TMJ Diseases & Disorders - Overview
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TMJDs Overview
- The Jaw Joint:
- "TMJ" stands for TemporoMandibular Joint, or the jaw joint. You have two TMJs, one in front of each ear, connecting the lower jaw bone (the mandible) to the skull. The joints allow movement up and down, side to side, and forward and back—all the mobility necessary for biting, chewing and swallowing food, for speaking and for making facial expressions.
- Temporomandibular Joint and Muscle Disorders:
- Temporomandibular Joint and Muscle Disorders (TMJDs), commonly called TMJ, are a collection of poorly understood conditions characterized by pain in the jaw and surrounding tissues and limitations in jaw movements. Injury and conditions that routinely affect other joints in the body, such as Arthritis, also affect the temporomandibular joint.
- Who is Affected by TMJDs?:
- Approximately 35 million people in the United States suffer from TMJ problems. While both men and women experience TMJ problems, the majority of those seeking treatment are women in their childbearing years.
- Causes:
- Not all causes are known. Some possible causes or contributing factors are injuries to the jaw area, various forms of Arthritis, dental procedures, genetics, hormones, low-level infections, auto-immune diseases, stretching of the jaw as occurs with inserting a breathing tube before surgery, and clenching or grinding of the teeth.
- Diagnosis:
- Diagnosing TMJDs can be difficult and confusing. For example, facial pain can be a symptom of many conditions, such as sinus or ear infections, decayed or abscessed teeth, various types of headache, and facial neuralgia (nerve-related facial pain).
At present, there is no widely accepted, standard test to correctly identify all TMJ conditions. In most cases, however, a complete evaluation, including a detailed medical history, the patient’s description of symptoms, and physical examination of the head, neck, face and jaw provide information useful for making a diagnosis.
Tests that are recommended are often intended to rule out other possible medical conditions. A diagnosis of TMJDs may be made only after every other possibility has been considered and eliminated. Many TMJ patients see multiple healthcare providers, such as primary care physicians, dentists, sleep specialists, ear, nose and throat specialists, neurologists, endocrinologists, rheumatologists, pain specialists, chiropractors, etc., in their search for answers.
Before undergoing any costly diagnostic test, it is always wise to get an independent opinion from another healthcare provider of your choice and one not associated with your current provider.
- Progression of TMJDs:
- Some TMJ problems improve on their own, without treatment, within weeks or months with simple home therapy. For others, symptoms worsen over time and develop into long-term, persistent and debilitating pain. Most people with TMJ problems have relatively mild or periodic symptoms.
- Symptoms:
- Pain is the most common symptom. TMJ pain is often described as a dull aching pain in the jaw joint and nearby areas, including the ear, which comes and goes. Some people, however, report no pain, but still have problems using their jaws. Other symptoms can include:
- pain in the neck and shoulders,
- headaches,
- jaw muscle stiffness,
- limited movement or locking of the jaw,
- painful clicking, popping or grating in the jaw joint when opening or closing the mouth,
- a change in the way the upper and lower teeth fit together or a bite that feels "off'
Additional symptoms may include: ringing in the ears, ear pain, decreased hearing, dizziness and vision problems.
Jaw noises unaccompanied by pain or decreased mobility do not mean you have a TMJ problem. Keep in mind that occasional discomfort in the jaw joint or chewing muscles is common, and is not always a cause for concern. Many people with certain TMJ problems get better without treatment. 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, see your healthcare provider.
- Overlapping Conditions:
- Millions of Americans suffer from chronic fatigue syndrome, endometriosis, fibromyalgia, interstitial cystitis, irritable bowel syndrome, temporomandibular joint and muscle disorders, and vulvodynia. Current research indicates that these conditions frequently coexist or 'overlap,' yet all of the disorders are poorly understood.
Research on the overlap of these conditions is in its infancy, so we don't know how/why they are connected. There are many unanswered questions. Some people suffer from two conditions, while others have three or more. In some cases, individuals suffer from one condition for many years before developing a second or third; in other cases, individuals experience symptoms of several conditions simultaneously.
- Treatment:
- Because most common jaw joint and muscle problems are temporary, lasting only weeks or months, simple care is all that is usually needed to relieve the discomfort. Self-care practices, for example, eating soft foods, applying ice or moist heat, and avoiding extreme jaw movements (such as wide yawning, loud singing, and gum chewing) are useful in easing symptoms.
Unfortunately, treatments are based largely on beliefs that are not grounded in thorough scientific research. As a result, some patients are made worse by these treatments.
- Insurance Coverage:
- Many medical and dental insurance plans do not pay for treatment of jaw joint and muscle disorders, or only pay for some procedures. Until the causes of the various TMJ diseases and disorders have been discovered, and quality science demonstrates that treatments are effective without causing harm, insurance companies will not recognize treatments that have questionable outcomes. Contact your insurance company to see which treatments are covered.
- Costs:
- There are no standardized costs for TMJ treatments.
- Can TMJDs be Prevented?:
- Patients who are told they should undergo treat-ment(s) to prevent the development of a TMJ problem should know that there is currently no evidence that such conditions can be prevented.