacial Pain and has specialized, advanced training in the diagnosis and treatment of the TMJs. If some or all from the above list of signs and symptoms of TMD describes you, and you are experiencing pain, dysfunction and a change in your quality of life, we encourage you to call our office. We will ask you some preliminary screening questions to determine if it would be beneficial for you to have a comprehensive history, examination, and consultation appointment with us.
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What treatment will I need?
Unfortunately, it is impossible to determine what treatment you may require without first gathering information from the comprehensive history, examination, and consultation, as well as diagnostic appointments. An accurate diagnosis is the first critical factor in receiving effective treatment. TMJ is not a diagnosis. Obtaining an accurate diagnosis and achieving successful treatment are dependent upon several factors.
These factors are:
- The patient providing an accurate medical history, dental history, and history of chief complaints.
- A thorough evaluation by the practitioner.
- The practitioner’s knowledge.
- The practitioner’s skill in providing treatment.
- The patient’s compliance with the treatment.
- Treatment needs are totally dependent upon the diagnosis.
Common treatments for TMD in our office are:
- Splint therapy (ARA/Centric relation appliances, stabilization appliances, muscle deprogramming appliances, NTI-tss appliances, etc.)
- Spray & Stretch - trigger point release therapy
- Therapeutic Ultrasound Therapy
- Neuromuscular microcurrent therapy
- Trigger point injections
- Therapeutic or diagnostic injections
- Unlocking of a closed lock jaw