Temporomandibular Joint Dysfunction (TMJ)Temporomandibular joint disorder, also known as TMJD, TMD or TMJ syndrome, is an umbrella term that refers to acute or chronic inflammation of the temporomandibular joint (TMJ), which consists of the mandibular condyle and the skull’s articular fossa. The disorder and resultant dysfunction can cause significant pain and impairment. One or both joints may be affected in people with TMJ. The condition can affect a person's ability to speak, eat, chew, swallow, make facial expressions and even breathe. 
The TMJ is a ball and socket joint similar to an elbow or knee joint. It is unique because it has a disc (or pad) between the mandibular condyle and the skull’s fossa. This disc moves along with the condyle as a person opens and closes his mouth and chews. One common TMJ problem occurs when the disc slips out of place. A click or pop in the jaw is an indication of this problem. The disc can actually move into a position in which the lower jaw locks open or closed. Dentists often use the term “recapturing the disc” to describe their treatment for getting the disc back into its place between the condyle and the fossa. A disc can slip forward, backward or to the side. It is important to see a dentist soon after a disc is dislodged, before it becomes deformed. Many people go through life with a TMJ click or pop. Children often fall or run into things, causing trauma to the TMJ. A pop, click or occasional locking of the jaw is accepted as normal by many individuals. However, when the problem results in persistent pain, patients will often seek help to relieve the discomfort. There are varying degrees of discomfort associated with TMD. Like many joints in the body, the TMJ is a synovial joint (i.e. it contains fluid that lubricates the joint). Excessive fluid can cause discomfort and even pain, like having fluid on the knee. This can be treated with anti-inflammatories, hot and cold compresses, etc. Over time, these episodes subside. An understanding of the TMJ may help a patient suffering with TMD. TMJ terms:
The disc has tendons attached to it and these tendons are attached to muscles. These muscles help to move the disc as the lower jaw moves while opening, closing, chewing and talking. The bony socket and condyle and the disc and tendons are not generally the site of discomfort; they do not have a substantial nerve supply. It is the muscles that have a nerve supply. When a disc is dislodged, the tendons are stretched and the condyle then puts pressure on a muscle, which can cause discomfort. Tendons are not elastic. Once they are stretched, they will remain stretched. This is why TMD sufferers often have various problems with differing degrees of discomfort intermittently over time. For example, pain may subside as the nerves and muscles atrophy. Because the TMJ is so small and complicated, it is often prudent to treat the symptoms of TMD. This is can be accomplished with biteplates, dental adjustments and orthodontics. Surgery in this area is generally performed on acute cases and patients experiencing pain over a significant period of time. Dr. Fulton adjusts orthodontic therapy to assist the general dentist or oral surgeon who is treating her patients with TMD. A word of advice from Dr. Fulton: More women than men suffer from TMD. More women than men chew gum. If you suffer from TMD, do not chew gum for long periods of time, but rather only as a quick breath freshener. |
