TMJ is one of the hardest conditions to get successfully treated. Many people with the condition spend years searching for successful TMJ treatment, and some find that the treatments they try can make the condition worse.
So how do you find the best treatment for this hard-to-treat condition? Understanding your options can help you follow a path through noninvasive and reversible treatments first before trying more aggressive therapies that have higher risk. Our guide will help you understand this process so you can navigate its twists, turns, and pitfalls.
What Is TMJ/TMD?
First, it’s important to understand that temporomandibular joint disorders, commonly called TMJ or TMD, is not a singular condition, but an unknown number of conditions that result in overlapping symptoms. These conditions all affect the temporomandibular joints, which connect the temporal bones of the skull with the mandible (lower jaw bone).
This joint sits at a complex and vulnerable intersection in human anatomy. When it has problems, these problems can affect nearby systems, which can lead to a wide array of symptoms (see TMJ symptoms under How Is TMJ Diagnosed?).
Which Is the Right Name?
Some people are confused about whether temporomandibular joint disorders should be called TMJ or TMD. The condition has had many names in the approximately 85 years it’s been a recognized disorder. It was known as TMJ for over a decade before some people decided to start calling it TMD, preferring to use TMJ to refer to the jaw joint. Since then, the condition has had about a dozen names.
Two large organizations of doctors and dentists got together in the late 1990s to try to resolve the naming issue. They agreed that the condition should be called TMD, so this has become its “official” name. However, by this time, so many people were accustomed to calling it TMJ, that the official declaration has made little difference.
Types of TMJ
There are at least three commonly recognized types of TMJ: myofascial pain disorder (MPD), disc displacement (DD), and degenerative joint disease (DJD).
MPD is the most common form of TMJ. It occurs when the jaw muscles are tense or strained, leading to muscle pain and dysfunction. DD is when the cushioning disc between the two bones comes out of place, causing jaw popping and clicking, as well as irregular jaw motion. DJD is when the joint begins to break down as a result of arthritis. The symptoms of these conditions often overlap, and people can have more than one of them at a time.
How Is TMJ Diagnosed?
Successful treatment of TMJ depends on a proper diagnosis of the condition. While in the past there was no standard process for diagnosis, in recent years, doctors and dentists have adopted a procedure that uses a detailed sequence to achieve more reliable diagnosis. First, Dr. Siegel will talk about your symptoms. Then they will ask about your medical history. Third, you will get a detailed exam, which will include palpitating (touching) the joint and muscles of the head and neck. Finally, Dr. Siegel may use different technologies to image the joint and measure its dysfunction.
One of the things that has stymied diagnosis of TMJ in the past is that it has so many symptoms that are so widespread. These can lead to misdiagnosis in part because patients often don’t report all related symptoms, since they might not recognize them as being related to TMJ. By focusing on just the most bothersome symptoms (such as headache or tinnitus), it can lead Dr. Siegel to consider just a few incorrect possibilities, such as salivary gland infection.
Here is a list of common symptoms that people with TMJ might experience:
- Jaw pain
- Irregular jaw motion
- Limited jaw motion (including locked jaw)
- Popping or clicking in the jaw
- Clenching or grinding teeth (bruxism)
- Damaged or worn teeth
- Ringing ears (tinnitus)
- Congested ears
- Ear pain
- Vertigo or dizziness
- Headaches (including migraines)
- Shoulder, neck, or back pain
- Facial pain
- Numbness in hands and fingers
In addition, sleep apnea and TMJ commonly occur together, so people with sleep apnea or its symptoms should consider themselves at risk for TMJ.
Next, Dr. Siegel will talk to you about your medical history. This will include potential injuries that might contribute to TMJ, other conditions that are linked with TMJ, and medications or other treatments that can sometimes occur with TMJ, such as rheumatoid arthritis, lupus, fibromyalgia, vulvodynia, or irritable bowel syndrome (IBS).
The more complete your medical history, the better your odds of a successful diagnosis.
After taking your medical history, Dr. Siegel will conduct a physical exam. You will be asked to move your jaw and report symptoms as they occur. The more symptoms that can be demonstrated, the better the diagnosis.
Dr. Siegel will feel your jaw joint and muscles, including head and neck muscles, and muscles inside the mouth. He may press on certain muscles in an attempt to elicit discomfort.
Imaging and Other Objective Measurements
Based on the results of the previous steps, Dr. Siegel may recommend objective measurements of the jaw joints and their function. This may include imaging techniques like panoramic x-ray, MRI, ultrasound, or CT (computed tomography) scans.
Neuromuscular dentists, like Dr. Ken Siegel in Blue Bell, PA, also use a number of tools that can measure aspects of your bite we can’t otherwise measure effectively. This includes a suite of tools called the K-7, which can measure jaw motion, jaw sounds, and jaw muscle tension. Dr. Siegel may also use a T-Scan bite measurement tool to identify the strength and balance of your bite.
How Is TMJ Treated?
In the past, doctors were quick to jump to invasive treatment for TMJ. However, less invasive treatments are often best, especially when the condition is detected early. With early treatment, you might be able to stop the progress of TMJ so you don’t need more invasive treatments later.
TMJ Home Care
Everyone should start with home care for TMJ. Here are some home care strategies