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TMJ (Temporomandibular Joint)What is TMJ? TMJ is an abbreviation for temporomandibular joint, or the jaw joint. There are two, one in front of each ear. The TMJ is the joint formed by the temporal bone of the skull (temporo) with the lower jaw or mandible (mandibular).
To accomodate this frequent use and to help us open our mouths wide, the TMJ is actually a sliding joint, not a ball-and-socket like the shoulder. This sliding allows for pressures placed on the joint to be distributed throughout the joint and not just in one area. In the medical community, the term TMJ is really not correct. It designates an anatomical structure (the joint) and not a painful condition. The correct term, as recommended by the American Dental Association, is TMD, or Temporomandibular Disorders. I will be using TMD and TMJ here to indicate painful condition, and not anatomy. But what is the condition of TMJ? TMJ is a set of separate and yet related disorders of the temporomandibular joints and associated structures. These structures include muscles, ligaments, tendons, nerves, and blood vessels. We used to think that TMJ was just one problem. Today we know that TMJ is really a group of several disorders that usually have similar symptoms.
1). Jaw Clicking(popping,snapping) This clicking sound may be so loud that it can be heard by others while you chew, The noise is actually produced by the cartilage disc being caught between the two bones of the TMJ as the lower jaw moves. There may or may not be pain in the joint itself with the sound of a click or pop. But one thing is for sure: If there is a displaced disc, as is usually the case when a click occurs, then the muscles that move the jaw while chewing are more tense than normal. This tenseness can and does cause muscle, facial, head and neck pain. 2). Jaw Locking. Locking of TMJs may feel like a catching of the lower jaw as it opens. Sometimes, the person with a locked joint must move the jaw to one side or another in order to open wide. Or a person might have to open until he hears and feels a loud pop, at which point the jaw actually unlocks. As with clicking, there may or may not be pain associated with locking. If the locking is a result of injury to the head or jaw, pain almost always occurs. 3). Change in bite. A dislocated TMJ may also be noticed by a change in the dental occlusion, or bite. If the TMJ disc goes out of place, the bones and disc do not fit together properly and therefore, the bite of the teeth changes. A dislocated TMJ disc can actually lock wide open. It usually occurs after a wide opening movement such as a yawn. However, an open lock of the TMJ can also occur after a long dental appointment, being put to sleep for any type of surgery, or even after opening wide to eat an apple or large sandwich. Open locking that occurs again and again is a sign of weak or loose TMJ ligaments. 4). Ear symptoms: pain, fullness or stuffiness, loss of hearing. Due to the close relationship of the TMJs and ears, an injury to the TMJ often causes ear symptoms. That is why many TMJ sufferers first go to their family doctor and then to an ear doctor for help. Usually, an examination of the ear is normal, even if there appears to be a loss of hearing. Patients may take several different types of antibiotics because of the fullness in the ears, even in the absence of other symptoms that usually signal an infection (fever, redness, heat, discharge). 5). Headache. Headache is one of the most common symptoms of a TMJ problem. Although any area of the head may be affected, usually the TMJ headache is located in temples, back of the head, and even the shoulders. Clenching and grinding of the teeth, both of which themselves may be TMJ symptoms, produce muscle pain which can cause headache pain. Also, a displaced disc in the TMJ may cause pain in the joint that is often referred into the temples, forehead or neck. These headaches are frequently so severe that they are confused and treated (with little success) as migraine headaches or abnormalities in the brain. 6). Facial Pain. Pain from the TMJ may be referred to the face even though the TMJ itself does not really hurt. Facial pain may be deep in the face or on the surface of the skin. The skin might even become sensitive to the touch or air blowing over it. Often, a neurologist is seen for this type of pain. 7). Tooth Pain. A displaced TMJ disc may cause tooth pain. The teeth may become sensitive to temperatures, especially cold. The teeth may also become sensitive because of jaw activities such as clenching of the teeth or grinding of the teeth. 8). Other symptoms. Many other symptoms may be associated with TMJ. Often, pain will be felt in the shoulders and back due to muscle contraction (a condition called myofascial pain dysfunction syndrome). Dizziness, disorientation and even confusion are also seen in some people who suffer with TMJ. Depression is common with TMJ. Plenty of scientific evidence shows that chronic pain patients (which includes most TMJ patients) have changes in chemicals in the brain (termed neurotransmitters) as a result of teh pain. These chemicals can and do produce depression. Along with depression comes an inability to get a good night's sleep. This may be due to TMJ pain itself or changes in the brain's neurotransmitters, which produce stimulation even though the TMJ sufferer is asleep. Sufferers often wake feeling like they never slept. A TMJ patient may also suffer with photophobia, or light sensitivity. A dislocated TMJ may produce pain in and behind the eye which can cause sensitivity to light. Blurred vision and eye muscle twitching are also common in TMJ patients. Another common symptom is ringing (tinnitus) in the ears.
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