SEEKING RELIEF FROM TMD !!!!

What You Should Know About Treatment For Temporomandibular Disorders (TMD)

The temporomandibular joint (TMJ) is the ball-and-socket joint where the jawbone (mandible) meets the temporal bone of the skull. Everyone has two TMJs, one on the left side and one on the right. TMD (Temporomandibular Joint Disorders) is a group of diseases that cause pain and dysfunction in the TMJ. Not everyone has TMD — but if you do, it can be a painful condition. 

The problem is how best to recognize and treat TMD, which has been called “the great impostor” because it can be confused with those of many other conditions. Its symptoms include clicking or popping sounds coming from the jaw joint, especially when accompanied by pain; feeling the jaw is “stuck” in the open or closed position; and pain in the muscles of the jaw, cheeks, or temples. Once, it was thought that aggressive treatments like orthodontics, tooth restorations, or even surgery were needed to treat TMD. Today, we know that most cases of TMD can be effectively resolved with more conservative therapies.A Dentist can recommend gentle stretching exercises, the use of ice or heat, a temporary change to a softer diet, and over-the-counter or prescription medications.

TMD stands for Temporomandibular Disorders, which is a collective term for the muscle and/or joint symptoms that commonly arise when there is TMJ pain and dysfunction. The dental profession is in the midst of a transition regarding TMD treatment. This has stirred up a controversy within the profession over how best to relieve TMJ pain. On one side you have those subscribing to the newer methods of conservative, less invasive approaches; on the other side you have those who are sticking with more traditional and often irreversible treatments. Therefore, what happens to you if you have a TMD problem could depend on whom you consult for diagnosis and treatment?

Unique Joints

The temporomandibular joints connect your mandible (lower jaw) to your skull on both left and right sides, which makes the lower jaw the only bone in the body with completely symmetrical joints at both ends. There is a ball-and-socket relationship between your jaw and your skull on both sides, but the unique part is the presence of a cushioning disk between the two surfaces in each joint. Each TMJ has a disk between the ball (condyle) and socket (fossa), and this sometimes ends up being an especially important area when trouble arises. 

TMD field today is in transition between a traditional dental model and a contemporary medical model, and this has tremendous implications for what will happen to you as you seek a proper diagnosis and treatment.

The current medical model is based on the proposition that the TMJ is a joint and has much in common with any other joint. Therefore, it can be subject to all sorts of typical orthopedic problems — sore muscles, inflamed joints, strained tendons and ligaments, and of course disk problems. Almost all of these problems are capable of being treated without permanently changing or altering the joint structure/s. Obviously, in this model the “alignment” of teeth and jaws is neither analyzed nor changed because those factors have been proven to be mostly irrelevant to what is causing the TMD symptoms. Thus, the medical model is also more conservative, and patients treated within this framework can be spared the more invasive and expensive dental procedures of the past. Additionally, TMDs are now known to be influenced by genes, gender, and age, as well as a host of environmental and behavioral triggers such as stress and anxiety. For many patients, jaw pain may be a manifestation of a larger medical malady, including other widespread pain-inducing conditions such as fibromyalgia (“fibro” – connective tissues; “myo” – muscle; “algia” – pain). These new discoveries make it even more important to deal with TMDs within a medical framework.

The American Association of Dental Research (AADR) regarding Temporomandibular Disorders (TMDs) concludes: “It is strongly recommended that, unless there are specific and justifiable indications to the contrary, treatment of TMD patients initially should be based on the use of conservative, reversible and evidence-based therapeutic modalities. Studies of the natural history of many TMDs suggest that they tend to improve or resolve over time. While no specific therapies have been proven to be uniformly effective, many of the conservative modalities have proven to be at least as effective in providing symptomatic relief as most forms of invasive treatment. Because those modalities do not produce irreversible changes, they present much less risk of being harmful. Professional treatment should be augmented with a home care program, in which patients are taught about their disorder and how to manage their symptoms.”