TMJ - Temporomandibular Joint Disorder

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TMJ - Temporomandibular Joint Disorder
by American Chiropractic Association
Massachusetts Chiropractic Society, Inc.


Does it hurt when you chew, open wide to yawn or use
your jaws? Do you have pain or soreness in front of the ear, in the jaw muscle, cheek, the teeth or the temples?

Do you have pain or soreness in your teeth? Do your jaws make noises loud enough to bother you or
others? Do you find it difficult to open your mouth
wide? Does your jaw ever get stuck/locked as you open it?

If you answered ÏyesÓ to some of these questions, you may have a temporomandibular joint disorder, or TMD. TMD is a group of conditions, often painful, that affect the jaw joint.

Signs may include:

Ô Radiating pain in the face, neck, or shoulders;
Ô Limited movement or locking of the jaw;
Ô Painful clicking or grating when opening or closing the mouth;
Ô A significant change in the way the upper and lower teeth fit together;
Ô Headaches, earaches, dizziness, hearing problems, and difficulty swallowing.

For most people, pain or discomfort in the jaw muscles or joints is temporary, often occurs in cycles, and resolves once you stop moving the area. Some people with TMD pain, however, can develop chronic symptoms. Your doctor of chiropractic can help you establish whether your pain is due to TMD and can provide conservative treatment if needed.

What Causes TMD?

Researchers agree that TMD falls into three categories:

Ô Myofascial painÛdiscomfort or pain in the muscles of the jaw, neck, and shoulders;
Ô A dislocated jaw or displaced disc;
Ô Degenerative joint diseaseÛrheumatoid arthritis or osteoarthritis in the jaw joint.

Severe injury to the jaw is a leading cause of TMD. For example, anything from a hit in the jaw during a sporting activity to overuse syndromes, such as chewing gum excessively or chewing on one side of the mouth too frequently, may cause TMD. Both physical and emotional stress can lead to TMD, as well. The once-common practice of sitting in a dentist's chair for several hours with the mouth wide open may have contributed to TMD in the past. Now, most dentists are aware that this is harmful to the jaw. In addition to taking breaks while they do dental work, todayÌs dentists also screen patients for any weaknesses in the jaw structure that would make physical injury likely if they keep their mouths open very long. In that case, they may use medications during the procedure to minimize the injury potential, or they may send the patient to physical therapy immediately after treatment. In less severe cases, they instruct patients in exercises they can do at home to loosen up the joint after the visit.

While emotional stress itself is not usually a cause of TMD, the way stress shows up in the body can be. When people are under psychological stress, they may clench their teeth, which can be a major factor in their TMD. Some conditions once accepted as causes of TMD have been ...