Temporomandibular Joint

PROBLEMS AND ORTHODONTICS

What is the Temporomandibular Joint (TMJ)?

The TMJ is the joint between the lower jaw (mandible) and the skull and is situated in front of the ear canal. The joint has a cartilage disc (articular disc) that sits on top of the head of the joint (mandibular condyle) and separates it from the skull (see diagram). This disc cushions the joint and allows it to move freely when the 4 powerful chewing muscles that are connected to the jaw move it when eating and talking.

What is Temporomandibular Joint Dysfunction (TMD)?

TMD is a group of conditions associated with the chewing function of the jaw.

Symptoms include:

Studies show that the frequency of TMD signs and symptoms increase with age and is more common in females. The likelihood of adolescents suffering from jaw joint dysfunction is anything between 5% and 35% – which means up to 1/3rd of teenagers may suffer from TMD. Whilst it may happen during brace treatment, Temporomandibular joint problems are not caused by orthodontic treatment but could be triggered by certain factors including; trauma (blow to face or jaw), unexpected wide mouth opening, biting down on something hard, grinding teeth and tooth clenching (often at night), stress, nail biting, uneven bite, or altered chewing pattern to avoid a sore tooth.

Sometimes there is no obvious cause but problems can be associated with other stress related disorders such as tension, headaches, or lower back and abdominal pain. What is clear is that most jaw problems are made worse by chewing and at times of stress – and having a jaw problem can also cause stress which exacerbates the problem.

What is happening to cause the symptoms?

What can you do to improve your problem?

The most important thing is not to worry. In the vast majority of cases the symptoms will go away on their own, however this can sometimes take a few months. Even with treatment the problem takes time to improve.

What treatment is effective for TMD?

What exercise can I do?

It is important to set aside 2 five minute periods each day at a time when you are relaxed – for example just before you get up and go to bed. Sit upright in a chair to perform the following exercise:

As you open your mouth you should feel the tension in the back of your neck and under your chin. The first few times you do these exercises watch yourself in a mirror to make sure that the teeth are moving vertically with no side to side movement. If there is sideways movement, you should open the mouth more slowly to control it.

If you are carrying out the exercises properly there will be no clicking or noise from the joints. If there is, restart and continue to practice until it is click free.

Do not do the exercise more than twice a day at the start. After the first week start to increase the time spent doing the exercise as this will help strengthen the muscles that close your mouth.

You may find that the pain is worse for a while at first; this is because you are not used to the
movement. Persevere and over time this will subside. After 2-3 weeks of doing the exercise your muscles will be re-trained and your jaw should not click when you open and close.

Diet during your treatment