Temporomandibular Disorders - TMD

Temporomandibular joint disorder, also known as TMJ, TMD, or TMJD, is a general acronyms identifying disorders causing inflammation of the temporomandibular joint, which connects the skull to the mandible. There are a number of conditions that can cause pain in the jaw joint (TMJ) and the muscles involved in the closing and opening of the jaw. Disorders affecting the temporomandibular joint can affect a person's ability to function with eating, speaking, swallowing, chewing, and breathing.

The set of TMD disorders are commonly divided into three general categories, though multiple conditions may be present at once.

Inflammatory joint disease: Arthritis is a disease that causes inflammation of the joints. A number of forms of arthritis including rheumatoid arthritis, osteoarthritis, traumatic arthritis and infectious arthritis may have an effect on the jaw joint. Synovitis is another condition that can bring about TMJ pain where the synovial membrane that lines the joint and lubricates it becomes inflamed.

Myofascial pain: The jaw joint and muscles around it can be affected by myofascial pain. This is a disorder where trigger points and muscle tension, commonly in the neck, back and shoulder areas, cause pain in a localized area and referred pain from another region of the body. 

Internal derangements of the temporomandibular joint: Between the mandible and the skull is a disc that acts as a cushion. Displacement or deterioration of the disc can cause pain and inflammation of the joint, and gradual loss of jaw function.

A person suffering from TMJD may experience:
 

• Clicking or popping or grating noise in the jaw (s)
• Being unable to open the mouth fully or comfortably
• Locking of the jaw when trying to open the mouth
• Neck pain, shoulder pain, back pain or headaches
• An irregular bite or a feeling that the teeth are not aligning correctly
• Swelling of the face around the jaw joint
• Ringing in the ears, decreased hearing, fullness of the ears and earaches
• Dizziness and vision problems
• Pain behind the eye

Occasional discomfort or pain of the jaw joint or facial muscles is not uncommon and can occur for any number of reasons. Often TMJ pain goes away within days or weeks, but if the problem persists for a month or more, a doctor should be consulted.

TM Disorders are still relatively an unexamined area of medicine, as such, diagnosis and treatment of these conditions can be difficult for many healthcare providers including physicians and medical specialists such as neurologists and headache specialists. There is no standard accepted tests for diagnosing TMDs and a good OFP clinical examination and history is the accepted as the gold standard for diagnosing TMDs. 

The American Dental Association recently, May of 2020, recognized Orofacial Pain Medicine as the 12th specialty in dentistry and those individuals who are Board certified by the American Board of Orofacial Pain are now considered specialists of Orofacial Pain Disorders which includes TMDs.