What is TMD/TMJ?
Although it is commonly called TMJ, that term actually means Temporomandibular Joint – or your jaw joint. The more accurate term is TMD (Tempormandibular Disorder) or more correctly CMD (Craniomandibular Disorder). It is a disease of Cranial Facial Anatomy and refers to a broad array of symptoms that can arise from an issue in how the lower jaw functions and rests.
The symptoms number in the dozens and don’t all affect people equally and has made accurate and consistent diagnosis of the condition very difficult and in fact, poorly understood by the dental profession as well as physicians and other health care modalities.
Some common symptoms include:
- ‘Migraine’ pain
- Facial pain
- Jaw joint pain
- Back, neck, cervical pain
- Postural problems (forward head posture)
- Pain in the face
- Opening of the mouth (commonly known as “Locked Jaw”)
- Headaches (tension type)
- Pain in the muscles surrounding the temporomandibular joints
- Pain in the occipital (back), temporal (side), frontal (front), or sub-orbital (below the eyes)
- Pain behind the eyes – dagger and ice pick feelings
- Multiple bites that feels uncomfortable or, “off,” and continually changing
- Tender sensitive teeth to cold
- Deviation of the jaw to one side
- The jaw locking open or closed
- Ringing in the ears, ear pain, and ear congestion
- Sinus like symptoms
- Dizziness or vertigo
- Visual Disturbances
- Tingling in fingers and hands
- Insomnia -difficulty sleeping
Hidden underneath these symptoms are generally a negative impact on the blood flow to the brain as well as diminished airway and often nighttime sleep problems.
Why hasn’t anyone caught it before?
The fundamental principles that are taught in dental programs are focused on the mechanical function of the hard tissue. The very foundation of traditional education in the study of occlusion is focused on creating harmony between the bony jaw joint and the articulation between the teeth. While this seems at first to be quite logical, there are significant portions of the system completely ignored.
The complete system is comprised of three critical components and all three must be considered and managed in order to create predictable success and relief for people who suffer with issues related to the occlusion. While it is obviously critical to have the upper and lower teeth contact and mesh correctly that isn’t sufficient. Additionally, it is important that the jaw joint itself is in a functional relationship, however what that precise relationship is has been the subject of debate for decades. In fact, there are approximately 30 different definitions of that one true relationship that makes the system work. These two considerations are important; however they cannot be addressed in absence of the muscles and soft tissue that complete the system.
A pioneer in the science and physiology of muscles and soft tissue, Dr. Janet Travell, recognized that approximately 90% of the pain in the body comes from muscles. Since the muscles of the head and neck are all related to or affected by the bite or jaw relationship, it is critical to consider muscle comfort in the assessment, diagnosis and treatment of patients who suffer with bite issues. Traditional dental education still focuses on the relationship between the upper and lower teeth combined with the jaw joint position but completely misses scientific evaluation of the musculature.
When addressing any system, it is essential to evaluate all of the system. Considering the bite or occlusion, the components of the system are the teeth, joints, and muscles and various soft tissues. The Physiologic Based Dentistry approach is the most complete perspective as it blends all three of these components starting with objective data to evaluate the function and comfort of the muscles.