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Temporomandibular Joint Disorder

“As a chiropractor I use Myofascial release techniques, muscular re-education and chiropractic manipulative therapy to get great results increasing jaw range of motion, decreasing pain levels and eliminating clicking and popping. I understand all too well the importance of a well-aligned bite, night guard and overall good oral health to help treat and prevent TMD. Having had surgery and a long history of TMJ problems, I chose to focus my training and practice in proper TMD rehabilitation and care.”
~ Dr. Jessie Young

Does it hurt when you chew, open wide to yawn or use your jaw? Do you have pain or soreness in front of the ear, in the jaw muscle, cheek, the teeth or the temples? Do you have pain or soreness in your teeth? Does your jaw make noise loud enough to bother you or others? Do you find it difficult to open your mouth wide? Does your jaw ever get stuck/locked as you open it? If you answered “yes” to some of these questions, you may have a Temporomandibular Joint Disorder, or TMD.

Dr. Jessie Young is no stranger to this condition. In 2006 she had Orthognathic surgery to correct a severe malocclusion that was believed to be the cause of her TMJ pain. Unfortunately, without receiving proper rehabilitation, it left her with reduced range of motion, pain and clicking.

She began treating her TMJ with chiropractic achieving amazing results. The pain and clicking disappeared and her range of motion was restored. Her personal experience has driven her passion to help others with this often-misunderstood condition.

What is TMD?
TMD is a group of conditions, often painful, that affects the jaw joint. Symptoms may include:

  • Radiating pain in the face, neck, or shoulders
  • Limited movement or locking of the jaw
  • Painful clicking or grating when opening or closing the mouth
  • A significant change in the way the upper and lower teeth fit together
  • Headaches, earaches, dizziness, hearing problems and difficulty swallowing

For most people, pain or discomfort in the jaw muscles or joints is temporary, often occurs in cycles, and resolves once you stop moving the area. Some people with TMD pain, however, can develop chronic symptoms. Our doctors can help you establish whether your pain is due to TMD and can provide conservative treatment if needed.

The Causes of TMD
Researchers agree that TMD falls into three categories:

  • Myofascial pain-discomfort or pain in the muscles of the jaw, neck, and shoulders
  • A dislocated jaw or displaced disc
  • Degenerative joint disease-rheumatoid arthritis or osteoarthritis in the jaw joint

Severe injury to the jaw is a leading cause of TMD. For example, anything from a hit in the jaw during a sporting activity to overuse syndromes, such as chewing gum excessively or chewing on one side of the mouth too frequently may cause TMD.

While emotional stress itself is not usually a cause of TMD, the way stress shows up in the body can be. When people are under psychological stress, they may clench their teeth, which can be a major factor in their TMD.

Some conditions once accepted as causes of TMD have been dismissed-moderate gum chewing, non-painful jaw clicking, orthodontic treatment (when it does not involve the prolonged opening of the mouth, as mentioned above), and upper and lower jaws that have never fit together well. Popular theory now holds that while these may be triggers, they are not causes. Women experience TMD four times as often as men. Several factors may contribute to this higher ratio, including sitting too long at the workplace, general posture and higher heels.

TMD Diagnosis and Treatment
To help diagnose TMD, we will do a careful examination of how your jaw moves and check the balance of your muscles and anatomy of your jaw. We can then look for signs of inflammation and abnormalities. Sometimes special imaging, an x-ray or an MRI may be needed to help confirm the diagnosis. If you have TMD, we may recommend chiropractic manipulation, massage, applying heat/ice and special exercises. In most cases, our first goal is to relieve symptoms, particularly pain. We may also consider special appliances or splints that would require co-management with your dentist or orthodontist.

In addition to treatment, we can teach you how to:

  • Apply heat and ice to lessen the pain. Ice is recommended shortly after the injury or after your pain has started. In the later stages of healing, you need to switch to heat, especially if you are still experiencing discomfort.
  • Avoid harmful joint movements. For example, chomping into a hard apple is just as bad as crunching into hard candy (The name “jawbreaker” should be taken seriously!). And giant sandwiches can cause the mouth to open too wide and have a destabilizing effect on the jaw.
  • Perform TMD-specific exercises. Depending on your condition, we may recommend stretching or strengthening exercises. Stretching helps to loosen tight muscles, and strengthening helps to tighten muscles that have become loose. Special feedback sensors in the jaw can be retrained, as well, if needed.

If you have experienced any of the symptoms of TMD, please contact us to schedule a complete assessment.

Excerpted from Healthy Living Patient Information from the American Chiropractic Association, Temporomandibular Joint Disorder, January 2006.

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