TMJ and TMD

What is TMJ / TMD?

Temporomandibular joint and muscle disorders (TMJDs) refer to a complex and poorly understood set of conditions that can cause pain in the area of the jaw joint and associated muscles and/or problems using the jaw. Both or just one of the TM joints may be affected. TMDs can affect a person's ability to speak, eat, chew swallow, make facial expressions and even breathe.

Temporomandibular Disorders, more commonly known as "TMJ" is a term to describe a jaw joint disorder and the muscles that control the joints. The head, neck and facial pain associated with TMD problems often masquerade as a multitude of other conditions such as sinus headaches, migraines, neck, shoulder stiffness and earaches. Fortunately, it can be treated successfully by a dentist who has the special required training that is needed to manage these disorders.

TMJ disorders (TMD) also known as Craniomandibular Dysfunction or Craniofacial Pain, refer to problems involving both the jaw joints and the muscles of the head, neck and face. These are the two joints that connect the jaw to the skull located on each side of the head in front of the ears. When these joints are displaced, they can cause mild discomfort to severe pain.

The tempormandibular joints may be the most flexible, yet sophisticated joints in the body because they move up and down, side to side and in a wide range of motion. Muscles attach the bones and joints that allow such movements. It is estimated that as many as one in every four Americans suffer from one or more of these symptoms:

• Headaches
• Pain behind the eyes
• Facial or throat pain
• Dizziness
• Earaches, congestion or ringing ears
• Clenching or grinding teeth
• Neck Pain or stiffness
• Numbness or tingling of the fingers
• Click, pop or grating sound in the jaw joints
• Tired jaws

The primary problem can be in the joints themselves, the muscles of the face and jaw or a combination of these. Because symptoms masquerade as so many other conditions, people travel from doctor to doctor in search of answers to pain relief. Many never think to seek out a dentist who is trained specifically in TMD such as Dr. Woodlief.

You can observe the action of the jaw join by placing your fingers on your jaw joints in front of your ears on the sides of your face. Open and close your mouth and you will be able to feel the movement. It should feel smooth without any clicking or popping when opening, closing or moving the jaw from side to side.

Pain Disorders that are confused with TMJ/TMD

Temporal Tendinitis

Temporal tendonitis has been called "The Migraine Mimic" because so many symptoms are similar to migraine headache pain. Symptoms include: TMJ pain, ear pain and pressure, temporal headaches, cheek pain, tooth sensitivity, neck and shoulder pain. Treatment consists of injecting local anesthetics and other medications, a soft diet, using moist heat, muscle relaxants and anti-inflammatory medications, and physiotherapy. Only rarely (in approximately 4% of cases) is surgery needed.

Ernest Syndrome

This TMJ-like problem involves the stylomandibular ligament, at tiny structure that connects the base of the skull with the mandibular, or lower jaw. If injured, this structure can produce pain in as many as seven specific regions of the face, head and neck: the temple, the TMJ, the ear, the cheek, the eye; the throat, especially when swallowing, and the lower back teeth and jaw bone. Treatment of Ernst syndrome, which is successful about 80% of the time, consists of injections of local anesthetic and medication (cortisone or Sarapin), physiotherapy, and at times, the use of an intraoral splint.

Occipital Neuralgia

Occipital neuralgia is generally ignored in the medical textbooks. This disorder is characterized by pain located in the cervical and posterior regions of the head (these are the occipital areas) which may or may not extend or radiate into the sides of the head and ultimately, into the facial and frontal regions. There are actually two major types of occipital neuralgia: lesser occipital and greater occipital, with the lesser type being more common

TMJ Self-Diagnostic and Self-Referral Program

(Use this Check list)
1. Do you have a grating, clicking or popping sound in either or both jaw joints when you chew or open and close your mouth?
2. Do you have sensations of stuffiness, pressure or blockage in your ears? Is there excessive wax production?
3. Do you ever have ringing, roaring, hissing or buzzing sound in your ears?
4. Do you ever feel dizzy or faint?
5. Is your jaw painful or locked when you get up in the morning? Does is get stuck?
6. Are you ever nauseous for no apparent reason?
7. Do you fatigue easily or consider yourself chronically fatigued?
8. Are there imprints of your teeth on the sides of your tongue?
9. Is it difficult or impossible to swallow quickly five times in a row with the last swallow being as easy as the first swallow?
10. Does your tongue go between your teeth when you swallow?
11. Do your fingers sometimes go numb?
12. Do you have pain or soreness in any of the following areas: jaw joints, upper jaw or teeth, lower jaw or teeth, side of neck, back of head, forehead, behind eyes, temples, tongue or chewing muscles?
13. Is it hard to move your jaw from side to side or forward and backward?
14. Do you have difficulty in chewing your food?
15. Do you gulp your food, swallowing it whole or almost whole?
16. Do you have any missing back teeth?
17. Have you had extensive dental crowns and bridgework that were painful afterwards?
18. Do you clinch your teeth during the day?
19. Do you grind your teeth at night? (Ask your family)
20. Do you ever awaken with a headache?
21. Have you ever had a whiplash injury?
22. Have you ever worn a cervical collar or had neck traction?
23. Have you ever experienced a blow to the chin, face or head?
24. Have you reached the point where drugs no longer relieve your symptoms?
25. Does chewing gum start or worsen your symptoms?
26. Is it painful, or is there soreness when you press your jaw joints or the cheek just below them?
27. Is it painful to stick your "pinky" fingers into your ears with your mouth open wide and then close your mouth while pressing forward with your "pinky" fingers?
28. Does your jaw deviate to the left or right when you open wide? (Look in a mirror.)
29. Are you unable to insert your first three fingers vertically into your mouth when it is opened wide?
30. Is your face crooked and not symmetrical?

If you answered "Yes" to 17 or more of these questions, you have some form of TMJ problem. Contact our San Jose office for a consultation regarding your TMJ problem.