Glossary: Temporomandibular joint disorder

Temporomandibular joint disorder (TMJD), or TMJ syndrome, is an acute or chronic inflammation of the temporomandibular joint, which connects the lower jaw to the skull. The disorder and resultant dysfunction can result in significant pain and impairment. Because the disorder transcends the boundaries between several health-care disciplines?in particular, dentistry, neurology and psychology?there is a variety of quite different treatment approaches. Attempts in the last decade to develop surgical treatments based on MRI and CAT scans now receive less attention. These techniques are reserved for the most recalcitrant cases where other therapeutic modalities have changed. Exercise protocols, habit control, splinting, or more recently neuromuscular dentistry should be the first line of approach, leaving oral surgery as a last resort. Certainly a focus on other possible causes of facial pain and jaw immobility and dysfunction should be the initial consideration of the examining oral surgeon or health professional. It is suggested that before the attending doctor commences any plan of approach utilizing medications or surgery a thorough search for inciting para-functional jaw habits must be performed. Correction of any discrepancies from normal can then be the primary goal. An approach to eliminating para-functional habits involves the taking of a detailed history and careful physical examination. The medical history should be designed to reveal duration of illness and symptoms, previous treatment and effects, contributing medical findings, history of facial trauma and a search for habits that may have produced or enhanced symptoms. Particular attention should be directed in identifying perverse jaw habits such as clenching or teeth grinding, lip or cheek biting, or positioning of the lower jaw in an edge to edge bite. All of the above puts strain of the bilateral external pterygoid muscles and resultant jaw pain. Palpation of these muscles will cause a painful response. There are many external factors that place undue strain on the TMJ. These include but are not limited to the following: Over-opening the jaws beyond their range for the individual or unusually aggressive or repetitive sliding of the jaws sideways (laterally) or forward (protrusive). These movements may also be due to wayward habits or a malalignment of the jaws or dentition. This may be due to: Speech habits resulting in jaw thrusting. Excessive gum chewing or nail biting. Excessive jaw movements associated with exercise. Size of foods eaten. These are the symptoms of TMJ, although not everyone who has TMJ may feel any or all of the symptoms. These include, but are not limited to: Unable to open mouth all the way Pain when trying to close mouth or bite down Feeling as if lower jaw muscles are tensed too tight If seeking relief from this disorder, make sure your doctor is up to date on all the current treatment options. Mandibular Repositioning Devices can be worn long or short term to help aleviate symptoms. Long term permanent treatment if the device is proven to work for your situation would be full mouth reconstruction, or building up of teeth to achieve the proper bite relation. Ask your doctor where he was trained to treat your disorder and what are the short and long term plans to help you achieve a pain-free life! It takes someone with an expertice to correctly treat this disorder. Treatments can vary in cost, but do not let the cheapest route cloud your decision. [edit]