Posts Tagged ‘TMJ New Fairfield’
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by Dr. Brandon Chorney | Sep 6, 2012 | Health Articles
Temporomandibular Joint Disorder, also abbreviated to TMD or TMJ, is the name for a variety of conditions that affect the jaw joint. Symptoms vary from case to case, as does the severity of the symptoms. Most people who suffer pain in the jaw muscles or joints experience only temporary or cyclical problems. Other people go on to develop chronic symptoms and are diagnosed as having TMD.
Signs of TMD may include:
- Radiating pain in your face, neck, or shoulders
- Limited movement or locking of your jaw
- Difficulty opening your mouth wide
- Pain when you chew or yawn
- Painful and/or loud clicking or grating when you open or close your mouth
- Pain or soreness in front of your ear, or in your jaw muscle, cheek, teeth, or temples
- A noticeable change in the way your upper and lower teeth fit together
- Headaches, earaches, dizziness, difficulties hearing or swallowing
If you have any of the above problems, your doctor of chiropractic can help identify whether TMD is responsible and offer appropriate conservative treatment if necessary.
Causes of TMD
TMD experts categorize the condition in three ways:
- Myofascial pain that affects the jaw, neck, and shoulders. (Myofascial refers to the muscles, not the face)
- Dislocation of the jaw or displacement of a disc
- Degenerative joint disease, meaning rheumatoid arthritis or osteoarthritis in the jaw joint
A physical insult to the jaw is a major cause of TMD. This may be in the form of a knock while playing sport, a punch, or simply through overuse syndromes such as excessive gum-chewing, or significantly favoring one side of the mouth over the other when chewing.
Extended periods of physical stress can also lead to TMD. For example, sitting in a dentist’s chair with your mouth wide open for hours, although most dentists are aware of this problem and schedule breaks for the patient, or screen them prior to treatment for any jaw joint issues. If there is a problem, appropriate physical therapy may be required after treatment, or the patient may be asked to prepare before treatment with a series of jaw-loosening exercises.
Emotional stress can also contribute to TMD, although it is not in itself a cause. When a person is stressed and reacts physically through repeated teeth clenching or grinding, especially when this happens unconsciously at night, TMD may develop if the stress continues to produce these physical effects for any length of time.
Certain conditions that used to be labeled as causes of TMD are now referred to as just triggers. This includes moderate gum chewing, jaw clicking that causes no pain, orthodontic treatment that does not involve excessive opening of the mouth, and upper and lower jaws that have never fitted together properly.
Women are four times more likely to experience TMD than men, which may be down to postural differences, exacerbated by high heels.
Diagnosis and Treatment of TMD
If your doctor of chiropractic is required to assess TMD as a possible cause of your symptoms, you may be asked to do several things: place three fingers vertically in your mouth and bite down, open and close your mouth, and chew repeatedly. The chiropractor will check your jaw joint and muscle balance as your do these exercises and this is usually sufficient to confirm or rule out TMD. You will also be checked for any signs of inflammation and abnormalities. If further investigation is required to confirm diagnosis, an x-ray or MRI may be ordered.
If it is TMD, you may require chiropractic manipulation and massage, the application of heat and ice, and special exercises, with the primary aim of alleviating any pain. You may also be referred to a dentist or orthodontist if any appliances or splints are required to reduce the causes of the TMD.
Further chiropractic advice for dealing with TMD:
- Heat and ice. An ice pack isrecommended shortly after the injury or onset of pain. Later on, heat will help promote healing and reduce discomfort.
- Certain joint movements need to be avoided, such as chewing on hard foods, or eating food that causes the mouth to open too wide.
- TMD-specific stretching or strengthening exercises may be prescribed according to the specific case, and special feedback sensors in the jaw may need to be retrained.
by Dr. Brandon Chorney | Jan 31, 2012 | Health Articles
Does it hurt when you chew, open wide to yawn or use your jaws? Do you have pain or soreness in front of the ear, in the jaw muscle, cheek, the teeth or the temples? Do you have pain or soreness in your teeth? Do your jaws make noises loud enough to bother you or others? Do you find it difficult to open your mouth wide? Does your jaw ever get stuck/locked as you open it?
