A Note on TMJ Disorders 

Question: What does TMJ stand for?  Answer:  It stands for the temporomandibular joint, or the jaw joint. The “temple” is the area on the side of your skull, and the mandible is the lower jaw. This is a very complex joint. Muscles attach around it and a pad separates the bones so that you normally don’t hear any bone to bone sounds with movement. Remarkably, the jaw moves not only in an opening and closing direction but can slide forward and side to side.

When something goes wrong with this complex joint it is known as temporomandibular joint disorder. It can be a little annoying or quite painful.

As a dentist, I have seen some patients get the run around on this and I have seen some get relief. There are multiple ways that it can be treated. The end result  of successful treatment is that the patient is comfortable with no special attention given to the joint and chewing.

In the past I sent patients with loud clicking and popping sounds and/or pain to a jaw pain specialist. In each case he did an expensive workup, made the patient a mouth guard and then referred the patient to a physical therapist. My normal treatment modality now (as long as the patient is not in too extreme a condition) is to first make them a bite guard, and if they still have pain, send them to physical therapy. This approach has worked well for many.

I personally had some pain in my joint about 12 years ago. I went to my chiropractor, mentioned the situation to him, and he got me fixed up in just a few treatments. I haven’t had any difficulty since then.

A couple of weeks ago I had a patient who had some trouble that sounded like my problems. I referred her to my chiropractor. He thought the joint itself was probably messed up and wanted a recommendation of whom to refer her. I have an oral surgeon who is very good with TMJ, but I’m concerned that his quick approach is surgery rather than some non-surgical interference. My chiropractor quipped ‘To the man trained in a hammer, everything looks like a nail!’

In this case, I don’t know how her case will work out. Non surgical treatments include short term medication, night guards, or occlusal adjustment (adjusting the bite with a drill or restorations to get the teeth to meet in a more favorable position when chewing). For acute pain, besides medication, a moist compress of hot, cold or a combination can be applied to bring both short term healing and relief.