From the first yawn in the morning wake-to the last minutes before we return to sleep, our jaws are active. Whether we’re speaking, eating, singing, or chewing a piece of bubble gum our jaws are continuously engaged. Proper functioning of our jaw joints is often taken for granted until a problem develops. When we develop pain in the jaw joint, the discomfort can be relentless due to its significant and ongoing workload.
The Human Jaw
It was previously thought that the human jaw, or mandible, was weak and ineffective when compared to the jaws of our primate relatives. New research, however, suggests that when engaged the human jaw is nearly 50 percent more powerful than either of the chimp, gorilla or orangutan. It’s no small wonder that our jaws are the largest and strongest bones anywhere in the front of the head.
Our jaws are expert mechanisms for chewing and breaking down the foods we eat. Human teeth are protected by our substantial enamel and deep-set roots – allowing us to enjoy a variety of nutritional options. In fact, the human mandible is effective in its ability to disperse the force of its bite along the jaw, resulting in less force acting on the bones of the head.
Unlike primates, however, we might struggle to engage in sustained and repetitive chewing. Primate diets often require hours of chewing every day in order to process the thick and fibrous plant-based foods that they consume. With sustained use, the human jaw muscles would likely underperform in comparison.
What is TMD?
TMD is short for temporomandibular disorder and refers to a group of conditions involving the temporomandibular joint. TMDs are often referred to as TMJ or as TM issues.
The temporomandibular joint joins the upper and lower jaw and is responsible for joining the lower (mandible) to the skull. The TM joints on either side of the jaw are complex and rely on the synchronous functioning of each in tandem. The parts of the temporomandibular joint structure are:
- Joint capsule – thick sinewy membrane formed around the joint
- Articular disc – cushions surface of the interfacing bones with flexible and elastic cartilage
- Mandibular condyles – rounded ends of the jaw bone where articulation with other bones occur
- Articular surface of the temporal bone – area of the temporal bone wherein articulation between bones occurs
- Temporomandibular ligament – major ligament which defines radial parameters of movement
- Stylomandibular and sphenomandibular ligaments – minor ligaments that do not attach directly to the joint
- Lateral pterygoid muscle – Muscle for mastication (chewing)
Branches of the carotid artery feed the joint, and nerve supply exists in free nerve endings in the bones, ligaments, and muscles of the TMJ
Symptoms of TMD
The interrelationship of the muscles and joints used for proper TMJ functioning means that the range of symptoms varies widely. Pain, locking, and clicking in the jaw is the primary complaint of those who suffer from TMD. But many other symptoms can indirectly point to a TMD problem.
Some symptoms of TMD include:
- Aching of the ear or area surrounding the ear may include chronic ringing
- Dizziness, with or without fainting and nausea
- Inability to open or close the joint (lock-jaw)
- Tooth grinding or clenching
- Neck, shoulder, or tongue pain
- Tooth imprints on the tongue
- Deviation of the jaw during use
- tooth pain
- back pain
Causes of TMD
Complaints of jaw pain and mechanical problems are primarily due to:
- Myofascial discomfort syndrome (involves structures and tissues used for eating)
- Internal abnormalities of the tissues or structure
- Degenerative osteoarthritis
- Temporal arteritis or giant-cell arteritis (inflammatory blood vessel disease)
Other causes of TMD include congenital, traumatic, and idiopathic disorders.
How Your Dentist Can Help
If you are experiencing symptoms upon waking in the morning, consider starting a journaling habit to track their severity and frequency. Your dentist will want to know which symptoms have been presenting and will use this information, along with the evidence that they are able to gather from a visual examination of your teeth condition and bite, to determine whether further examination is required. Further examination could involve diagnostic X-rays or an MRI of the jaw.
Depending upon what information your dentist can collect regarding the functioning of your TM joint, he or she may be able to offer treatment options to help you manage your TMD. Some dentists may refer to TMD specialists for further exploration of your discomfit and the underlying cause.
Possible Treatment Options
The first course of treatment for TMD is typically a custom-fit night guard. While night guards will not necessarily stop the clenching or grinding, it will reduce the force applied to the teeth throughout the night, when grinding is unconscious and hard to control. Other treatments for TMD include muscle relaxant medications, Botox injections into the TM joint, stress management techniques, and in extreme cases – surgery.
If you need more information about TMD contact our dentist in west Edmonton at Lotus Dental Wellness.