For years we called it TMJ (temporomandibular joint) but now we refer to it as TMD or temporomandibular joint dysfunction which is certainly more descriptive of why treatment is necessary.
There is much confusion in the field of TMD, many times leading to incredibly expensive and unnecessary, sometimes invasive dental treatments. In previous articles I have reviewed many of these protocols from the use of electromyography, to pharmaceuticals, to full mouth reconstruction or even surgery.
In this article I want to share what you can do to help your TMD and what to avoid in order to prevent damage to this very complex joint. First, we can take a look at what makes up the TMJ. It is composed of the glenoid fossa of the temporal bone, the condylar head of the mandible, an articular disc and articular capsule. The purpose of the disc is to prevent bone to bone contact and, when functioning correctly, the disc and capsule provide a smooth, well lubricated, rotation and translation of the joint.
The elastic ligaments associated with the capsule are responsible for keeping the disc in place. Excessive stretching, like opening too wide to yawn, taking a big bite of a sandwich, or singing can stretch or even tear these structures. The disc then is allowed to become displaced, many times not returning back when the condyle reseats itself in the fossa. When the patient then opens their mouth, the condyle has to bounce over the back of the displaced disc, resulting in a popping sound, sometimes accompanied by pain and limited opening or a feeling that one’s bite is misaligned.
This pain is due to inflammation of the stretched or torn ligaments. When the disc continues to be displaced, or if clenching wears a hole in the disc, the condyle and fossa begin to touch, resulting in a sandy or gravely sound as the joint moves. At this point, arthritis and degeneration can develop.
What can you do to help?
- Like any other joint, over use can be abuse, such as chewing gum.
- Regularly patients show me their pop by moving the jaw laterally. Never do anything on purpose to cause a pop! Lateral jaw movement is not what the jaw was designed to do.
- Learn to hide your yawns like you are in the front row of an important class.
- Eat smaller bites and avoid big sandwiches.
- Avoid hard, tough or crunchy foods, such as nuts, ice or beef jerky.
- Never check to see if the popping is still there. If the joint is quiet, it is getting better.
- Stress is a major factor causing us to keep our teeth together (clenching or grinding). Teeth are only supposed to meet when swallowing, as little as one minute per hour. Learning to control the stress in your life will help. My next article will address this subject.
- Learn to follow an anti inflammatory diet. Google it.
- If you are prescribed drugs, check out the side effects. You may possibly get professional help to correct what causes the need for that drug. Many of my patients are experiencing a greatly improved life by doing this.
- Schedule a free consultation with my office. I treat TMD differently than most dentists. If needed, I make a custom appliance, in office, fit specifically to your bite, not made by an outside lab.
Don’t let the dysfunction and pain get out of control before you seek help. Occasionally I find something quite simple that is causing the problem.