Temporomandibular Disorders

What are TMD's?

Temporomandibular Disorders (TMD) refers to a group of conditions affecting the temporomandibular joint (TMJ), which connects your jawbone to your skull. This joint acts like a sliding hinge, letting you move your jaw up and down and side to side, so you can talk, chew, and yawn. When problems occur with the joint or the muscles around it, it can lead to TMD, which causes pain and discomfort.

At Tangram Health, our team of Physiotherapists, Chiropractors, and Exercise Physiologists often see patients with jaw pain and TMD and we understand how this condition can affect your daily life and overall wellbeing. So we've put together this guide to help people better understand this condition and make sense of the many treatments to get their jaw better.

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What are the symptoms of TMD?

TMD can present with various symptoms, including:

• Pain or tenderness in the jaw
• Pain in and around your ear
• Difficulty or pain while chewing
• Aching facial pain
• Locking of the joint, making it difficult to open or close your mouth
• A clicking or grating sensation when you open your mouth or chew
• Headaches
• Neck pain
• Ringing in the ears (tinnitus)
• Dizziness

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What causes TMD?

TMD can be caused by various factors, including:

• Teeth grinding or clenching (bruxism)
• Arthritis in the TMJ
• Stress, which can cause you to tighten facial and jaw muscles
• Injury to the jaw or TMJ
• Dislocation of the soft cushion or disc between the ball and socket of the joint
• Erosion of the joint
• Structural jaw problems present from birth
• Poor posture, especially forward head posture

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What are the risk factors for developing TMD?

Certain factors can increase your risk of developing TMD:

• Age: It's most common in people between 20 and 40 years old
• Gender: It's more common in women than men
• Certain types of arthritis, such as rheumatoid arthritis and osteoarthritis
• Jaw injuries
• Long-term (chronic) grinding or clenching of teeth
• Certain connective tissue diseases that affect joint function
• Stress
• Poor posture

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How is TMD diagnosed?

When you visit one of our clinics at Tangram Health with symptoms of TMD, our Physiotherapists, Chiropractors, and Exercise Physiologists will use several methods to diagnose your condition:

1. Medical history: They'll ask about your symptoms, when they started, and how they affect your daily life.
2. Physical examination: Your physiotherapist or chiropractor will:
   • Listen and feel your jaw when you open and close your mouth
   • Observe the range of motion in your jaw
   • Press on areas around your jaw muscles to identify sites of pain or discomfort
3. Specific tests: They might ask you to bite down on a special strip to check your bite alignment.
4. Imaging tests: In some cases, X-rays, CT scans, or MRIs may be recommended to get a closer look at your jaw joint and surrounding structures.

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What role does imaging play in diagnosing TMD?

While TMJ jaw pain is often diagnosed through physical examination, imaging tests can be helpful in some cases:

• X-rays: These can show the bones of the joint and check for arthritis or bone problems.
• CT (Computed Tomography) scan: This provides detailed images of the bones involved in the TMJ.
• MRI (Magnetic Resonance Imaging): This can reveal problems with the joint's disc or surrounding soft tissues.

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How is jaw pain from TMD treated?

Treatment for TMD and jaw pain aims to reduce pain, improve jaw function, and prevent future problems. This can include:

• Physical therapy: Our Physiotherapists and Chiropractors in Sydney can teach you exercises to strengthen your jaw muscles and improve flexibility.
• Manual therapy: Techniques like massage and mobilisation can help relieve pain and improve jaw movement.
• Pain relief: Over-the-counter pain medications or prescription drugs may be recommended.
• Heat or cold therapy: Applying heat or ice to the jaw can help reduce pain and inflammation.
• Lifestyle changes: We can provide advice on diet, posture, and stress management.
• Night splints: These can help prevent teeth grinding during sleep.
• Botox injections: In some cases, these may be used to relax the jaw muscles.
• Surgery: This is typically only considered in severe cases that don't respond to other treatments.

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What is a night splint and how does it help with jaw pain from TMD?

A night splint, also known as an occlusal splint or bite guard, is a custom-made plastic mouthpiece that fits over your upper or lower teeth. It's typically worn at night and helps with jaw pain by:

• Preventing teeth grinding and clenching during sleep
• Reducing pressure on the jaw joint
• Promoting a more relaxed jaw position
• Protecting your teeth from wear caused by grinding

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When are Botox injections used for TMD?

