TMJ Disorder and Dysfunction
What is TMD?
TMD stands for TemporoMandibular Disorder or Dysfunction. People commonly refer to this as "TMJ". TMJ actually means TemporoMandibular Joint, and we all have two TMJ’s. TMD is what dentists refer to when the joint has a problem. There are many different types of problems and different levels of severity of these problems.
What is TMJ?
TMJ is the TemporoMandibular Joint, which connects your lower jaw to your upper jaw. It is a ball and socket joint, and it is the most complex joint in the body because it is the only joint in which the ball comes out of the socket during normal function. Anytime you open to speak, yawn, chew or laugh the joint must move within the socket and many times out of the socket. The joint involves two bones (the ball and the socket, anatomically named the condyle and the fossa) separated by a cartilage disc. The disc is held in place by ligaments and muscles.
How does TMD happen?
There are many reasons for TMD to happen. One of the most common reasons is damage to the muscles and ligaments that hold the disc in position. The muscles and ligaments work to maintain the disc’s position within the joint space during function. If the muscles or ligaments are put under pressure or torqueing forces, damage to the joint can occur. These pressures can develop from many causes; some of these include trauma to the head and/or neck, functional habits like clenching or grinding of the teeth, or posturing the jaw into abnormal positions.
What does it mean to be high risk?
If you are high risk, you show signs that the muscles, ligaments, or disc may be in a vulnerable state or have suffered damage in the past. When there is vulnerability and/or damage, it is necessary to diagnose and stabilize or treat the joint and supporting structures, including the teeth. Some of the risk signs include, but are not limited to:
Flat spots on the teeth (wear facets)
Enlarged jaw muscle size
Presence of a line on the inside of the cheek (linea alba)
Joint sounds, including popping or crunching/gravel-like noise with or without pain
Asymmetry of the face structures or asymmetry during opening or closing
Scalloping of the tongue
Tenderness of the jaw muscles
Headaches in the temples
Tenderness in the ear, ringing of the ear
Gum recession or tooth notching at the gum line
Anterior open bite; the front upper six teeth do not overlap the lower front six teeth
What can I do about it?
Diagnosis for TMD is similar to diagnosis for any other joint problem. It is essential to acquire radiographic images of the bones and MRI images of the soft tissue and disc in order to determine the condition of the joint. These images need to be interpreted by a radiologist trained in TMD. In addition to 3D imaging, we use models and photographs of the teeth to aid in the diagnosis of the joint condition and how it has affected your bite. This allows us to correlate the 3D images with the evidence in your mouth.
What treatment will I need?
Treatment for TMD varies greatly. Like damage to the knee, some injuries require surgery. More moderate injuries and concerns can sometimes be treated with oral appliances, orthodontics, physical therapy and/or medication. In order to determine what treatment best suits you, a proper diagnosis with radiographs, MRI, models and photographs is the key. Without the correct diagnosis, it is impossible to determine what treatment is right for your joint condition.
How do I get started?
If you would like to get a complete diagnosis of your TMJ condition, you will need to complete three steps:
Photos, dental models and MRI bite registrations completed.
CBCT radiographic image taken in our office and interpreted by our doctors.
MRI imaging with bite registration. Referral to an imaging center and interpreted by a medical radiologist.
What if I don’t do anything?
Without treatment, a very high percentage of high-risk joints progress to a degenerative state over time. This can include loss of the disc (similar to a slipped disc in the back), arthritis, and changes in the occlusion of the teeth (bite). Many people without treatment develop chronic neck and jaw pain. Other patients will adapt to the dysfunctional joint. It is impossible to predict how TMJ dysfunction will affect a person over the course of his or her life.
Need more information?
Call our office at 605-925-4999 (Freeman) or (605) 928-3363 (Parkston) to schedule your TMJ consultation today with Dr. Jason Aanenson, Dr. Alex Whitesell or Dr. Serena Whitesell!