TMJ Dysfunction

Temporomandibular Joint Dysfunction encompasses a broad range of problems and symptoms. Many names are used by different doctors and patients. The term "TMJ" refers to the normal joint, the Temporomandibular Joint. When someone says 'they have TMJ', the right answer is 'yes, you, and everyone else, has two – one on each side'. TMJ Dysfunction, also called TMD, is a disease process. Myofascial Pain Dysfunction is another commonly used term to describe the disease process.

The most common symptoms of TMJ Dysfunction include:

• Facial pain
• Jaw joint pain
• Back, Neck, cervical pain
• Postural problems (forward head posture)
• Pain in the face
• Limited opening of the mouth
• Headaches 
• Pain in the muscles surrounding the temporomandibular joints
• Pain in the occipital (back), temporal (side), frontal (front), or sub-orbital (below the eyes)
• Pain behind the eyes - dagger and ice pick feelings
• Multiple bites that feels uncomfortable or, "off," and continually changing
• Clenching/bruxing
• Tender sensitive teeth to cold
• Deviation of the jaw to one side
• The jaw locking open or closed
• Ringing in the ears, ear pain, and ear congestion feelings
• Sinus like symptoms
• Dizziness or vertigo
• Visual Disturbances
• Tingling in fingers and hands
• Insomnia - difficulty sleeping

Many of patients with TMJ Dysfunction or Myofascial Pain Dysfunction can be treated by a well trained, experienced Neuromuscular dentist. Usually the most effective treatment involves coordination with other specialists including ear nose and throat, chiropractic, physical therapy, massage therapy and acupuncture. We will review treatment options after a description of the anatomy and pathology of this very complex area. Many excellent reference sites exist including www.tmjcare.com

The Temporomandibular Joint, found in front of your ears on both sides, connects your lower jaw (mandible) to your skull (temporal bone) via a set of muscles and ligaments. There is a firm disc between the mandible and the temporal bone that is shaped like a biconcave disc called the articular disc. In normal function it rides between the two bones as your mandible moves, cushioning and protecting the bones. The TMJ is the only joint in the body that requires perfectly simultaneous coordination between both joints on both sides to work properly. There is a series of large and small muscles that function primarily to open, close and make fine adjustments to the mandibular movement. The masseter (at the side of your jaw) and anterior temporalis (at your temples) are the outside closing muscles. Inside your mouth are the medial and lateral pterygoids, which close and adjust fine mandible movements. There are small muscles called the digastrics under your tongue which open the lower jaw. It is important to know that ALL the other muscles of your head, neck, and even shoulders and upper back participate in more extreme movements of your mandible like wide opening or clenching. Just try opening wide or pushing your lower jaw forward without moving the rest of you head. Because of this your lower jaw position plays a major role in head and neck posture, even affecting the shoulders, upper and lower back.

Diagnosis

Dr. Bader starts with a comprehensive examination and review of your symptoms to diagnose TMJ disease. The examination takes about an hour and includes a tooth by tooth exam and measurements of your teeth, tooth position, alignment of the teeth, proportion of teeth height and gum position. Then your TMJ’s are examined for sounds and tenderness, as well as range of motion. Your occlusion, or bite, is evaluated for alignment with your jaw, as well as balance on closing. A complete examination of the muscles of your face, head, neck and shoulders is the final information collected. 

Based on this evaluation Dr. Bader can advise you as to whether your problems are likely to be helped by Neuromuscular Occlusal Therapy. If you are a good candidate, the next phase of diagnosis consists of models, photographs and electronic measurements of your jaw movement, TMJ, muscle tension and activity, and occlusion using the K7 Jaw Tracking computer. 

TMJ Dysfunction Therapy >>