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Q.        

What are "Temporomandibular Disorders (TMD)"?

A.        

Temporomandibular is taken from two words

Temporo = Temple area

Mandibular  = Mandible or Lower jaw

The Temporomandibular disorders arise in one of the major joints in the head and neck area known as the Temporomandibular Joint.

Temporomandibular Joint (TMJ)

‘The Temporomandibular joint’ is a joint which is responsible for movement of your jaw during chewing, eating and talking etc. It is one of the most complex joints in the human body which provides not only a hinge like movement in one plane but at the same time also provides for gliding movements. This is what helps the lower jaw move in a wide array of directions in order to chew food or talk etc.

This joint like any other joint has ligaments of particular lengths which do not stretch. However, if extensive forces are applied either suddenly or for prolonged periods of time, the ligaments can be elongated. If elongated, the function of the ligament can be compromised thereby altering joint function seen in TMD.

Temporomandibular Disorder (TMD)

Temporomandibular disorder can occur due to any problem in or around the Temporomandibular joint (TMJ). It can be muscle, bone or ligament related.

Causes

There is difficulty in ascertaining the exact cause for temporomandibular disorders (TMD). The main known cause is usually a direct injury or a blow to the TMJ itself or its surrounding muscles.

Sometimes the injury can be indirect in those patients who have a habit of clenching or grinding their teeth. Emotional imbalances and stressful life style can also play a pivotal role for TMD problems, as these people are prone to unintentionally clenching their teeth.

Sometimes the precipitating factor to actually initiate the painful phase of TMD can be as simple as a person yawning and causing an injury to the TMJ; just because they were already susceptible to it due to previous factors like stressful lifestyle and grinding of their teeth etc.

Symptoms

Those who are suffering with TMD can present with a variety of symptoms.

1)      Inability to open one’s mouth fully

2)      Hearing a click when opening or closing the mouth

3)      Pain of a moderate intensity in or around one or both ears which can be worse in the morning but slowly reduces during the day

4)      Headache, neck ache or a ringing sound in the ears

5)      ‘Locked jaw’ or getting your jaws locked in either the open or the closed state e.g. when yawning or laughing loud and then being unable to close the jaw etc

6)      Swelling on either side of the face around the ear area

7)      Tiredness of the jaws or feeling tired and an aching sensation when chewing food

Diagnosis

Usually your dentist would carry out a detailed investigation to ensure whether you actually have TMD. It usually includes simple basic examination, though in some instances a referral to the medical practitioner for checking for Osteoarthrosis (degenerative joint disease) might be deemed necessary.

Management

Your dentist might prescribe you a cause-related therapy which might include wearing transparent splints to cover your teeth and jaw exercises. The symptoms usually resolve in most cases and sometimes the only remnant is the clicking of the joint; which can persist as a harmless feature of a previous exaggerated TMD. Patient compliance and accurately following the instructions of your dentist are important to improving your TMD symptoms.

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