What is TMD?
Summary: Temporomandibular Disorders, or TMD, encompasses a wide range of conditions that affect the jaw joint (TMJ), the muscles of mastication (chewing muscles that move the jaw), and the associated structures.
Key TMD takeaways:
Symptoms: TMD symptoms include jaw pain, difficulty chewing, jaw sounds, headaches, and sometimes jaw locking, with varying severity and frequency.
Causes: TMD is caused by multiple factors like jaw injuries, genetic predisposition, arthritis, and lifestyle habits (e.g., caffeine consumption, poor posture).
Diagnosis: Diagnosis involves a dental examination, which may include palpation and observation of jaw movement, and sometimes x-rays or scans.
Treatments and Management: Self-management techniques (diet adjustment, relaxation, physical therapy), over-the-counter medications for short periods, and in some cases, cognitive-behavioral therapy or dental splints. Most TMD cases respond well to simple interventions, with surgery being rare.
What is TMD?
Temporomandibular Disorders, or TMD, encompasses a wide range of conditions that affect the temporomandibular joint (TMJ or jaw joint), the muscles of mastication (chewing muscles that move the jaw), and the associated structures.
The temporomandibular joint (TMJ), is a hinge-like connection between the jaw and the temporal bone of the skull. The TMJ enables essential functions such as speaking, chewing, and yawning.
TMD is a common condition that affects an estimated 10% to 15% of the adult population worldwide. This means that it is the second most common form of orofacial pain after toothaches, and the second most common musculoskeletal pain after back pain. Specific rates can vary, depending on the population studied and the diagnostic criteria used.
TMD often occurs in young adults between the ages of 20 and 40, with a higher prevalence in females. The reasons behind this gender difference could be related to factors such as hormonal influences, differences in pain perception, and psychosocial factors.
Common TMD symptoms
Symptoms of TMD vary from person to person, but TMD can often lead to:
Pain or tenderness in the jaw, face or around the ear
Difficulty chewing
Difficulty in opening or closing the mouth
Clicking, popping, or grating sounds in the jaw joint
Headaches and earaches
Facial pain and swelling
Jaw locking (either open or closed)
The severity and frequency of these symptoms can differ from person to person. It is important to note that jaw locking either open or closed is a very uncommon event and only happens in a very small subset of those who are experiencing a specific subtype of TMD.
Causes of TMD
There is no one singular ‘cause’ for TMD and multiple things contribute towards it, including:
Injury to the jaw or TMJ
Dental issues
Genetic predisposition
Arthritis
Substances such as caffeine and tobacco
Changes in the sensitivity of the pain signalling system
Other pain conditions such as migraine
Additionally, certain aggravating activities, such as frequent gum chewing, nail biting, poor sleep, poor posture, and excessive jaw movements can begin, worsen or prolong TMD symptoms.
Diagnosis
Diagnosing TMD requires a thorough examination by a dentist. The examination will involve physical palpation of the joint and surrounding muscles, and observation of jaw movement. It doesn’t always require x-rays or scans, but can do so if a specialist feels they will give added benefit over the findings from the physical examination.
Treatments and management of TMD
Treatment options for TMD depend on the underlying cause and severity of the symptoms. Self-management techniques are important and likely to be helpful regardless of pain severity. Self-management forms a foundation that supports additional management options if required. Often supported self-management alone is effective in managing symptoms.
Self-management includes strategies for easing pain and habits that support living well alongside pain. Common components of self-management to reduce pain exacerbations include: adjusting your diet to have eat softer foods for 10-14 days, applying heat or covered ice packs, practising relaxation techniques, completing some self-administered physical therapy and/or massage.
Over-the-counter pain relievers and anti-inflammatory medications may also provide relief. If these types of pain relief medications are used, then they should be used for a short period of time; 5-10 days maximum.
More holistic elements of self-management might also include:
Prioritising the things that you find meaningful and valuable in life
Balancing activity and rest
Making sure to plan things that you enjoy
Learning to live well with, not fight pain
Relaxation or meditation for wellbeing
Maintaining relationships and communication
Cognitive-behavioural therapy (CBT) may be recommended and can help to support self-management of pain. CBT or other psychological therapies may also be helpful to treat any symptoms of anxiety or depression that are present alongside pain.
Dental splints may be used to help with some of the muscular pain of certain subtypes of TMD. It is extremely unusual for injections or surgery to be required as most cases (75-90%) respond well to simple treatments. Injections to the muscles or joint or surgery to the joint are possible but are usually only considered in very specific circumstances.
While some subtypes of TMD can be painful, TMD generally is not a serious or life-threatening group of conditions, and many people find relief with appropriate treatment. If you suspect you have TMD, consult a dental professional for a comprehensive evaluation. Although TMD can be intensely painful this pain will usually respond well to very simple interventions. It would be very unusual for TMD to cause lasting and ongoing damage to joints or muscles, and a dentist can easily identify any worrying causes that are mimicking TMD and may need specific treatment.