Botox (Botulinum toxin) injections are sometimes used to treat TMD when other conservative treatments haven't provided enough relief. Botox works by:

• Relaxing the overactive jaw muscles
• Reducing pain and inflammation
• Decreasing teeth grinding and clenching

Botox injections are typically considered a temporary solution and may need to be repeated every few months. At Tangram Health, our Physiotherapists and Chiropractors can discuss whether Botox injections might be appropriate for your condition and refer you to to Dentists or Specialists who can perform this procedure.

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When is surgery required for TMD?

Surgery for TMD is generally only considered when:

• Conservative treatments haven't improved your symptoms after several months
• Your pain is severe and significantly affects your quality of life
• There's clear evidence of a structural problem in the joint

Surgical options may include:

• Arthrocentesis: A minimally invasive procedure to remove debris and inflammatory byproducts from the joint
• Arthroscopy: A type of keyhole surgery used to remove scar tissue or reposition the disc in the joint
• Open joint surgery: Used for more complex problems like joint replacement

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What role does exercise play in treating jaw pain from TMD?

Exercise is a crucial part of treating and preventing TMD. It helps to:

• Strengthen the muscles that control jaw movement
• Improve flexibility and range of motion in the jaw
• Reduce pain and stiffness
• Promote relaxation of the jaw muscles

Our Physiotherapists, Chiropractors, and Exercise Physiologists at Tangram Health can design an exercise program tailored to your specific needs. This might include:

• Jaw stretching exercises
• Jaw strengthening exercises
• Neck and shoulder exercises to improve overall posture
• Relaxation exercises to reduce tension in the jaw muscles

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How can I prevent TMD or stop it from getting worse?

While you can't prevent all cases of TMD, there are steps you can take to reduce your risk or prevent it from worsening:

• Practice good posture: Poor posture can affect your jaw alignment
• Avoid excessive jaw movements: Like wide yawning or gum chewing
• Use proper chewing technique: Chew food evenly on both sides of your mouth
• Manage stress: Stress can lead to jaw clenching and teeth grinding
• Wear a mouthguard during sports: To protect your jaw from injury
• Address teeth grinding: If you grind your teeth at night, talk to your dentist about a night guard
• Be mindful of your jaw position: Try to keep your teeth slightly apart and your jaw relaxed throughout the day

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What lifestyle changes can help manage TMD?

Making certain lifestyle changes can significantly improve your jaw health and help manage TMJ jaw pain:

• Eat softer foods: Temporarily switching to a soft diet can give your jaw a chance to rest
• Avoid chewy foods: Like tough meats or chewy candies
• Cut food into smaller pieces: This reduces the amount of chewing needed
• Apply heat or cold: Use heat before jaw exercises and cold after to manage pain
• Practice stress-reduction techniques: Like deep breathing or meditation
• Improve your sleep posture: Avoid sleeping on your stomach, which can strain your jaw
• Be aware of jaw habits: Try to stop habits like biting nails or chewing on pens

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When should I see a healthcare professional about jaw pain?

You should consider seeing a healthcare professional if:

• You have persistent pain or tenderness in your jaw
• You're having difficulty opening or closing your mouth completely
• You hear a clicking or popping sound in your jaw joint
• Your jaw pain is affecting your ability to eat or speak
• You're experiencing headaches, neck pain, or ear pain along with your jaw pain

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Can TMD go away on its own?

In some cases, mild jaw pain from TMD may improve on its own with rest and self-care measures. However, if the pain persists or worsens, it's important to seek professional help. Without proper treatment, TMD can lead to chronic pain and complications.

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How long does it take to recover from TMD?

Recovery time can vary greatly depending on the severity of your condition and the treatment approach:

• For mild cases treated early: You might see improvement in a few weeks to a couple of months
• For more severe or chronic cases: Recovery can take several months of consistent treatment and management

Remember, everyone's recovery is different. Factors like your age, overall health, and how well you follow your treatment plan can all affect your recovery time.

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Take home message

Jaw pain and TMD can significantly impact your daily life, affecting everything from eating and speaking to your overall comfort. However, with proper diagnosis and treatment, most people with TMJ disorders can find relief and improve their jaw function.

At Tangram Health, our team of experienced Physiotherapists, Chiropractors, and Exercise Physiologists can help you manage your TMD and jaw pain effectively. We offer a range of treatments and can provide personalised advice on exercises, lifestyle modifications, and pain management strategies. Remember, early intervention is key in managing TMJ jaw pain.

If you're experiencing persistent jaw pain or have concerns about your jaw pain, don't hesitate to contact us at Tangram Health. We have clinics conveniently located in Mt Kuring-Gai, Asquith, Willoughby, Milsons Point, Dural, and Blacktown so you can get the right advice and treatment for your TMD.