TMJ is an acronym for the Temporomandibular Joint. But ‘TMJ’ has been used by many people through the years to actually describe TMD which is an acronym for Temporomandibular Joint Disorder. TMD describes many symptoms related to the jaw and supporting structures. This disorder is a subgroup of Orofacial Pain Disorders that include many different types of pain in the head and neck. The TM Joint itself is located directly in front of the ear and is commonly called the "jaw joint".Common symptoms of TM Disorders are pain or discomfort around the ear, jaw, jaw joints, facial muscles, headaches, temple pain, throat pain, pain with opening, chewing, locking, limited opening, clicking, popping and grating noises. If you have any of these symptoms for more than a month you should seek treatment from your Dentist.

2. "What causes TMD?"

Usually several factors are involved, rarely one single symptom. Some factors include trauma to the face or jaw, arthritis, bruxism or neck conditions. Most common cause is clenching of the jaw. There are many causes of clenching, which is at the core of any treatment plan to address. Any or all of these can perpetuate TMD symptoms and need to be addressed. TMD and Facial Pain is a chronic condition that must be managed to reduce the aggravating factors, there is no "quick fix."

3. "Does TMD cause my headaches?"

It could be one possible contributing factor but there are many causes for headaches. The contracture of the facial muscles can produce a headache cycle that is sometimes difficult to stop. TMD is but one possible cause of headache, or it might the effect of some other contributing factors such as Migraine. If you suffer continually from headaches, chances are that you are also developing a clenching habit that can put undue stress on the Temporomandibular Joint.

4. "How many headaches are normal?"

Normal is about 1 to 2 headaches per week with a pain level of 3 out of 10. More frequent or greater pain should be evaluated. Countless hours of work and quality time with your family is lost because of headaches, not to mention how it affects your quality of life. Your headaches are treatable! Something else that you should consider is all the medication taken for headaches (Advil, aspirin, Motrin) can cause major stomach disorders. Also more than 4 to 6 Advil a day can lead to liver disorders. Once your stomach becomes sensitive to these anti-inflammatories, you will be severely compromised in your ability to deal with inflammation in the future.

5. "Will I have to have to have TMJ surgery?"

Conservative, mainstream treatment for TMD does not include surgery as first line of treatment. Surgery is the very last treatment to consider. Nonsurgical treatment options for this condition are consistent with other orthopedic or rheumatologic conditions such as a painful knee or shoulder. The goals of management are to decrease pain, loading of the joint and restore function of the joint (40mm opening between front teeth without pain) and normal activity for the patient.

6. "What do you do for TMD?"

It depends on your symptoms and the different factors that are contributing to those symptom. Again as with other muskuloskeletal conditions medication, Physical Therapy, behavioral modification, orthopedic appliances are all used in combination or alone, depending on the etiology (cause), to achieve good function and decrease pain. Long term, the key to a healthy joint is movement and lubrication (synovial fluid). Anything less can lead to arthritis in the joints and internal derangement of the joints. 

7. "My jaw only clicks but I have no pain, can it get worse?"

Clicking may or may not be a symptom of a future problem. If it is occasional with no pain, then it may not present a future problem. The key here is if there is a progression of clicking, changes in the click intensity or frequency, or if it has just started. However, if it clicks every time you chew or open your mouth or changes in nature, then it may be an early symptom of a more severe problem. You should consult your Dentist before it progresses to a locked jaw.

8. "My jaw locks occasionally, usually in the morning, but I can work it open, is this normal?"

No! Even an occasional lock is cause for concern. Joints are designed to move. A joint that locks up, even occasionally, is a joint under stress, unstable and is not being lubricated properly. Episodic locking is very difficult to treat and should be treated as soon as possible. You could run the risk of being permanently locked and then your treatment options would diminish. Please see your Dentist as soon as possible if you have this condition.

9. "I already have an splint that does not work, what more can be done?"

The splint only address one contributing factor of your headaches, or pain. There may be others that need to be identified. Once they are identified, they can be treated. However, during the treatment of these other factors, it is critical that a good working splint needs to be used because as these other factors resolve themselves, the facial muscles will be affected and the splint needs to respond to these changes.

10. "Are all splints created equal?"

No! There are many different types of splints, all for different purposes. There are soft splints (such as the ones you can purchase at drug or sporting good stores), which are designed to protect the teeth, but in most cases actually increase muscle activity and forces on the joint. There are different types of hard acrylic splints that are designed to accomplish different results. A specialist such as Dr. Prehn can determine which type is the best for you.

11. "What is the key to the long term health of the TMJ?"

Painless mobility of the jaw is the key. It is the lubrication in the joint (synovial fluid) that keeps the joint health. Everytime the jaw opens, it lubricates itself, giving nutrition to the bone and soft tissues of the joint. The jaw must open to at least 40 mm (distance between the front teeth) in order to stay healthy. Less opening than that can lead to arthritis and other internal derangements of the TM Joint. This opening measurement of 40mm would be the goal of any surgical or non surgical TM Joint therapy.