What are TMJ or TMD?
Temporomandibular disorders (TMD) is a term used to include a number of disorders characterised by pain in or around the jaws joints. The problems are thought to be quite common, although only a small proportion of patients seek treatment. Adolescents and young adults are most commonly affected, though the symptoms can occur at any age.
Tooth clenching or grinding, especially at night, can also lead to its development. Some patients, however, are unable to identify any particular cause. Anxiety, stress and depression can also be significant factors in the development and progression of TMD.
The main complaint is usually jaw pain or difficulty with jaw movement, including jaw locking. Some patients have clicking of the joint, although many people with clicking jaw joints do not have pain. Other symptoms include earache, a ringing in the ears, a blocked sensation in the ears or dizziness. There may also be headaches and neck and shoulder pain. The pain is usually constant and not particularly severe though it may vary in severity over a period of time. It does not usually prevent sleep or interfere with daily activities, The pain may be episodic, can last from days to years and may recur.
How we diagnose the problem
Sometimes the way you bring the problem to us makes the diagnosis quite straight forward. However there may be cases where it is important to have a thorough examination, which should include assessment of the muscles of the head and neck and jaw, measurement of jaw movements and evaluation of any joint noises. A dental cause needs to be excluded. The teeth should be examined to identify any wear caused by grinding or any tooth interferences which might be affecting the bite. X-rays are useful in case of degenerative conditions of the joints and any other pathology in the jaws.
Physiotherapy and jaw exercises can be helpful. Counselling and/or medication are indicated if anxiety, stress or depression are involved. Life-style changes which include relaxation, regular exercise and yoga are helpful for some patients. Other less commonly used treatments include acupuncture and biofeedback. Changes to the teeth and bite are not generally helpful unless an obvious bite interference or poor bite relationship are present. If back teeth are missing and causing a loss of jaw support, this is an indication for their replacement. Rarely, if pain and jaw limitation are persistent and there is clear evidence of degenerative changes on X-rays, joint surgery
Ways to minimise problems with TMJ and promote healing
Injuries to jaw joints and muscles are quite common and usually resolve with rest. Often the condition resolves spontaneously. It is very difficult to voluntarily rest jaw joints and muscles, especially as jaw movements often occur during sleep. During waking hours, however, it is possible to minimise activity and the simple guide-lines below allow you to avoid those jaw movements which might re-injure your joints, muscles or ligaments. Just as you would rest and support a twisted ankle, so it is necessary to reduce the load placed on your chewing muscles and joints.
An occlusal splint is a custom-made mouthguard-like device which is worn over the upper or lower teeth at night. It is particularly helpful when a clenching or grinding habit is present. The splint may need to be worn for several months and may be helpful indefinitely if a long-term grinding habit is present.
Mon - Fri 8:30 am -5:30 pm
Sat 8.30 am -1 pm
575 Riversdale Rd
Camberwell VIC 3124 AU
Monash University Health Service Dental Clinic (Clayton)
21 Chancellors Walk,
Clayton Campus, Monash University.
03 9905 1000
Two convenient locations
Camberwell and Monash University
Dr Erik Magee BDSc (Melb)
Dr Stephen Liew BDSc (Mel), FPFA, FADI, MAICD, FICD
Dr Sue King BDSc (Melb)
Dr Lin Liang BDSc (Hons Melb)
Dr Jordan Hawkins DDSc (Melb)
Dr Marjan Ardebili BDS (Manchester,UK), MFDS (RCS Ed)
Dr Nigel Gamage BDSc (Sheffield)
Dr Balakka Reddy BDSc
Mr Richard Huggins MBBS (Hons), BDSc, BSc, BSc (Hons), Grad Dip Surg Anat, MPhil, FRACDS
Camberwell Dental Group and Monash University Dental Clinic. Dentists promoting health care for life. Family orientated