Temporomandibular Disorder

WHAT YOU SHOULD KNOW:

• Temporomandibular (tem-po-ro-man-DIB-u-lar) disorder, also called TMD, is a condition that affects the temporomandibular joint (TMJ) and the structures around it. These structures include the muscles, nerves, and tendons of the jaw, face, or neck. The TMJ connects your mandible (jawbone) to the temporal bone of the skull (head). The jaw is a long bone that forms the chin and holds the lower teeth. It goes up towards the ear on both sides of the face. The TMJ contains a small cartilage disc that keeps the temporal bones and jaw bones from rubbing on each other. The TMJ and jaw muscles help in opening and closing the mouth, and are used particularly with chewing.
  
  
• The most common cause of TMD is a cartilage disc that may have moved out of its proper position. Signs and symptoms may include teeth grinding and clicking or popping sounds when the jaw opens or closes. Your jaw may lock and you may also have headaches, or jaw, ear, or facial (face) pain. An arthrogram, x-ray, computerized tomography (CT) scan, or magnetic resonance imaging (MRI) may be used to diagnose TMD. Treatment includes the use of splints or mouth guards, medicines, surgery, rehabilitation, and behavior therapy. With treatment, TMD may be cured and further problems may be prevented.

AFTER YOU LEAVE:

Take your medicine as directed:

Call your primary healthcare provider if you think your medicine is not working as expected. Tell him if you are allergic to any medicine. Keep a current list of the medicines, vitamins, and herbs you take. Include the amounts, and when, how, and why you take them. Take the list or the pill bottles to follow-up visits. Carry your medicine list with you in case of an emergency. Throw away old medicine lists.

Ask for information about where and when to go for follow-up visits:

For continuing care, treatments, or home services, ask for more information.

Diet:

Chewing and swallowing problems may cause you to change what you eat and drink. A caregiver called a dietitian or nutritionist will work with you to find the right diet.

• You may not be able to eat solid foods for a period of time. You may only be allowed to drink liquids to rest your jaw or they may be the only things you can swallow. You may need to use a straw to help you drink. You may drink water, broth, apple juice, or soda. You may also suck on ice chips or eat gelatin.
  
  
• As you improve, you may be given soft foods that are easier to bite, chew, or swallow. Eat softer and smaller pieces of food, such as custards, puddings, yogurt, gelatins, and soft fruits, such as bananas. Ask your caregiver for more information about what foods or liquids you are allowed to eat or drink.

Learn ways to manage stress. Deep breathing, meditation, and listening to music may help you cope with stressful events. Talk to your caregiver about other ways to manage stress.

Mouth guards and splints:

Your may need to wear a splint or a mouth guard to keep your TMJ in the right position. A physical therapist may help you with your splint or mouth guard if needed.

Rehabilitation program:

A rehabilitation, or rehab, program may restore or help maintain functions that are important for your daily living. Therapies teach you special skills to correct your TMD and may give you a better quality of life.

• Physical therapy is an exercise to help your bones and muscles get stronger. A physical therapist teaches special exercises to help you use your jaw properly. These exercises help your muscles stay as flexible and relaxed as possible.
  
  
• TMD may cause you to have problems talking or swallowing. A speech therapist may work with you to try to improve how you talk. A swallowing therapist can help if you have trouble swallowing and may help you learn safer ways to swallow.

For more information:

Having a temporomandibular disorder may be hard. Contact the following for more information:

• National Institute of Dental and Craniofacial Research
  National Institute of Health
  Bethesda , MD 208922190
  Phone: 1- 301 - 4964261
  Web Address: http://www.nidcr.nih.gov/
  

CONTACT A CAREGIVER IF:

• You cannot make it to your next appointment with your caregiver.
  
  
• You have a fever.
  
  
• Your pain is getting worse, even after taking your pain medicines.
  
  
• Your splint or mouth guard is loose.
  
  
• You have questions or concerns about your condition, treatment, or care.

SEEK CARE IMMEDIATELY IF:

• You have nausea (upset stomach) or are vomiting and cannot keep liquids down.
  
  
• You have increased pain that does not go away, even after taking your pain medicine.
  
  
• You have problems breathing, talking, drinking, eating, or swallowing.
  
  
• Your splint or mouth guard gets damaged or broken.

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The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.

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