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Only Fools Rush into TMD Treatment
TMD is a serious condition that needs immediate attention, but you could be fooled into the wrong treatment if you're not careful to make smart, informed decisions.
/Dental PR News/ - February 28, 2008 - Disorders of the temporomandibular joint (TMJ), the joint that connects the jaw to the skull, are controversial. Even the name of the disorder is not agreed upon. In addition to temporomandibular joint disorder (TMD or, confusingly, TMJ or TMJD), the condition has been described as myofascial pain dysfunction syndrome (MPD), and Craniomandibular disorder (CMD), and Trigeminal Mandibular Disorder, which, conveniently, can still use the TMD acronym. But, according to the National Institute of Dental and Craniofacial Research (NIDCR) of the National Institutes of Health (NIH), over 10 million American suffer from the condition. Understanding this condition and the controversy surrounding it are crucial to ensuring that you receive appropriate treatment if you are a sufferer.
Could You Be a Sufferer?
TMD (as I will call it) can have a lot of potential symptoms, including:
• Headaches
• Facial pain
• Sore teeth
• Sore, stiff, swollen, or popping jaw
• Back, neck, or shoulder pain
• Uncomfortable bite
• Dizziness, hearing difficulty, or ringing in the ears
If any of the above symptoms describe your condition, you may be suffering from TMD.
Anatomical Basics
The source of TMD is one or two temporomandibular joints that are out of alignment. The temporomandibular joint is the joint connecting the jaw to the skull, at a complex of muscles, nerves, and bones. It is a complex joint, designed to let the jaw move in many directions, with strong muscles that have to work thousands of times a day in everything from chewing and swallowing to talking to smiling. It is also physically intertwined with many nerves, including the trigeminal nerve, the largest of the cranial nerves, and the one responsible for sensing pain in the face and transmitting that signal to the brain.
The basic theory of TMD is that when this joint is out of alignment it can lead to a great deal of pain and discomfort in places ranging from the extremities to the head. Although the basic theory seems sound, many things are unknown, including how, exactly, the displacement of the TMJ causes the various symptoms.
Controversy
The main controversy about TMD (other than its name) is the level of treatment necessary or desirable for TMD. Although many dentists, especially those trained in neuromuscular dentistry, recommend high levels of diagnosis and treatment for TMD, up to an including bite reconstruction that can involve dental implants or crowns to replace or build up lost or damaged teeth, the TMJ Association advises people to proceed with caution.
As yet, there is no thorough scientific evidence about the efficacy of TMD treatments. Not only are these treatments often very expensive, but due to the lack of understanding about this condition the treatments can sometimes leave patients worse off than before. The treatments are in many cases not covered by insurance, leaving patients to pay the bill alone.
What to Do?
The TMJ Association recommends caution in proceeding with any form of treatment. They point out that most TMDs resolve themselves in a few weeks or months, and add that for the relief of pain and other symptoms in the meantime, self-treatment might be the best option. These treatment options include:
• Moist heat, such as a hot water bottle wrapped in a damp cloth, can improve function and reduce pain.
• Ice packs not applied directly to the skin, but wrapped in a cloth, can be used at intervals of 10-15 minutes to numb pain and decrease swelling.
• Soft foods can allow the jaw to rest temporarily. It is especially important to avoid foods that are crunchy or force you to open your mouth wide.
• Jaw exercises, in contrast, such as slow, gentle movements of the jaw, can help realign your TMJ
• Over-the-Counter pain medications can provide temporary relief. Remember to follow the dosage limitations indicated on the label.
Remember, too, that all pain is partly psychological. Relaxation techniques and guided imagery have been shown to be very effective at reducing pain and promoting healing in conditions of this sort.
If your pain continues for several weeks, it is important to consult your doctor to determine the origin of your pain. It is often advisable to start with a general physician and then consult your dentist if your physician is unable to diagnose the problem.
If you've been suffering from migraines or a painful jaw, contact Dr. Kenneth A. Mogell, DMD, today for your TMD consultation.
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