Head, neck, and facial pain affects a significant percentage of the population (one in every four Americans seeking care for both acute and chronic pain in the medical model we deal with every day). The majority of temporomandibular disorder (TMD) suffers are women although men, young children, and adolescents are also affected. Too often patients endure a frustrating and expensive doctor-to-doctor search to find answers for the relief of symptoms. These patients may seek help first from their primary care provider.
44 million people in North America suffer from cardiovascular disease and 40 million from symptoms of TMD. At TMJ & Sleep Therapy Centre of San Fernando Valley, we understand that these conditions are related, which is why the goal of our treatments is to alleviate TMD symptoms and make you more functional at the same time. Contact Dr. Ariz and Dr. Arami if you would like to learn more about the benefits of receiving treatment for the TMJ in Northridge, California.
The majority of TMD sufferers are women; although men, young children, and adolescents are also affected. Too often patients endure a frustrating and expensive doctor-to-doctor search to find answers for relief from symptoms. A dentist who is trained and experienced in TMD is usually the one who treats it conservatively.
Causes of TMD can be multifactorial; however, they often involve the relationship between the upper and lower teeth, the TM joints, supporting ligaments, and associated musculature. Often the conditions that cause TMD place unacceptable pressure on the joints’ discs. The clicking, popping, or grating of the jaw joints are caused by the abnormal movement of the discs as they move over the head of the joints upon opening and closing. Just as nutrition affects teeth and joints, some contributing factors to TMD may include:
- Trauma: Direct and indirect trauma to the masticatory structures and upper quadrant can lead to TMD head, neck, and facial pain. Strains, sprains, and injuries can lead to both pain and dysfunction. Either micro or macro traumas may be etiologic factors.
- Improper occlusion: When teeth do not fit together properly, it causes sustained microtrauma to the joints. When this condition is prolonged, the body begins to compensate by involving muscles in other areas: the neck, throat, and upper back.
- Muscle hyperactivity: this goes hand-in-hand with internal jaw joint problems. Any condition that prevents the complex system of muscles, bones, and joints from working together in harmony can contribute to TMD. Some of the various ways this system can be disrupted include trauma, connective tissue disorders, arthritis, or skeletal malformation.
- Posture: Poor posture places unnecessary wear and tear on all the joints, including the jaw joints. Over time, consequences of postural neglect can be as damaging as an injury.
- Stress: Increased physical and emotional stress is another factor that impacts patients with TMD as it reduces the adaptive capabilities of the jaw. Some patients unconsciously brux and/or clench their teeth in response to increased stress. Chronic clenching and bruxing creates strain on the TM joints and muscles which can exacerbate TMD problems.
Other conditions that can result in TMD include:
- Head and neck muscle imbalance
- Chronic mouth breathing (snoring/sleep apnea)
- Poor tongue position
TMD is a common problem, but its effects on people’s lives are very serious. For instance, families have a hard time understanding when a parent suffers from TMD. This person can’t handle much more than their jaw pain, so they are highly stressed and may shut down, not wanting to go places or do things that they would normally do. They also are more irritable and short tempered.
The most common symptom of TMD is noise from the joint, but it can also be present without joint noise. This noise is usually related to the rapid reduction of the fibrous disc malpositioned between the condylar head and the glenoid fossa. The sound is often accompanied by a restricted mandibular range of motion.
Pain is usually localized in the muscles of the mastication, the accessory muscles of mastication in the posterior cervical area, the temporomandibular joints, and the area about the ears. Many of these patients complain of:
- Chronic headaches
- Limited mandibular movements or locking when opening/closing the jaw
- TMJ sounds: clicking , popping, grating
- Ear fullness or pain with no other apparent etiology
- Facial pain
- Neck pain or stiffness
When an occlusion problem or tissue damage to the head, neck, and facial area is diagnosed, it is important to have an evaluation by a trained and qualified TMD dentist. Our office performs a full examination of the TM joints, head, neck, and facial region, as well as X-rays and occasionally MRI evaluations. We are able to objectively determine the pathological nature and extent of joint sounds and injuries to the TM joint area to arrive at a realistic prognosis. Frequently, a custom-made orthotic (splint) is prescribed for orthopedic and musculoskeletal stabilization.
While many of the symptoms are temporarily improved with pharmacological agents such as analgesics, muscle relaxants, anxiolytics, and anti-depressants, additional adjunctive therapies include:
- Physical therapy
- Massage therapy
- Hot/cold therapy
- Spray and stretch
- Various injections
- Stress counseling
- Relaxation therapy
- Nutrition counseling