Have you been told by a healthcare professional, whether it be a dentist or medical provider that you have “TMJ”? Actually we all have it, we actually have 2, a right and a left! “TMJ” stands for temporomandibular joint. When there is dysfunction in this joint system it is referred to as “TMD” or Temporomandibular Disorder/Dysfunction. There are a variety of disorders when it comes to this joint as well as a variety of causes. A dentist trained in this area of treatment can diagnose and treat these disorders.

The jaw joint or TMJ is unlike any other joint in your body. Not only does it hinge like your knee but it also translates down the bony eminence of your skull as you open wide. In between the skull bone and your lower jaw bone there is a cartilaginous disc that is held in place by ligaments and muscles. As you open this disc should stay in between the two bones but sometimes it can “click” out of place and back into place which is usually the noise one might hear or feel. Like other joints in the body it can also break down and experience degenerative disorders. These degenerative disorders can sound like crunch noises or sand like noises. It is important to seek a dentist with advanced training in the diagnosis and treatment of TMJ disorders to get the proper diagnosis.

Typically you should seek treatment when the disorder is painful, disrupting the function of it such as chewing or speaking and when it is interfering with the quality of your life. Dentists trained in the diagnosis and treatment of TMD call this "PDQ"-pain, dysfunction and quality of life. If you suspect your have a jaw joint disorder and are concerned it may get worse and cause “PDQ” then you should seek an evaluation by a dentist who has had additional training in TMJ disorders to make sure there are not other causes contributing to it. Other causes may be cervical spine issues, sleep apnea, certain medications that cause bruxism, or stress.

First, it is important to seek out a dentist who has had additional training and focus in the diagnosis and treatment of jaw joint disorders. In general, dental school does not prepare graduates well in this area. For those doctors who have completed additional training, most start with conservative treatment. It is important to determine the proper diagnosis and then treat based on the diagnosis. The use of splint therapy along with physical or massage therapy would be one form. The splint, or orthotic, allows the jaw joints to rest in a neutral position, providing biofeedback for muscle relaxation. Depending on the issue your doctor will see you every few weeks to adjust the orthotic as your joint heals. The use of physical therapy or massage therapy modalities allow for the release of tense muscles, strengthening of supporting muscles and additional biofeedback. Together the orthotic and therapy provide the best conservative approach to treatment of TMD. Surgery should be reserved as a last course of treatment.