The Temporomandibular Joint is a hinge that connects your lower jaw bone (the mandible) to the temporal bones of your skull, which are in front of each ear. Your TM joints work together as a pair, and allow your jaw to move up and down, side to side, and forward and back, so you can talk, chew and yawn.
When you open and close your mouth, the rounded upper ends of your lower jaw on each side of the jaw (the condyles) glide along the joint socket at the base of the skull. A soft tissue disc between the condyle and the socket absorbs the shock from chewing and other movements.
Problems with your TMJ and the muscles in your face that control it are known as temporomandibular disorders (TMD)
TMD affect up to 25% of the population of all ages but are more common in women and between 20 and 50 years. Musicians, particularly wind and string players, are often affected.
What Causes TMD?
- Injury to your jaw, the joint, or the muscles of your head and neck from a heavy blow or whiplash
- Clenching your jaw or grinding your teeth when you sleep (bruxism) overworks your jaw muscles and puts pressure on jour joint. This is often caused by stress.
- Arthritis in the joint
- Stress, which can cause you to tighten facial and jaw muscles or clench the teeth
- TMD may be associated with specific diseases such as rheumatoid arthritis, gout or fibromyalgia
What Are the Symptoms of TMD?
- pain in your jaw muscles
- pain in your neck and shoulders
- chronic headaches
- jaw muscle stiffness
- limited movement or locking of your jaw
- ear pain, pressure, fullness, or ringing in your ears (tinnitus)
- painful clicking, popping or grating noises in your jaw joint when opening or closing your mouth
- vision problems
How is TMD treated?
There are a number of self-help measures that can help improve TMD.
- Softer diet
- Eating softer foods will help relieve pain and lets your joint rest.
- Avoid steaks and instead have mince or try fish and mashed potatoes.
- Avoid chewing gum, raw vegetables and big sandwiches.
- When eating an apple or similar foods, cut into bite size pieces rather than biting into the apple.
2. Avoiding opening your mouth too wide until the pain settles
3. Avoiding clenching your teeth for long periods of time by placing your tongue between your top and bottom teeth.
4. Applying cold therapy
Holding an ice pack to the jaw for 20 minutes in the evening. Ice packs can decrease inflammation and also numb pain and promote healing.
Ice packs can be made from ice cubes in a plastic bag wrapped in a clean cloth to avoid direct contact between the ice and your skin.
A packet of frozen peas is also ideal as they mould nicely and can go in and out of the freezer. Frozen peas should not be eaten if they have been thawed and re-frozen.
Short-term use of over-the counter pain medications such as Ibuprofen tablets, may provide temporary relief from jaw and muscle discomfort.
If you are unable to take non-steroidal anti-inflammatory tablets you can try Topical non-steroidal anti-inflammatories gel.
Topical non-steroidal anti-inflammatories
To address the inflammation in the joint topically applied gel containing NSAIDs (non-steroidal anti-inflammatories) can reduce the inflammation and pain around the joint. The gel have less systemic effects than taking tablets, such as Neurofen and work just as well. The gel should be applied over the area of the joint four times a day and should continue for four weeks or after the majority of pain has settled. Examples of non-steroidal anti-inflammatories is Cuprofen gel (ibuprofen), Difflam cream (benzydamine), Ibugel (ibuprofen) or Ibuleve (ibuprofen).
Soft Bite raising Appliance
How to wear your appliance
First 3 weeks- Wear your bite raising appliance every night
The following 2 weeks - Wear your appliance every other night
Following 2 weeks- Wear your appliance for 1 night in every 3 nights.
After this wear your appliance if and when you feel joint pain or you are feeling stressed.
Initially you might find it difficult to keep your appliance in your mouth and find that you have discarded it by the morning. It is important to persist. Your teeth might feel strange when you remove your splint in the morning but should settle after a few minutes.
How a splint works for Temporomandibular Disorder
- Because it is soft it spreads the load and reduce the force that is being transmitted to the joint.
- It increases the gap between the teeth it allows the muscles to stretch and therefore helps to reduce muscle spasm and to reduce clenching of the teeth overnight.
- By a mechanism of the level and the fulcrum principle the force exerted by biting the teeth together is now acting further towards the back of the mouth and therefore the load, which is passing through the joint, is reduce.