“Hey Doc! My jaw joint really pops and clicks when I eat.” This is something that I hear often from my patients. The noise is only one facet of many that lead us into the depths of what TMJ disorder can entail. TMD is an acronym that is thrown about often by dentists and health professionals but may be unclear to the general population. Going forward I hope to shine a bit of light on its scope and breadth. We call it TemporoMandibular joint Disorder, but it not only points to the joint but the muscles used for chewing and most of the structures in your skull.
Here are some signs that you may have TMD to some degree. The muscles of your temples and angle of your jaw may be sore when you press on them, you may have trouble opening your mouth wide enough to bite through your double-decker club sandwich, headaches may emanate from behind your eyes and may plague you during the day, your bottom jaw may move to the right or left as you open it, your neck and shoulders may be painful, and many other symptoms could be on your list. We broadly categorize these disorders into joint or muscle issues, but coming to a firm diagnosis involves a thorough exam that takes into account multiple factors.
The dentist and clinical psychologist S.F. Dworkin and others proposed a biopsychosocial diagnostic approach in 1992 that takes into account many factors aiding in a definitive diagnosis. Not only is the diagnosis multifactorial and complicated, but treating TMD revolves around multiple disciplines e.g., physical therapy, psychological therapy, surgery, sleep studies, and dentistry. This highlights the fact that we are merely managing the disorder and rehabilitating many problems not CURING this disorder. It’s not as definitive a disease as a cavity, whose cure involves removing the bacteria and placing a filling material. TMD is a fuzzy disorder similar to others found under Functional Somatic Syndromes like fibromyalgia, myofascial pain syndrome and chronic fatigue syndrome. Females are most prone to these syndromes and often have symptoms onset before 30 years of age. Researchers have found high correlation of those who suffer with Fibromyalgia also having TMD problems (as high as 75%). Lastly, the most staggering statistic is that 60-70% of the general population deals regularly with one or more TMD symptoms but only 5% seek any medical/dental treatment.
Dentists will often be the first line of diagnosis for any sort of TMD. Even a simple phone call to your dentist for a question answered is highly advisable.