Temporomandibular Dysfunction (TMD) – What a mouthful!

The jaw is often thought of as a floating bone that seemingly functions perfectly well on its own… until it doesn’t. It could be a click when you are chewing, or pain on yawning, or even your jaw locking into place. Some people experience headache and neck pain from their jaw. It’s a joint like any other, formed of a synovial capsule with cartilage disc and strong ligaments and muscles that control its movement. However, there are inconsistent messages on treatment of TMD.

In my experience, patients can have jaw pain for years and often sent between the GP, dentist, chiropractor and specialists, without a significant result.

Let’s have a quick look over some the common types of TMD and what can be done about them.

Type 1: Muscle Disorders

The most common and least disabling of the TMD diagnosis, characterised by several tender regions across the musculature of the face. This is usually linked with teeth grinding (bruxism), head and neck posture or habits, like chewing gum. Along with the pain, it can also limit how wide the mouth opens, making eating, speaking and yawning difficult.

Fortunately, the symptoms of this type of TMD can be settled quickly with simple manual techniques (like massage, mobilisation and dry needling) and some specific exercises. However, finding and addressing the cause of the muscle tension (eg stress, grinding, poor posture) may take longer to resolve.

 

Type 2: Disc displacements

This involves the small cartilaginous disc which sits on top of the head of the jaw bone (mandible). There are few different problems that can occur here:

  1. The disc clicks on opening and closing
  2. The disc clicks on opening, but not closing
  3. The disc used to click, but now is stuck

Each of these problems involve different treatments, with some that can be altered with simple remedies and other require referral to an oral and maxillofacial specialist. Regardless, these conditions are treatable and do not need to be lived with.

Type 3: Joint Related

As with all joints, the smooth cartilage, joint fluid and surrounding ligaments can become painful when used in a sub-optimal way, exposed to trauma or as we age, with degeneration. Imaging can be useful here, to show the best course of treatment and provide a guide to how long it may take to improve.

A combination approach is often best with this category, including medications, physiotherapy, orthodontics, and a specialist’s opinion. Due to the more chronic nature to this type, psychology and behavioural interventions are also beneficial.

It’s important to note there are many other variables that play into pains of the face and head. Each person may have several types at once, making an opinion from your GP or Physio essential, to getting the best possible care. So, no matter what kind of pain your jaw is giving you, there are options out there for you.

 

Written by Andrew Alexander 

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