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Jaw Pain / TMD / TMJ



Temporomandibular disorder (TMD) is one of the most common reason an individual will seek dental and/or medical assistance. Physical therapy is an important avenue to consider for treatment of this disorder.

The hallmark of TMD is an abnormal jaw movement or function. The temporomandibular joint connects the temporal bone (the bone that forms the sides of the skull) with the mandible (jaw bone). A cartilage disk inside the joint is susceptible to “wearing out” due to daily use of the joint. The force of chewing, clenching or grinding the teeth creates an enormous tension and pressure in that region of the face, and can cause the bones of the joint to rub against each other, rather than gliding smoothly.

CAUSES

Causes of TMD include:

  1. stress
  2. poor posture
  3. whiplash
  4. faulty bite
  5. grinding of the teeth, especially at night (called bruxisam)
  6. hard blows to the jaw or chin
  7. poor habits, such as cradling the telephone between the shoulder and jaw, gum chewing, or thumb-sucking



A common contributing factor is hypoglycemia, where people tend to clench and grind their teeth when their blood sugar is low.

To diagnose TMD, a dentist or oral surgeon may use x-rays and a technique called anthrography, in which opaque dye is injected into the joint and then viewed.

SYMPTOMS

Symptoms a patient would experience include:

  1. pain in muscles and joints of jaw (sometimes radiating to the face, neck and shoulders)
  2. difficulty opening the mouth completely and closing the jaw normally
  3. clicking/grinding/popping with jaw movement or chewing
  4. headaches
  5. toothaches
  6. dizziness
  7. pain and ringing in the ears
  8. pain and pressure behind the eyes
  9. occasions where the jaw may lock open or lock closed



TMD is a very common problem in the adolescent and adult years. This dysfunction can start when braces are used and the jaw becomes realigned. Teenagers typically do not complain of jaw pain; however, the discomfort may manifest as headaches or other maladies.

PHYSICAL THERAPY TREATMENT

ultrasound

  1. moist heat/ice
  2. E-stim or TENS
  3. exercise and stress reduction program
  4. biofeedback to the masseter muscle, which opens and closes the jaw
  5. patient education in relaxation techniques
  6. instruction in proper posture to restore normal joint position
  7. manual techniques to strech various structures


Dentists and oral surgeons often recommend a bite plate, worn at night , to prevent clenching and compression of the joint, and to correct the bite. Physical therapist at Family Physical Therapy work closely with dentists and oral surgeons to determine the structures causing the problem and the appropriate modalities for treatment to correct this dysfunction.


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