What Is Temporomandibular Disorder (TMD)?

By Jeffrey L. Brown, DDS

Sleep & TMJ Therapy

. http://sleepandtmjtherapy.com/

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What Is Temporomandibular Disorder (TMD)?

So, what does it mean when a person says “I have TMJ”?   Well, technically, it means that you have a temporomandibular joint. And technically, that’s all it means- you have a jaw joint. In reality, most people are actually saying “I have TMD”- which more literally means they have TMJ disorder.

TMD refers to the displacement or actual slipping of the articular disc off of the condyle. In English, this means that the little cushioning disc on top  of your jawbone has slipped off the bone and is now rubbing around in that little socket just in front of your ear.  That slipped disc can and will pinch nerves and blood vessels and this can wreak havoc with your entire body.

The symptoms of TMD include head and neck pain, migraines, jaw clicking/popping/pain, facial tics or tremors, and various other body issues. There are many patients over the years who have presented with body tics (and this is sometimes a Tourette’s situation) and the appliances used can help mitigate their symptoms. There was actually a study done in Osaka at the university that confirmed symptoms of Tourette’s were actually reduced greatly by wearing a TMD appliance! The understanding is that the nerve in the jaw joint- most likely the auriculotemporal nerve- is being pinched and this can cause the tics of Tourette’s.  By decompressing the TMJ joint disc, this can alleviate those tics and Osaka University has confirmed the efficacy of the dental appliance used for Tourette’s.

The bottom line here is that when the little disc is slipped off the condyle bone in the jaw socket, it can really hurt the body badly. Our office has become quite efficient at identifying the damaged disc through the use of a detailed MRI that looks directly at the discs and the radiologist we use is able to produce a very detailed report that can be used to diagnose the problem. From there, a treatment plan that includes wearing various devices can be developed.

You do not need to wear the device(s) forever. The good news is that after a year of treating the damaged joints, usually the patient feels so much better and we can then use orthodontic techniques to raise the teeth up to the right height to support the TM joints. It is quite a process and took years to develop, but nowadays we can use clear aligners in almost all cases and this makes the work so much easier for everyone.

It is rare, but sometimes we need to have surgery done for the discs when they are beyond repair. Years ago, this was a difficult procedure, but today it has become much easier for both the patient and the doctor. We even have a technique called ‘arthrocentesis’ in which the joints are flushed out and cleaned to remove debris and bony pieces that can cause pain.  This procedure has shown good promise.

There are other techniques in treating TMD and those can be reviewed in the next article.