TMD & TMJ are acronyms that stand for “Temporomandibular Disorder” and “Temporomandibular Joint” respectively. Historically, “TMJ” is the term that has been used to describe problems with and around the jaw joint. However, everyone has a “TMJ” – just like everyone has an elbow or knee joint. It’s simply a part of our anatomy. The term “TMD” is therefore the more commonly term used today to describe a painful condition in and around the jaw joints and the jaw, face and neck muscles.

What is TMJ?
The left and right jaw joints are very unique joints in the body because they are the terminal ends of a single bone which crosses the midline of the body and which hangs in a sling of muscles and ligaments beneath the base of the skull, with each side being controlled by separate muscles and nerves.

Furthermore, the alignment and position of the teeth dictate the relative position which the lower jaw must assume as it occludes or closes tightly against the upper jaw, using the teeth like gears to close together. Because of this anatomical arrangement the lower jaw has three planes of space it can move through, however it does so in six degrees of freedom. In addition to the up/down, forward/backward, and left/right directions of movement through spatial planes, the lower jaw can also move in “pitch yaw and roll” orientations as it relates to the cranial base. This introduces the possibility of jaw and muscle torque into how the jaws and teeth fit together.

What is TMD?
If the position of the dental bite places strain or stresses on the joint/muscles/ligaments, or if the muscles and nerves are not comfortable with how the jaws and teeth fit together, it can lead to increased muscle tension, damage to ligaments and muscles, and deterioration of the jaw joint itself. As the damage and stain continues, TMD dysfunction conditions can create collateral problems in nearby areas of the body and create a variety of other complaints which often seem unrelated and which can baffle physicians and dentists alike. This is the reason why TMD is often referred to as “The Great Imposter.”

Other terms commonly used by doctors and researchers to describe this condition are “craniomandibular dysfunction” and “myofascial pain dysfunction” because they too describe the dysfunction that occurs between the anatomical parts in question. Regardless of which term is used, they basically all describe a common problem related to how the lower jaw fits beneath the cranial base, and whether this relationship is one where the muscles and ligaments are in tension and under strain, or they are relaxed and comfortable. In short, the muscles, nerves, ligaments and joints have a “vote” in whether they like or don’t like the way our jaws fit together.

Currently the term “TMD” is used to describe a grouping of signs and symptoms which includes but aren’t limited to: headaches, unresolved ear pain and complaints, worn or broken teeth, clicking/popping of the jaw joints, restrictions or limitations in jaw movement or function, and facial pain. Not infrequently TMD sufferers also report neck and back pain, snoring or sleep apnea, teeth grinding, ringing in the ears or dizziness, extended pain through the neck and back, tingling in the arms due to nerve compression, and migraines. These signs and symptoms can present independent of each other, but are often seen in multiples. Again, similar to hacking away at the leaves on a tree, several of these complaints could understandably mislead doctors into reaching inaccurate diagnoses and prescribe in appropriate treatment – all because of TMDs great importer capability.

Treatment for TMD
The interesting thing about many of the symptoms of TMD and headaches, is how often people assume that these are “normal” or untreatable. For a variety of reasons, many people discount their headaches and other aches and pains as well as popping joints and worn down teeth – as being something that is “normal”; even something they’ve always had.

The truth is that most people have never known a bite or jaw relationship other than the one they have! The good news is that because we have access to the teeth and the dental bite, we have a way to alter the manner in which the lower and upper jaws fit together. When the jaws are orthopedically balanced and properly supported with appropriate TMD treatment, the muscles relax, the ligaments become unstrained, and the joint decompresses. This rehabilitation allows healing to occur as well as makes it more unlikely that a previously hurting patient will be content with going back and living in pain now that they know what no pain is like!

After careful record taking and a thorough TMD evaluation, a proper diagnosis and treatment plan can be put together which can significantly diminish if not eliminate the symptoms associated with TMD. Of course, there are limitations because irreversible damage to joints and ligaments cannot be undone. This is why it is very much advisable to deal with TMD earlier rather than later, and where possible to use conservative non-surgical treatment approaches before it is too late. Thankfully, not all TMD conditions progress to the extremes which require surgery or other more aggressive approaches. And - thankfully the days of having to live with headaches, facial pain and jaw problems are long past.

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