The Tribune

BY DR SPARKMAN

FERGUSON

REGISTRAR BAHAMAS DENTAL COUNCIL

TEMPOROMANDIBULAR Disorders (TMD) occur as a result of problems with the jaw joint, and the muscles responsible for chewing and movement of the jaw.

These disorders are often incorrectly referred to as TMJ, which stands for temporomandibular joint.

• What is the Temporomandibular joint (TMJ)?

The TMJ is a hinge joint that connects the bottom jaw to the skull. There is one on either side of the head and immediately in front of the ears. These two joints are flexible thereby allowing movements up and down, and side to side. This enables us to talk, yawn, and most importantly chew.

• What causes TMD?

The causes of TMD are not very clear but it is believed that the symptoms arise mainly from the muscles that control jaw movements or from parts of the joint (TMJ) itself.

The main causes are:

1. Clenching or grinding the teeth

2. Rheumatoid arthritis or osteoarthritis in the TMJ

3. Stress

4. Dislocation of the soft cushion disc that sits between the ball and socket of the joint

The main symptom of TMD is pain. This pain may be in the jaw, face, TMJ, neck, shoulders, ears; and experienced whenever you chew, open wide, or speak. Other symptoms of TMD include a clicking or grating sound when opening or closing the mouth, a tired feeling in the face, swelling of the face, dizziness, toothache, earache, and the inability to open the mouth wide.

The treatment of TMD requires a multi-disciplinary approach, which is targeted at the prevailing symptoms that a patient presents with. Since the main symptom is pain, this is almost always the first matter that must be addressed. After the pain is brought under control, the restoring of normal function of the TMJ is sought.

TMD can be brief, or can last for months or years depending on the severity of the concern. Since stress or other emotional matters can be a part of the disorder, the appropriate professional in conjunction with the dentist work together to alleviate the person’s discomforts.

Although it has been a long known fact, doctors and patients often underestimate the power of the emotions in TMD. It is also useful to remember that skeletal muscles (including the muscles surrounding the TMJ) generally behave similarly wherever they are in the body. These muscles can tighten, and remain tense causing pain much like a calf muscle. Unlike a calf muscle that can be manipulated, and massaged, the majority of the muscles surrounding the TMJ are internal and therefore can only be stretched or treated with skeletal muscle relaxers to help restore function.

In conclusion, prevention of TMD is important. This can be done by reducing stress and practicing relaxation techniques, recognising when we are clenching the teeth and stop the practice. Additionally, we need to avoid overusing the jaws with activities such as constantly chewing gum, biting the nails, resting your chin on your hands, or cradling the telephone receiver between your shoulder and your jaw.