Do I Have TMJ?
Hopefully you do. TMJ is an abbreviation for the name of the joint. Joints are named for the bones that articulate together. The lower jaw is called the mandible and the socket into which it fits is in the temporal bone, therefore the temporo-mandibular joint or TMJ. What people suffer from is temporo-mandibular disorder or TMD. This means one or a combination of three things. First is a slippage of the carolage disc in the joint. This is similar to a slipped disc in the back or a football knee injury, it has to do with ligaments and cartilage. The disc sits on top of the lower jaw condyle and is attached with ligaments, when the ligaments get stretched or torn the disc becomes lose and slips on and off the lower jaw creating a click, pop or grating sound. When a person bites down the lower jaw puts pressure in the socket and the disc slips off, pulling blood vessels and nerves over on top of the condyle which are then "pinched" causing pain in the joint. The ligaments may become so stretched or torn that the disc gets caught in front of the jaw condyle and the patient can't open wide, the jaw "locks". The second thing that comprises TMD is perforation of the disc or the tissue around the disc. This is infrequent. The third thing is adhesion of the disc to the socket. which also is infrequent but when it does occur it may require surgery. These things also occur with "footbll knee" injuries. When the joint hurts the muscles around the jaw, the face and neck tighten up to protect the joint and they become painful. Temporal headaches, neck aches, pain behind the eye and ear pain/dizziness are all part of TMD. Many patients seek help from their physicians who can find nothing wrong, even after taking CAT scans and MRIs. Many are misdiagnosed with migraine headaches and are prescriped meds which help only a little. With TMD the headaches and muscle aches are totally secondary to the joint disorder. If the TMD is properly treated, the headaches/muscle pain will disappear. Hence, things like botox or trigger point injections and pain meds/muscle relaxers are simply treating the symptoms of the TMD, not the cause. Research from Dr. Williamson's practice show 22% of adolecent patients 6 to 15 years of age seeking routine orthodontic treatment have signs or symptoms of TMD and are unaware of it.
What causes TMD?
Usually some type of trauma. It may be minor trauma over a long period of time causing wear/tear in the joint. Bruxism, or grinding of the teeth, is an example. Major traumas such as blows, falls or auto accidents. Another trauma might be opening wide under general anesthesia when they pass the airway tube down. Dr. Williamson has seen many young children with TMD that may have been the result of learning to walk, falling, or hitting the chin. Four wheeler accidents are a frequent cause. Systemic disease such as connective tissue problems, loose joints or genetic factors enter in as well.
How is TMD treated?
Dr. Williamson has been researching/teaching and treating TMD for over 40 years with over 100 publications. In that period of time he has seen a plethora of treatment modalities come and go. His treatment to date revolves around treating the cartilage disc displacement by attempting to achieve repair/regeneration of the disc and peri-discal tissues. He has developed a technique of jaw repositioning to get the disc back in place as best possible and reduce the pressure in the joint. The procedure has proven to be 95% successful non-surgically and is based upon solid research reported in the professional literature. Approximately 5% of the patients will require surgery on the joint similar to football knee surgery. When successful, the headache/muscle pain is reduced with days since the cause of the TMD is treated not the symptoms.