What Is TMJ?
What Is TMJ?
TMJ is an abbreviation for the “Temporomandibular Joint”. When we discuss TMJ, what we are really talking about is TMD, or “Temporomandibular Joint Disorder”. Therefore, the temporomandibular joint can become affected by temporomandibular joint disorders. According to the National Institute of Health (NIH) TMJ affects approximately 5-12% of the population. The group most affected are women between 20-50 years of age, and make up approximately 90% of patients seeking TMJ treatment. The temporomandibular joint is a very complex joint that is classified as a “Ginglymoarthroidal” joint, which means it has both hinge movements (like your knee) and sliding movements (like your wrist). When your jaw opens, you first have an initial hinge movement called Rotation”, followed by a sliding movement called “Translation” that allows you to fully open your jaw when you yawn or take a big bite of food. The temporomandibular joint has two bones that function together. First, there is the “Temporal” bone at the base of the skull, which is a fixed bone. Second, there is the “Condyle of the Mandible” (or jawbone) that articulates with the temporal bone (see
animated video below). There is also a unique structure between these two bones called the “Articular Disc”, that acts a cushion when the TMJ is in function and many times it is the articular disc that is the source of pain. Finally, the temporomandibular joint is “held together” by several muscles and ligaments which can also be a source(s) of jaw pain (see animated video below). As one can imagine, this complex “structural wonder” experiences a lot of wear and tear throughout one’s life. Some people take out their daily stresses on their jaw joints by clenching and grinding while they sleep, some people have genetic disorders that affect their jaw joints, and some people have autoimmune disorders that degenerate their jaw joints. That is why it is imperative to seek out an “Orofacial Pain Specialist” who understands the complexities of the temporomandibular joint and how to treat them.
Causes of TMJD (Temporomandibular Joint Disorder):
According to the American Academy of Orofacial Pain, the underlying causes of TMJD are not fully known because there are so many different factors that contribute to TMJD. Some of those factors include
– Teeth clenching and grinding
– Dental Procedures
– Genetic Disorders
– Autoimmune disorders
The two main types of TMJD pain are “Myogenous” (muscle related) and “Arthrogenous” (Joint related). Myogenous pain is usually a result of overworking the jaw muscles due to stress, clenching/grinding, hard diet, obsessive habits, and medications. Arthrogenous pain can result from degeneration of the hard and/or soft tissues of the joint due to autoimmune disorders, trauma, rheumatoid arthritis, osteoarthritis, and genetic disorders. It is important to remember that usually these disorders present with a multitude of symptoms, stemming from multiple comorbidities.
Appointments & Consultations
Treating TMJ is a very complex process as there are many different TMJD disorders. According to the NIH Department of Craniofacial Research, “experts strongly agree that the best treatments for TMJD are those that are the most conservative and REVERSABLE treatments”. Some of these conservative, reversible treatments include:
– Heat/Cold Packs, Massage, Physical Therapy and Biofeedback
– Spray and Stretch
– Soft Diet
– Dental (Occlusal) Splint Therapy (Night guard)
– Corticosteroid and Lidocaine Injections
– PRP and Prolotherapy Injections
– Botox Therapy
On occasion, there are more advanced cases of TMJD that require
surgical intervention that include arthroscopic and open joint surgery.
These procedures are performed by oral and maxillofacial surgeons.
These surgeons are highly trained, usually dual degreed (DDS and MD)
physicians, that perform these surgeries in the hospital and/or the
university teaching hospital setting.