If you answered “yes” to some of these questions, you may have a temporomandibular joint disorder, or TMD. TMD is a group of conditions, often painful, that affect the jaw joint.
Signs may include:
- Radiating pain in the face, neck, or shoulders;
- Limited movement or locking of the jaw;
- Painful clicking or grating when opening or closing the mouth;
- A significant change in the way the upper and lower teeth fit together;
- Headaches, earaches, dizziness, hearing problems and difficulty swallowing.
For most people, pain or discomfort in the jaw muscles or joints is temporary, often occurs in cycles, and resolves once you stop moving the area. Some people with TMD pain, however, can develop chronic symptoms. Your doctor of chiropractic can help you establish whether your pain is due to TMD and can provide conservative treatment if needed.
What Causes TMD?
Researchers agree that TMD falls into three categories:
- Myofascial pain: discomfort or pain in the muscles of the jaw, neck, and shoulders
- A dislocated jaw or displaced disc
- Degenerative joint disease, rheumatoid arthritis or osteoarthritis in the jaw joint.
Severe injury to the jaw is a leading cause of TMD. For example, anything from a hit in the jaw during a sporting activity to overuse syndromes, such as chewing gum excessively or chewing on one side of the mouth too frequently, may cause TMD.
Both physical and emotional stress can lead to TMD, as well. The once-common practice of sitting in a dentist’s chair for several hours with the mouth wide open may have contributed to TMD in the past. Now, most dentists are aware that this is harmful to the jaw. In addition to taking breaks while they do dental work, today’s dentists also screen patients for any weaknesses in the jaw structure that would make physical injury likely if they keep their mouths open very long. In that case, they may use medications during the procedure to minimize the injury potential, or they may send the patient to physical therapy immediately after treatment. In less severe cases, they instruct patients in exercises they can do at home to loosen up the joint after the visit.
While emotional stress itself is not usually a cause of TMD, the way stress shows up in the body can be. When people are under psychological stress, they may clench their teeth, which can be a major factor in their TMD.
Some conditions once accepted as causes of TMD have been dismissed: moderate gum chewing, non-painful jaw clicking, orthodontic treatment (when it does not involve the prolonged opening of the mouth, as mentioned above), and upper and lower jaws that have never fit together well. Popular theory now holds that while these may be triggers, they are not causes.
Women experience TMD four times as often as men. Several factors may contribute to this higher ratio, posture and higher heels.
TMD Diagnosis and Treatment
To help diagnose or rule out TMD, your doctor of chiropractic (DC) may ask you to put three fingers in your mouth and bite down on them. You may also be asked to open and close your mouth and chew repeatedly while the doctor monitors the dimensions of the jaw joint and the balance of the muscles. If you have no problems while doing these things, then the problem is not likely to be TMD. Your DC can then look for signs of inflammation and abnormalities. Sometimes special imaging, an x-ray or an MRI may be needed to help confirm the diagnosis.
If you have TMD, your doctor may recommend chiropractic manipulation, massage, applying heat/ice and special exercises. In most cases, your doctor’s first goal is to relieve symptoms, particularly pain. If your doctor of chiropractic feels that you need special appliances or splints (with the exception of the “waterpack” and other guards against teeth grinding), he or she will refer you to a dentist or orthodontist for co-management.
In addition to treatment, your doctor of chiropractic can teach you how to:
- Apply heat and ice to lessen the pain. Ice is recommended shortly after the injury or after your pain has started. In the later stages of healing, you need to switch to heat, especially if you are still experiencing discomfort.
- Avoid harmful joint movements. For example, chomping into a hard apple is just as bad as crunching into hard candy (some hard candies are even called “jawbreakers” for good reason). And giant sandwiches can cause the mouth to open too wide and have a destabilizing effect on the jaw.
Perform TMD specific exercises. Depending on your condition, your DC may recommend stretching or strengthening exercises. Stretching helps to loosen tight muscles and strengthening helps to tighten muscles that have become loose. Special feedback sensors in the jaw can be retrained, as well, if needed.
