Wednesday, May 22, 2013

TMJ (jaw) disorder (TMD)

TMD is surprisingly common and usually self limiting however a small group of the population (mainly women) can suffer from chronic pain and while we know a certain amount about this problem there is still robust debate about what is going on and how best to treat.  The good news is it's estimated that over 80% of cases respond well to non invasive, conservative approaches.  The most important aspect again is making as accurate a diagnosis as possible, trialing treatments and being prepared to revise or refer if progress is not sustained.

It's such a simple joint but unique with regards to the amount of use it gets (eating, talking, yawning) it's vulnerability to insignificant but repeated trauma and it's inherent mobility.  It's also a part of the face and thus neurologically highly sensitive so perhaps it's surprising that humans (who apparently love to talk:)) don't have more trouble with it.

There isn't enough room in a blog to go into the details of TMD suffice to say that a reasonable clinical approach is to consider what they call peripheral and central components to the problem.  Peripheral = the joint itself (which can include the skull) and central is when the central nervous system becomes sensitive to the joint.

Who do you see?  I suggest that people ask specifically if TMD diagnosis and management is something a practice commonly deals with.  As such what profession you consult is less relevant than if the professional is familiar with TMD and if they have a reasonable degree of success with it. 

Doug Scown

1 comment:

  1. If your jaw pain does not resolve with more-conservative treatments and if it appears to be caused by a structural problem within the joint, your doctor or dentist may suggest surgery to repair or replace the joint. The National Institute of Dental and Craniofacial Research considers TMJ surgery to be controversial and recommends that it be avoided whenever possible.

    Grinding or clenching the teeth, which puts a lot of pressure on the TMJ. Thanks.

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