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TMJ Disorder

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19 views

TMJ Disorder

Uploaded by

alifiaauras
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
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Fact Sheet:

TMJ (Temporomandibular joint)


Dysfunction
_________________________________________________________________

The temporomandibular joint (TMJ) is formed by


the mandible or jawbone joining with the
temporal bone of the skull, just below and in
front of the ear. Each joint has a cartilage disc
inside keeping the temporal bones and the
mandible bone apart to prevent the bone
surfaces from wearing and damaging each
other, as well as to act as shock absorber for
the joint. The jaw joint is surrounded by a
capsule or envelope enclosing it.

The TMJ is opened and closed thousands of


times each day as we eat, speak, breath, and
yawn, and is thus the focal point of much
activity and physical forces. Jaw movement is driven by many muscles connected to the
skull and the neck, which are responsible for its different actions. Additionally the
muscles involved in keeping the jaw in a rest position have a direct connection to the
neck. Therefore in diagnosing a TMJ disorder it is important to look at the neck and
areas of the body that may affect the neck.

Symptoms
Common TMJ disorder symptoms include: A problem in your TMJ can cause
• Headaches multiple, seemingly unrelated problems.
• Ringing in ears While some symptoms can be easily
• Jaw pain traced back to the jaw joint – such as
• Back pain difficultly or pain in biting and chewing,
• Face pain clicks and grating noises from your jaw,
• Ear pain/stuffiness or pain in your jaw or face – other
• Neck ache symptoms, like neck back, knee, and
• Dizziness shoulder pain, sinus pain, pain behind the
• Difficulty chewing eye, or ringing in the ears, may make it
• Clenching/grinding less obvious that the TMJ is the root
• Fatigue cause of the problem.
• Shoulder pain

Causes
Discomfort or pain in the TMJ can have many causes:
• Trauma to the TMJ or surrounding muscles and tissues from a sporting injury, car
accident or other physical incident
• Misaligned bite from uneven teeth, incorrect positioning of jaw, or loss of bite
height
• Daytime clenching of the jaw and nighttime grinding of teeth while asleep
(referred to as bruxism). The underlying cause of night time grinding is often
sleep apnoea.
• Stresses on other areas of the skeletal system, e.g. neck
All too often, the foundation of the problem will be a combination of many different
causes, which are all interacting and exasperating each other.
Treatment
In some cases, the symptoms of TMJ disorders may go away without treatment.
However if symptoms persist the following options are available for treatment:

Physiotherapy
Treatments might include massage, mobilisation, ultrasound, heat, and ice - along with
exercises to stretch and strengthen jaw muscles (see below).

Medications
In conjunction with other nonsurgical treatments, medications may help relieve the pain
associated with TMJ disorders.

Bite guards (oral splints)


Often, people with jaw pain will benefit from wearing a soft or firm device inserted over
their teeth.

Counseling
Education and counseling can help you understand the factors and behaviors that may
aggravate your pain, so you can avoid them. Examples include teeth clenching or
grinding, leaning on your chin, or biting fingernails.

Surgical or other procedures


When other methods don't help, your doctor might suggest procedures such as:
Arthrocentesis
This procedure involves the insertion of needles into the joint so that fluid can be
irrigated through the joint to remove debris and inflammatory byproducts.
Injections
In some people, corticosteroid injections into the joint may be helpful. Infrequently,
injecting botulin toxin (Botox, others) into the jaw muscles used for chewing may relieve
pain associated with TMJ disorders.
Surgery
If your jaw pain does not resolve with more-conservative treatments and if it appears to
be caused by a structural problem within the joint, your doctor or dentist may suggest
surgery to repair or replace the joint. The National Institute of Dental and Craniofacial
Research considers TMJ surgery to be controversial and recommends that it be avoided
whenever possible.

Exercises
Tongue Clucking
Making a clucking sound by positioning the tongue against
the hard palate. Aim to maintain appropriate tongue/jaw
resting position throughout the activity. Do each exercise
_____ times. Repeat ______ times a day.

Controlled jaw opening


Maintain your tongue on the hard
palate whilst opening and closing
the jaw. This will limit excessive
movement of the mandible. Do each exercise _____ times.
Repeat ______ times a day.
Mandibular Rhythmic Stabilisation
Apply resistance to opening, protrusion and lateral deviation of the jaw in a resting
position. The goal is to promote normal positioning of the jaw while maintaining
postural alignment. Do each exercise _____ times. Repeat ______ times a day.

Resistance to opening Resistance to protrusion Resistance to lateral deviation

Cervical retraction
Keep your head level and move it straight back. This stretches
the muscles at the base of your skull and strengthens those at
the front of your neck. Hold for _____ seconds. Do each
exercise _____ times. Repeat ______ times a day.

Shoulder blade retraction


Sitting upright, squeeze your lower
shoulder blades together without lifting
your shoulders up. Hold for _____
seconds. Do each exercise _____
times. Repeat ______ times a day.

Upper trapezius stretch


Gently pull your ear to the side so it
approaches your opposite shoulder.
Hold for ____ seconds.
Repeat ____ times.

Levator scapulae stretch


Place an arm behind your back. Rotate your head to the
opposite side and gently pull your chin towards your
underarm. Hold for ____ seconds. Repeat ____ times.

Scalene/Sternocleidomastoid
Stretch
Slightly tilt your chin up to the roof. Gently
pull your ear to the side so it approaches the back of your
opposite shoulder. Hold for ____ seconds. Repeat ____ times.

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