Temporomandibular Disorder

GENERAL INFORMATION:

What is a temporomandibular disorder? 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.

What causes a temporomandibular disorder? The most common cause of TMD is a cartilage disc that may have moved out of its proper position. The following factors or conditions may also cause TMD:

• Deformities: An abnormal jaw or TMJ may be present from the time you were born or happen while you are growing up.
  
  
• Diseases: Muscle problems, arthritis, (swelling of the joint), infections, or cancers (tumors) in the jaw area.
  
  
• Injury: Fracture (break in the bone) of the jaw. Getting hit directly on the jaw during fights or a car accident may cause TMD.
  
  
• Muscle strain: The muscles of the TMJ may be strained by grinding or clenching the teeth, especially during sleep. Clenching happens when you tightly clamp the top and bottom teeth together, especially the back teeth. Grinding is when you slide the upper teeth over the lower teeth, such as in a sideways or back-and-forth movement. The stressful force of clenching and grinding causes pressure on the muscles, tissues, and other structures around your jaw. You may also overuse your muscles when yawning, taking huge bites when eating, or chewing gum.
  
  
• Stress: Emotional stress, such as from fear and feeling upset or angry, may also cause frequent grinding and clenching.

What are the signs and symptoms of a temporomandibular disorder? You may have any of the following:

• Bruxism (too much teeth grinding or clenching of jaw muscles).
  
  
• Clicking, popping, or grating sound when the jaw opens or closes.
  
  
• Headache or pain of the jaw, ear, neck, or face.
  
  
• Swelling and tenderness of the jaw muscles.
  
  
• Tingling or numb feeling in the jaw or face.
  
  
• Trouble opening or closing the mouth, or locking of the jaw.

How is temporomandibular disorder diagnosed? Your caregiver will take a detailed health history from you. This may include information on what triggered your signs and symptoms, when they started, and how long they lasted. You may also be asked to provide information about your past diseases, activities, or injuries. You may be given dye for some of the tests that may help your caregiver see the pictures better. People who are allergic to iodine or shellfish (lobster, crab, or shrimp) may be allergic to some dyes. Tell your caregiver if you are allergic to shellfish, or have other allergies or medical conditions. You may need any of the following:

• Physical examination: Your caregiver will closely look at your face, mouth, and teeth. He will feel your jaw and check for any swelling or popping sounds when you open your mouth. He may also need to see if your teeth are properly positioned or worn out from grinding.
  
  
• Arthrogram: An arthrogram is an x-ray of the joint using dye. The dye helps your caregiver better see the joint and the area around the joint.
  
  
• Bone scan: This is a test to look at your bones. You are given a small, safe amount of radioactive dye in an IV. Pictures are then taken of your bones. Caregivers can look at the pictures for broken bones, infections, or cancer in the bones.
  
  
• Computerized tomography scan: This is also called a CT or CAT scan. A special x-ray machine uses a computer to take pictures of your head. It may be used to look at your jawbone, muscles, or nerves. You may be given dye to drink or in an IV before the pictures are taken.
  
  
• Magnetic resonance imaging scan: This test is also called an MRI. An MRI uses magnetic waves to take pictures of your head or jaw. During an MRI, pictures are taken of your bones, muscles, nerves, or blood vessels. You will need to lie still during an MRI. Never enter the MRI room with an oxygen tank, watch, or any other metal objects. This may cause serious injury.
  
  
• X-rays: You may need to have x-rays of your skull, jaw, or teeth. X-rays may tell how bad your condition is and what is causing the problem.

How is temporomandibular disorder treated? Treatment of TMD may depend on its cause and how bad your symptoms are. Your caregiver may suggest that you have a liquid or soft diet for several days. You may also need any of the following:

• Aiding devices: Splints may be used to support your jaw. They may also be used to keep your jaw from moving. Mouth or bite guards may be worn to avoid clenching or grinding of your teeth while you are sleeping.
  
  
• Cold or warm compress: Ice may be applied on the swollen part to decrease swelling, pain, and redness. Warm compresses bring blood to the injured area and help it heal faster.
  
  
• Medicines: Medicines may be given to ease your pain. You may also need steroid medicine if there is swelling or redness.
  
  
• Surgery: Your caregiver may need to do a surgery to return your teeth, jawbone, or TMJ to its normal position. Surgery may also be needed to correct a deformity or fix damaged tissues in your mouth or jaw.
  
  
• Therapies:
  
  
  • Behavior modification: Behavior modification therapy teaches you how to change your behavior by looking at the results of your actions. With "behavior mod" therapy, you learn that certain behaviors (actions) have good or bad results. These results may make you feel either good or bad about yourself. Most people feel good about themselves when they use good behaviors. Good behaviors are often rewarded.
    
    
  • Rehabilitation therapy: This program may include physical therapy, and swallowing and speech exercises.

Where can I find 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/
  

CARE AGREEMENT:

You have the right to help plan your care. To help with this plan, you must learn about your health condition and how it may be treated. You can then discuss treatment options with your caregivers. Work with them to decide what care may be used to treat you. You always have the right to refuse treatment.

Link to this page

Printable Version

Email Page