Temporomandibular dysfunction (TMD) causes pain, joint sounds, and functional issues, often affecting women. Diagnosis relies… See more →
Do you experience jaw pain, clicking sounds when you open your mouth, difficulty chewing or jaw locking?
These could be signs of temporomandibular joint (TMJ) disorders.
The TMJ is one the most frequently used joints in your body (2000x), essential for eating, speaking, and expressing emotions.
Understanding this complex joint and its potential issues can help you recognize symptoms early and seek appropriate care.
Let’s explore the anatomy, symptoms, and treatment options for TMJ disorders
Both joints are composed of a mandibular condyle, a bone sphere that fits in a fossa of the temporal bone.
Between the bone surfaces, there is an articular disc. This disc is supported by ligaments posteriorly and anteriorly, it is attached to a muscle (lateral pterigoid muscle).
The joints have a natural lubricant called synovial fluid. All these structures are encased by a fibrous capsule.
During function, the condyle rotates and slides forward and downward, and together with the disc, they leave the fossa, and move under a bone eminence. This movement requires a complex coordination of an extensive muscle system.
The three major symptoms and signs of temporomandibular dysfunction are: pain, functional impairment and joint sounds.
As far as pain is concerned, it may arise either from the joint or the masticatory muscles.
It may radiate to other facial locations, in particular to the ear. So, the first perception of pain might not give you a direct clue to the actual source of the pain. Actually, temporomandibular dysfunction is also known as Costen syndrome, named after James Costen (1895-1962), an American Otolaryngologist who first published on this orofacial pain.
There can be changes in the range and direction of the jaw movement (functional impairment). This must be divided into two categories:
Another common complaint is the annoyance caused by joint sounds. The most common noise is the clicking sound caused by non-synchronous movements of the disc and the condyle or a crepitation sound when the bone surfaces of the mandible and temporal rub onto each other, in the case of degenerative joint disease.
These symptoms and signs that we have just seen, are the basic guidelines to pointing to a diagnosis, within the extensive list of the diagnostic chart.
Actually, temporomandibular dysfunction is not a diagnostic term on its own. It is rather an umbrella term, for a set of approximately thirty health disorders. However, the term temporomandibular disorders is generally used to refer to the subset of the most frequent conditions within the list shown in the video (3:27).
It should be noted that, temporomandibular disorders can range from a single isolated condition to multi-system involvement, which means that diagnostic chart can be expanded even further. For many patients, in particular those with chronic symptoms, there might be an overlap with other health conditions, such as headaches, bruxism, sleep apnea, postural problems and psychological and psychiatric disorders, namely: anxiety and depression.
Temporomandibular disorders are highly prevalent.
But for most it will be a mild and transient condition. However symptoms may persist chronically with high impact in the quality of life. TMD associated chronic pain is the third most common chronic pain condition after headaches and lower back pain.
Temporomandibular disorders are twice as prevalent in women than in men.
The reasons behind this gender difference and, in fact, the causes of temporomandibular disorders, are still under a long ongoing investigation. It is believed to be a combination of different factors, here I will mention only a few of them:
The different levels on how these factors play in each of us, may explain one of the most intriguing characteristics of temporomandibular disorders:
The magnetic resonance images show a dislocated disc (video 5:04). They could belong to any hypothetical patients, but the symptomatic
expression would range from no symptoms at all, to an occasional joint movement disorder or a long-lasting pain with severe interference in the quality of life.
Despite having similar imaging features, the need for care and treatment strategies are different between them.
Treatment strategies are driven mainly by the symptoms of each patient.
But since there is a wide range of different symptomatic expressions and intensities, and an extensive diagnostic list, as you have seen, there isn’t a care pathway for temporomandibular disorders, because one size does not fit all.
Instead, every treatment plan must be tailored.
One very important point in all treatment plans is education. Explaining to the patient their condition is the main pillar for effective self-management, particularly in patients with chronic pain.
In general, it’s possible to organize treatment plans as: conservative or interventional.
In the conservative therapies:
The interventional procedures list includes:
These two procedures tend to have a very quick recovery time and are almost scarless.
A successful treatment plan for temporomandibular disorders must address possible co-morbidities, and therefore call on-board an intertwined network of other professionals, such as rheumatologists, neurologists, physical therapists or chronic pain clinicians, providing a global care, coordinated by a health professional that looks into the whole spectrum of diagnostic chart and is able to integrate the full portfolio of therapeutic.
The temporomandibular joint connects your jawbone to your skull. It’s a complex joint that allows you to move your jaw up and down and side to side, enabling you to talk, chew, and yawn.
TMJ disorders are a group of conditions that cause pain and dysfunction in the jaw joint and the muscles controlling jaw movement. These disorders can affect one or both sides of your face.
TMJ disorders can be caused by various factors, including:
Common symptoms include:
Diagnosis typically involves:
Treatment options include:
While not all cases can be prevented, you can reduce your risk by:
Consult our team if you experience:
Some home remedies that may provide relief include:
Yes, TMJ disorders can be associated with:
Don’t let TMJ pain affect your quality of life. If you’re experiencing symptoms of TMJ disorders, schedule a consultation with our experienced team today. We’ll provide a comprehensive evaluation and develop a personalized treatment plan to help you find relief. Contact us now to take the first step towards a pain-free jaw.
Know more about the biography of James Costen (click here).
Some celebrities of the showbiz industry have allegedly been diagnosed with temporomandibular dysfunction:
The movie Poison Ivy, from 1992, has a brief reference to the symptoms of temporomandibular dysfunction, including the Burt Reynolds torments.
My reference authors on temporomandibular dysfunction are: Daniele Manfredini, Florencio Monje, Dorit Nitzan, Eric Schiffman among other.
From a vast literature on temporomandibular dysfunction, I also recommend the following papers:
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