What is the temporomandibular joint (TMJ)?

The temporomandibular joints (TMJ) are the 2 joints that connect your lower jaw to your skull. More specifically, they are the joints that slide and rotate in front of each ear, and consist of the mandible (the lower jaw) and the temporal bone (the side and base of the skull). The TMJs are among the most complex joints in the body. This joint is unique in that it is a bilateral joint that functions as one unit. Since the TMJ is connected to the mandible, the right and left joints must function together and therefore are not independent of each other. These joints, along with several muscles, allow the mandible to move up and down, side to side, and forward and back. When the mandible and the joints are properly aligned, smooth muscle actions, such as chewing, talking, yawning, and swallowing, can take place. When these structures (muscles, ligaments, disk, jaw bone, temporal bone) are not aligned, nor synchronized in movement, several problems may occur.

• Smiling, laughing, talking, chewing — these all are facial movements you make daily with little to no thought. But, if you have temporomandibular joint dysfunction (TMJ), those simple movements may cause you a lot of pain.
• TMD stands for temporomandibular joint disorder. This refers to any dysfunction of the TMJ. Many people use the terms TMJ and TMD interchangeably.

WHAT IS TMJ OR TMD ?

Temporomandibular disorders (TMDs) are a group of more than 30 conditions that cause pain and dysfunction in the jaw joint and muscles that control jaw movement. “TMDs” refers to the disorders, and “TMJ” refers only to the temporomandibular joint itself. People have two TMJs; one on each side of the jaw. You can feel them by placing your fingers in front of your ears and opening your mouth.

There are three main classes of TMDs:

1. Disorders of the joints, including disc disorders.
2. Disorders of the muscles used for chewing (masticatory muscles).
3. Headaches associated with a TMD.

What are the causes ?

The etiology of TMD is mildly understood, but it is believed to be multifactorial; the appropriate management of the condition requires recognizing the predisposing and contributing factors.

Myofascial and intraarticular TMDs differ in their etiological factors. As the name implies, a myofascial disorder means that the muscles – in this case, the ones involved in mastication – are affected, becoming tensioned, fatigued, and painful. Several factors are linked to muscular dysfunction, including stress, parafunctional habits like bruxism and abnormal posture, psychological conditions like depression and anxiety, and autoimmune diseases. Chronic pain conditions such as fibromyalgia are also often linked to TMD.

Intraarticular disorders refer to inflammatory or mechanical factors that affect the joint itself, articular disc displacement being the most common. Other intraarticular causes include trauma, capsular inflammation, osteoarthritis, hypermobility, and inflammatory diseases, like rheumatoid arthritis. It is not clear yet if malocclusion contributes to TMD.

Who can be affected with it?

TMD symptoms can appear at any age, but a peak incidence occurs in adults between 20 to 40 years.  Women are much more likely to be affected than men, the reason for which is still unknown. Even though up to 60 to 70% of the population shows signs of TMJ disorders, only 5% to 12% of people report symptoms and require treatment.

What are types of Temporomandibular joint Disorders?

TMJ dysfunction occurs when the muscles and ligaments around your jaw joints become inflamed or irritated. The condition may be acute or chronic, and the resulting pain may be mild or severe.

• Myofascial pain
• Acute muscle strain
• Muscle spasm
• Fibromyalgia
• Chronic pain conditions
• Myotonic dystrophy

TMD can be classified into articular and non-articular disorders. Articular disorders include:

• Osteoarthritis
• Trauma
• Infectious arthritis
• Prior surgery (iatrogenic)
• Gout / pseudogout (crystal arthropathies)
• Rheumatoid arthritis (RA) / juvenile RA
• Psoriatic arthritis
• Axial spondyloarthritis (also known as ankylosis spondylitis). Non-articular disorders include:

What are the symptoms?

The following symptoms are associated with TMD

• Pain (the most common emerging symptom ) usually in the preauricular area and / or the masticatory muscles
• Limited range of mandibular movement
• Presence of TMJ sounds, such as popping, clicking, grating or crepitus
• Earache, headache, jaw ache and facial pain
• Non-painful hypertrophy of the masticatory muscles
• Abnormal occlusal wear which is associated with oral parafunction (this may be related to tooth grinding and jaw clenching)
• It has also been found that 87 percent of patients have otological symptoms (i.e. symptoms related to the ear), including:
• Tinnitus
• Deafness
• Dizziness
• Imbalance
• Ear fullness

Diagnosis

There is no widely accepted, standard test available to diagnose TMDs. Because the exact causes and symptoms are not clear, identifying these disorders can be difficult.

Your doctor or dentist will note your symptoms and take a detailed medical history. He or she will ask questions about your pain, including its location, when it occurs, what makes it better or worse, and if it stays in one area or spreads to other parts of your body. The doctor or dentist will also ask if you have other pain conditions such as headache or back pain.

He or she also will examine your head, neck, face, and jaw for tenderness; jaw clicking or popping; or difficulty with movement. The doctor or dentist might also suggest imaging studies such as an x-ray, magnetic resonance imaging (MRI), or computed tomography (CT).

• How to practice TMJ Pain Relief ?

• Maintain the resting position of your jaw: To help alleviate TMJ pain, minimize wide jaw movements, such as chewing, yawning, singing, and yelling. Do your best to keep your muscles as relaxed as possible.
• Correct your posture: Sitting in an unideal position for long periods of time can cause you to feel more pain in your jaw. When working, choose a chair with back support and take frequent breaks to improve your posture. While driving, set your seat to be as upright as possible, and while doing leisure activities, such as watching TV or reading, choose a space that allows you to sit upright and place a pillow behind your back for support.

Hearn suggests the following exercise to correct your sitting or standing posture: Raise            your chest bone, pull your shoulders back and gently squeeze your shoulder blades to            straighten your back muscles.

• Get a good night’s sleep: Sleep is important for many aspects of good health. To help minimize TMJ pain, sleep on your back and use pillows to support your neck. You should avoid sleeping on your stomach, and if sleeping on your side, do not place your hand on your jaw.
• Use a hot or cold compress: Ice helps reduce swelling and pain, while heat can increase blood flow and relax your jaw muscles. Apply a hot or cold compress to your jaw for 15 to 20 minutes at a time using a light layer between the compress and your skin.

• Reduce stress: Try meditation techniques to help loosen and relax your jaw. Yoga practices can also help put less stress on your muscles, and gardening is a great activity to try to calm your mind and relax your face.
• Exercise your jaw: Jaw exercises can help increase mobility in your joints. There are three types of jaw exercises that can be used together to relieve pain:
  • Stretch exercises
  • Strengthening exercises
  • Relaxation exercises
• Take notice of bad habits: You may have a few tendencies that can cause TMD pain. Such habits include:
  • Nail biting
  • Chewing cheeks and lips
  • Resting your jaw in your hand

Clenching your teeth

• • Grinding your teeth
  • Clenching jaw muscles pushing the tongue against your teeth.
• Avoid certain activities and foods: Specific activities and foods can cause you to open your mouth forcefully or move your jaw in an extreme way. Try to avoid the following:
  • Yawning or yelling
  • Crunchy or hard foods
  • Taking large bites of food
  • Foods that require prolonged chewing

Why Cosmic Homeo Healing Centre?

Cosmic Homeo Healing Centre is run by second generation Homeopath Dr. Mahavrat Patel having vast clinical records of more than 75 years and clinical experience of nearly 50 years in treatment of various cases of Temporomandibular joint disorders. Under the able guidance of Dr. Mahavrat Patel, our team of experts have been successfully treating thousands of cases of Temporomandibular joint Disorders since many years.