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Treatment of TMD Syndrome

Definition

TMD (Temporo-Mandibular Disfunction) is a group of symptoms and signs related to the jaw joint and/or the muscles, nerves, and soft tissues surrounding the joint space. It is often referred to as TMJ syndrome.

Signs & Symptoms

  • Pain
    • In the joint area on the face (directly in front of the ear canal)
    • In the muscles of the face surrounding the joint area
    • Radiating to the neck, shoulder, or chest
  • Limited opening of the mouth
  • Clicking sounds emanating from the joint

Structure of the Joint

The jaw joints are somewhat unique in the human anatomy. They are the only joints at opposite ends of a single long bone which must function together as a single unit; that is you can't move one side without affecting the other. Furthermore, it is a diarthrodial joint (two joints in one). The bottom part functions as a simple rotating hinge while the top section slides down and forward against the base of the temporal bone of the skull. It is the muscles which move the mandible forward, thus allowing full opening, which can go into spasm and produce the syndrome.

Factors Which Affect TMD

The following are often causative factors in TMD syndrome:

  • Parafunctional jaw motions (movements or functions other than eating for survival) such as:
    • Gum chewing
    • Pencil biting
    • Nail biting
    • Constant snacking
  • Unusual jaw positions
    • Use of telephone for long periods
    • Talking for extended periods
    • Smoking
  • Irregularities in the bite
    • Missing teeth
    • Malocclusion
    • Broken, missing, or irregular fillings
    • Systemic diseases (osteoporosis, arthritis, etc.)
    • Trauma to the jaw and/or joint area

Treatment of the Symptoms of TMD

  • Avoid heavy function (tough meats, sticky foods, etc.)
  • Avoid parafunctional movements
  • Apply moist heat to the joint areas
    • Wet heating pad (UL approved only)
    • Wet wash cloth
    • Hydrocollator (1/2 size)
  • Medications
    • Mild pain medication (aspirin or ibuprofen)
    • Muscle relaxants as prescribed
  • Possible fabrication of bite appliance
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