The temporomandibular joint (TMJ) is the foundation for all movement of the jaw for the functions of speaking, chewing and swallowing. A healthy joint is important for proper daily function that is pain free.
Patients can present multiple symptoms of TMD, or TMJ dysfunction, and be unaware that the pain they are having is related to a dental problem. Headaches, vague or multiple tooth pain, shooting jaw pain, stiffness of the face or neck, and broken teeth may all be signs of TMD. Frequently, patients with chronic migraines may find themselves headache free once treated for TMD.
The TMJ is a bilateral synovial articulation between the mandible and temporal bone. The name of the joint is derived from the two bones which form the joint: the upper temporal bone which is part of the cranium (skull), and the lower jawbone or mandible. The unique feature of the joint is an articular disc that separates the mandible from the temporal bone. Each joint is surrounded by a capsule of fibrous membranes that surround the mandibular bone and the disc and attaches onto the temporal bone. This creates to separate spaces, each filled with synovial fluid to ensure smooth movement of the jaw during function. The shape of the temporal bone offers a perfect space for the mandibular bone and disc to rest at the uppermost and most posterior point of the joint space. The disc serves as a cushion to prevent the two bones from rubbing against one another and wearing down.
Patients may note a "clicking" or "popping" sound in one or both of their joints. This noise can be made if the ligaments that hold the disc in place in one or both of the joints become overly stretched and are not holding the disc in its proper position. The mandibular bone may then "pop off" of the disc during movement when opening or closing the jaw, and a noise may be heard. Often, this is of minimal concern as this can happen with no pain noted. Over time, the clicking and popping may disappear as the disc becomes "worn in" to this new functional pattern.
Occasionally, the joint may become painful and inflamed and could require treatment. The disc may be "pinched" in an area that is filled with nerves and blood vessels and cause tension and pain, or the disc may be permanently displaced causing the two bones to rub together. The bones may begin to wear down and create chronic inflammation. In these cases treatment is required and a dental guard may need to be fabricated to help place the jaw in a stable position where further damage to the joint can be prevented.
Many patients inherit a condition known as bruxism, more commonly known as clenching or grinding of the teeth. This is a condition that a patient has no control over and it may improve or worsen at different times in life, but never completely goes away. The teeth can be damaged due to excessive function of the jaws, especially at nighttime, where 200 pounds of pressure per square inch is placed on the teeth for many hours at a time. The teeth can flatten over time due to wear, crack or break, or loosen due to these heavy forces. Sensitivity in the teeth can occur and even pain that may mimic a toothache due to the trauma the teeth are enduring. A dental mouthguard must be created to lessen and perfectly distribute the forces placed on these teeth while the patient is clenching or grinding. This guard can help protect against broken, worn teeth and stiffness and pain in the jaw muscles relating to over activity.
If you are experiencing any of the symptoms or conditions listed above, please call 1-513-777-6444 for an evaluation.
Tomorrow could be headache and pain free!