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TMJ Disorder And Facial Pain

TMJ Disorder And Facial Pain


Problems with your jaw and the muscles in your face that control it are known as temporomandibular disorders (TMD).



If You Suffer From Any Of The Following You May Have TMD:


  • Discomfort in the jaws
  • Difficulty in opening the jaws or difficulty with chewing
  • A tired feeling in your face
  • Jaw joint locking or clicking
  • Clenching or grinding of teeth
  • Constant tooth ache in absence of dental problem
  • Pain or tightness in the muscles of neck, shoulders or head
  • Migraine and frequent headaches
  • Experiencing pain behind your eyes
  • Experiencing blocked ears or ringing ears (tinnitus)
Causes Of TMD

There is no single cause of TMD, as it is caused by a combination of factors

  • Symptoms usually are created by a lack of harmony between the patient’s bite, muscles, and/or temporomandibular joint. For example, jaw misalignment, which is a consequence of poor teeth alignment. This misalignment makes the jaw muscles work extra hard to compensate for incorrect positioning.
  • Stress, which can cause you to tighten facial and jaw muscles or clench the teeth
  • Faulty dental treatment – high dental filling, crown and bridge
  • Previous jaw injury - if you’ve experienced a previous injury to the jaw, you’re more likely to experience an issue with joint alignment.
  • Hormonal fluctuation
  • Teeth grinding (bruxism) - grinding your teeth places a lot of stress on your teeth and gums as well as the jaw joint. The long-term repercussions of teeth grinding often include a TMJ disorder.
  • Tears in the TMJ capsule
  • Arthritis - the long-term wear and tear on the jaw joint can cause arthritis, which can make TMJ disorders more likely
  • Poor posture
  • Obstructive sleep apnea
Treatment Of TMD

Treatment of TMD is liberating.
Treating TMD early is important for overall well being. It can be distracting to have chronic pain…all the time.

The first step in treatment is reviewing a patient

TMJ symptoms is simply getting detailed history. We will ask you lot of questions related with present problem, your lifestyle, work environment, prior trauma, personality type, dental history and medical history. This discussion helps us to know any additional factors which could be linked to exacerbating your symptoms.

The second step is physical examination.

A comprehensive exam of the head and neck , which includes muscles, joint mobility, how the teeth come together, the position of the top and bottom jaw relative to one another, and contributing factors like headaches, migraine, acidity, sleep disorder or ear pain.
Many other conditions cause similar symptoms -- like tooth decay, sinus problems, arthritis, or gum disease, which are ruled out in history and physical examination.

We may take full x-ray (OPG) to view your jaws, temporomandibular joints, and teeth to rule out other problems. We may suggest MRI to check the proper position of disc only in case of advanced TMD.

After examination a customized treatment plan is created, which depends upon how much disharmony in TMJ, how long have the symptoms been left untreated, etiological factors, severity of the symptoms.

Some treatment options that may be a part of your treatment plan may include the following.
  • Permissive splints
    • The alignment of how the top and bottom jaw come together can create tension on the muscles and joints of the jaw. Permissive splint can allow repositions the jaw into a more stable position to remove the relax muscle and to heal the joint.
  • Restorative dentistry
    • Severely worn or broken teeth create unbalanced force muscles and TMJ of the jaw. To balance the force, the teeth can be restored with dental crowns, bridges, implants, or composite fillings which reduce symptoms.
  • Occlusal equilibration
    • The teeth are designed to fit together in a particular balanced way. In many cases the teeth hit harder in some spots than others. This uneven force creates instability. The muscles feel strained by this instability. The occlusal equilibrium includes selective grinding of occluding tooth surface.
  • Painkillars and muscle relaxant medication to relax jaw muscles
  • Jaw exercises
  • Heat and ice application according to condition
  • Ultrasound. Deep heat applied to the joint can relieve soreness or improve mobility.
  • Trigger point relief in painful muscle
  • Diet instructions
  • Avoid wide mouth opening
  • Posture correction
  • Physical self regulation
  • Relaxation technique in case of stress related TMD
  • Transcutaneous Electrical Nerve Stimulation (TENS)
  • Acupuncture
  • Laser
  • Rarely, surgery in advanced case of TMD like arthrocenthesis, arthroscopy

Kindly Note:

There is no permanent cure for TMD’s. TMD is like diabetes and hypertension. We can control it's symptoms, but can’t cure completely.

You may need to follow instruction for the rest of your life.

Due to so many causes of TMD’s, no single therapy has been proved to be totally effective. Thus, based on your symptoms, contributing factors and scans, an individualized treatment approach will be recommended to you. However, the original treatment plan may need to be revised on the bases of your symptoms response.

The key to success is being patient and believing in the therapy.

Treatment can often take extended periods of time and recovery is subjective to one’s healing ability and mental make-up.

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