Diagnosing a TMD often requires working with a dental professional.
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Taming TMDs
Temporomandibular disorders, also referred to as TMJ, can be treated
Perhaps it is a sharp pain in the jaw whenever you yawn, an earache when you do not have an ear infection or pain in your teeth without a cavity. There may be severe facial pain or swelling, even frequent headaches.
Dr. Steven Bender, a professor and director of the Center for Facial Pain and Sleep Medicine at Texas A&M College of Dentistry, in Dallas, says it’s possible that any of these symptoms could be the result of a temporomandibular disorder (TMD), which many people simply refer to it as TMJ, short for “temporomandibular joint,” because frequently the joint and the surrounding muscles are the troublemakers causing the misery.
The National Institutes of Health (NIH) estimates that, at any one time, between 5% and 12% of people have signs or symptoms of a TMD.
No one is certain why someone develops a TMD, though people with these issues often clench or grind their teeth (bruxism) and live with a lot of stress. “We also have found that between 20% and 30% of these individuals have other health issues, such as headaches, fibromyalgia, atypical facial pain and arthritis,” says Dr. Robert Glickman, a professor at New York University College of Dentistry. It also appears to be more prevalent in women, who are diagnosed with a TMD at double the rate of men, according to Glickman.
Diagnosing TMDs
TMDs can be tricky to diagnose. Facial and ear pain or severe headaches and dizziness could be symptoms of infections or even tumors. Conditions such as osteoarthritis and rheumatoid arthritis, or trauma from an accident might be causing pain.
But proper diagnosis is critical prior to treatment, Glickman stresses. “Your health care team might order an MRI, special dental X-rays and other exams. Care always should be coordinated with an individual or team well versed in pain management, surgical and nonsurgical interventions, and be available for long-term follow-up.”
Treatment strategies
Because no one treatment will help all individuals living with TMDs, each patient needs an individualized treatment plan.
Dr. M. Franklin Dolwick, a professor in the Department of Oral and Maxillofacial Surgery at the University of Florida College of Dentistry, in Gainesville, Florida, says, “Most people do very well with conservative therapy such as a soft diet; behavior modification techniques to curb behaviors that may be worsening the pain, such as teeth clenching; home physiotherapy [heat, ice, stretching, etc.]; or over-the-counter nonsteroidal analgesics.”
Often, a person experiencing TMD symptoms can find a team approach of dental experts, physicians, physical therapists and other practitioners under one roof. That team approach, which includes diagnosis and treatment options, can be found at a TMD or orofacial (mouth and face) pain clinic, often part of dental colleges in the United States and Canada, or in free-standing orofacial pain clinics.
Dolwick says surgery is rarely needed for TMD. “It is estimated that only about 5% of patients who have a temporomandibular disorder need surgical intervention. It is also important to note that surgery does not always solve the pain issue.”
For most patients, he adds, physical therapy and counseling can be helpful. “Patient education, custom-made bite or night guards, medications such as nonsteroidal anti-inflammatories or muscle relaxers often are prescribed. Narcotics should not be used.”
The good news
Bender says because the TMJ is by far the most adaptable joint in the body, for most people “improvement of the symptoms will occur over time with limited or even no treatment.”
He adds, “Temporomandibular disorders are not necessarily progressive. People suffering with these disorders should be strongly encouraged to avoid irreversible or invasive treatments such as bite adjustments, braces or surgeries. Just because a jaw joint pops does not mean treatment is needed. If in doubt, seek another opinion before agreeing to any treatment.”
Claudia M. Caruana is a New York–based health and medical writer.
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Sound bites
If you have TMD issues, here are some basic points to consider.
- Consult with one or more specialists who have experience treating TMDs. Get a second opinion if needed, especially if surgery is suggested.
- Don’t chew gum.
- Biofeedback, physical therapy and meditation can all play a role in pain relief, and, if successful, should be continued after treatment has ended, says Dr. Robert Glickman.
- If you have been prescribed a night or bite guard to stop teeth grinding, use it as prescribed by your dental health care provider. Make certain you keep it clean with over-the-counter products made for dental appliances.
- Pass up steaks and chops in favor of chicken or fish, which require less chewing.
- Avoid eating bagels, other hard breads and raw foods such as carrots. Opt instead for soft and less chewy foods, especially when you are experiencing pain.—CMC
Costco Connection: Prescription medications, over-the-counter items such as anti-inflammatories and nonsteroidal analgesics and more are available in Costco warehouses and at Costco.com.
