What is TMJ Syndrome?

Introduction

Signs and symptoms of TMJ Syndrome vary and can be very complex. The anatomic structures affected in TMJ Syndrome are the muscles, the temporomandibular joints, and the teeth.

Muscles & TMJ Syndrome

Disorders of the muscles of the temporomandibular joint are the most common complaints by TMJ Syndrome patients. The two major observations concerning the muscles are pain and dysfunction. In TMJ Syndrome, muscle" pain is "described as a "deep pain" and does not seem to be simply from overuse and fatigue. Instead, it is believed that this pain is a result by mechanisms from the central nervous system.

Muscle pain can sometimes be associated with trigger points in muscle tissue. The trigger points are attributed to deep, constant pain and to causing the pain to be referred to other parts of the body. For example, the trapezius muscle refers pain more commonly to the ear, temple, and angle of the jaw. Trigger points residing in the shoulder muscles can also cause muscle disorders of the temporomandibular joint.

Trigger points are also associated with migraines in TMJ Syndrome, even though migraines themselves are not fully an aspect of TMJ Syndrome. When pain of the temporomandibular joint precedes migraines, then treatment of the TMJ Syndrome may reduce the number of migraines, but TMJ Syndrome treatment is not a "cure" for migraines.

The dysfunction involved is usually a restriction on mandibular movement upon opening of the mouth. In some cases, it is possible to continue opening the mouth if done slowly, but the pain may stay present or intensify. Additionally, the dysfunction of the muscles may cause the teeth to occlude with each other incorrectly. This condition is called an acute malocclusion and is the result of TMJ Syndrome, not the cause.

Temporomandibular Joints & TMJ Syndrome

Disorders of the temporomandibular joints are usually the most noted observation upon examination of TMJ Syndrome patient because most signs are readily detected by the clinician, not necessarily the patient. The two major observations concerning the joints are pain and dysfunction. In a healthy joint, the surfaces in contact with one another do not have any receptors to transmit the feeling of pain. The pain therefore must originate from one of the surrounding soft tissues: the discal ligaments, the capsular ligaments, and the retrodiscal tissue. When receptors from one of these areas are triggered, the pain causes a reflex to limit the mandible's movement. Furthermore, inflammation of the joints can cause constant pain, even without movement of the jaw.

Due to close proximity of the ear to the temporomandibular joint, TMJ pain can be expressed as ear pain. The pain may be referred in around half of all patients and experienced as otalgia (earache). TMJ Syndrome is an important possible cause of secondary otalgia. Treatment of TMJ Syndrome may then significantly reduce symptoms of otalgia and tinitus, as well as atypical facial pain.

The dysfunction involved is most often in regards to the relationship between the condyle of the mandible and the disc. The sounds produced by this dysfunction is usually described as a "click" or a "pop" when a single sound is heard. When there are multiple, rough sounds, it is described as "crepitation" or "crepitus".

Teeth & TMJ Syndrome

Disorders of the teeth can also be present in TMJ Syndrome patients. Tooth mobility can be caused by destruction of the supporting bone and by heavy forces being placed on teeth. Movement of the teeth affects how they contact one another when the mouth closes, and the overall relationship between the teeth, muscles, and joints can be altered. The heavy forces on the teeth have been associated with the presence of mandibular tori in TMJ Syndrome patients. Pulpitis, inflammation of the dental pulp, is another symptom that may result. It is usually caused by heavy forces on the teeth and can cause pain. Lastly, tooth wear is the most common sign associated with a dysfunction of the teeth, but it is not strongly associated with TMJ Syndrome symptoms. Tooth wear can be a result of bruxism or by interfering with the movement of the mandible during function, referred to as the "functional envelope of motion." Depending on the cause, the treatment for tooth wear differs.

Benefits of Neuromuscular Dentistry

To put it simply, neuromuscular dentistry places the jaw into its optimal position, relieving the symptoms associated with TMJ. While traditional dentistry evaluates primarily the teeth, bones, and gums, neuromuscular dentistry works with the hard tissues and the soft tissues, muscles and nerves. Neuromuscular dentists understand that your hard and soft tissues have a complex relationship and work to make that relationship a harmonious one. Neuromuscular dentists understand the necessity for including the power source (muscles) and the controls (nerves) which create the movement, pressures, and function of the mouth.

When the jaw is misaligned, both the hard and soft tissues are affected and many physiological problems can result, such as headaches, jaw pain, neck and shoulder pain, tinnitus, or ringing in the ears, and clicking or popping sounds in the jaw joint. In a number of cases, these symptoms are the result of TMJ (temporomandibular joint syndrome), also referred to as TMD (temporomandibular joint disorder) or MPD (myofascial pain dysfunction).

TMJ / TMD is a chronic degenerative disease that often takes years to develop. TMJ affects millions of people. People who suffer from TMJ have an imbalance in the jaw-to-skull relationship, which is caused by a bad bite (malocclusion).

Treatment

Neuromuscular Dentistry serves to correct the bite and realign the jaw.

First the dentist determines the optimal position of the jaw by measuring the relaxed position of the head and neck muscles, and then repositions the jaw to achieve those exact measurements.

Malocclusion is relatively easy to correct. Treatment options include adjusting the bite, orthotics, orthodontics, or restoring the teeth to their correct positions.

Benefits

Patients of neuromuscular dentistry experience a range of benefits from decreased or eliminated pain and discomfort to better overall health and longer-lasting dental restorations.