All of the above abbreviations refer to what is commonly known as Temporomandibular Dysfunction. It is an orthopedic dysfunction of the jaw joint. It has many similar findings of other joint disorders (pain in the affected joint and associated ligaments and muscles). Characteristically, TMD, like all the other joint disorders, is aggravated by over usage, poor movement patterns and emotional stress (which heightens muscle spasm). If significant damage has occurred to the joint it will, like all joints, be more prone to swelling during changes in barometric pressure (changes in the weather).
TMD is a condition highlighted by a combination of various symptoms: Headaches, inexplicable ear symptoms (earache, dizziness, ringing in the ears aka tinnitus), clicking and popping of the jaw, difficulty opening/closing the jaw, neck pain, toothaches (including all symptoms related to occlusal dysfunction) and face pain. Historically, it was first described by Dr Costen, an ear, nose and throat specialist over sixty years ago. Patients presented to his office with ear symptoms that could not be explained by the presence of any organic ear disorder.
The causes of TMD fall into 2 major categories:
In most cases TMD’s major source of stress comes from the occlusion. However, all of the above mentioned stresses influence the course of the disorder as well as the success of treatment. If external stresses are unrecognized, left untreated and/or ignored by the patient, treatment failure is most likely. Fortunately, at Groton Dental Wellness Spa, we have the ability to help you address these stresses either by coordinating treatment with your own health care professional(s) or by offering treatment at our new medical facility.
Dental Therapy for TMD begins with a thorough Diagnosis:
Accurate impressions of the upper and lower teeth and registration of your jaw position
X-rays of your jaw joints and skull, including the bones of your face followed by an orthodontic analysis (this will determine how you arrived at this point in your dysfunction as well as aid in establishing a treatment goal that is realistic for you)
Use of various oral orthotics or specially designed mouth splint to help you return your muscles and joints to optimum position and function. This is in the category of “night guards”, that are designed to specifically treat your unique orthopedic problem. Depending on the nature of your problem, up to two orthotics may be used.
Hands-on therapy to address the jaw mobility issues. This may include the use of therapeutic local anesthetic and/or cold laser therapy into inflamed associated muscles, ligaments and tendons of the jaw. Manual mobilization techniques may also be used including, but not limited to, Craniosacral therapy, Myofascial release and Post-isometric Relaxation. This is dependent upon who you may be currently seeing for therapy.
Length of therapy is dependent on the severity of your dysfunction and the presence of associated stressors. Initial therapy, which is designed to dramatically reduce pain and dysfunction, should last approximately three months. Second phase dental therapy for TMD usually depends on the severity of the occlusal dysfunction (see Functional Occlusion). Treatment may range from minor, precise reshaping of the surfaces of the teeth to coordinate better occlusion and optimum jaw function to orthodontic therapy and/or possibly the need for new crowns, bridges, dentures or partials to achieve long lasting jaw stability.
It is important to remember that TMD is no different from other joint problems in that total success in therapy does not mean a total reversal in joint damage. You may always have a certain level of dysfunction, just not to the extent that it dominates your life the way it had previously. You must ask the question: Can I live with the possibility that treatment would result in a 70-80% reduction in my symptoms and a restoration to acceptable function? If you can accept that, we can help.