Temporomandibular joint dysfunction (TMD) refers to dysfunction within the temporomandibular joint where the mandible (jaw) articulates with the glenoid fossa of the temporal bone of the skull, separated by a biconcave disc much like those seen in the spine.  The entire apparatus includes this paired joint, the teeth and their supporting structures, the cervical musculature, and the muscles of mastication (chewing muscles).  Dysfunction in any of these can result in the three cardinal features of TMD:  orofacial pain, clicking or popping sounds of the jaw, and altered jaw function.  An estimated 60-70% of the population will experience at least one of the three cardinal signs at one time.  Other associated symptoms include headaches, earaches, numbness, tingling, tooth sensitivity, and jaw locking.  Females are four times more likely to experience TMD than males and the peak incidence falls in the age range of 20-40.

     There are many causes of TMD.  A proper history and examination should better identify possible causes and sources of the dysfunction.  Disc derangement is an extremely common cause that results from improper positioning and/or movement of the biconcave disc within the joint.  This typically produces pain, auditory clicking and popping, and jaw locking in more severe cases.  Hyper/hypomobility of the joint is another common cause.  Too much or too little movement in one of the joints can offset the normal motion of the jaw during chewing and speech.  These can be caused by overactive muscle contraction, most commonly involving the lateral pterygoid, or fixation within the joint, limiting motion.  Certain dental conditions can lead to TMD symptoms.  Bruxism (grinding the teeth) is the most common dental cause of TMD.  Grinding of the teeth can cause unbalanced wear and tear on the teeth resulting in malposition.  It can also cause tooth chipping and cracking and muscle spasms that can forces the jaw to close incorrectly.  Poorly fitting dentures and other dental alterations including crowns, build-ups, and fillings can also cause similar problems.  Any possible dental cause should be evaluated by a dentist so that proper alterations can be made.  Rounding out our list of common causes of TMD are trauma to the head and jaw, osteoarthritis, and in some cases excessive talking or chewing. 

     A simple history and examination is usually sufficient to diagnosis the cause and source of TMD.  As stated before, any dental origin needs to be evaluated by a dentist or dental specialist.  In more severe or chronic cases, an MRI maybe necessary to check for disc positioning and possible tearing or fracture and to determine if surgical intervention is needed.  In most cases conservative treatment is recommended.  Routine conservative treatment can be handled by your primary care physician, chiropractor, or physical therapist.  At Dolan Family Chiropractic both Drs Collin and Alorna Dolan have received special training in the management of TMD and have successfully treated a wide variety of injuries as noted above.  They follow a simple and painless treatment plan consisting of soft tissue manual therapy, physical therapy, and chiropractic adjusting that produces great results without the use of prescription drugs or invasive surgery.  Each course of treatment is different based on the underlying cause of the dysfunction but most include the use of therapeutic ultrasound, electric stim treatments, myofascial release, massage, trigger point therapy, stretching, and specific at home exercises and lifestyle modifications to realign the jaw and stabilize the joint to prevent future injury.  If you have any questions or would like to personally speak to one of the doctors call Dolan Family Chiropractic at 630-236-3090 or check out the website at http://Dolanchiro.com .