What you need to know about temporomandibular disorder

Persistent pain in the jaw and chewing muscles—also called  temporomandibular disorder (TMD)—can arise for various reasons. With proper diagnosis, the discomfort of this condition can be overcome. So where should you start if you suffer from TMD?

In the unhappy event that your doctor uses temporomandibular disorder (TMD) to describe your persistent jaw pain, you should first understand that TMD is an umbrella term that covers many kinds of facial pain caused by different sources. In fact, the world medical community has yet to agree on nomenclature, and currently there are more than a dozen syndromic terms to be found in the medical literature.

The temporomandibular joint is the hinge-like point where the jawbone (mandible) connects with the skull. Like other joints it connects via an intricate web of ligaments and muscles. Combined with its proximity to important areas like the teeth, throat and ear, diagnosis can be a complex endeavour.

• Symptoms include pain in the jaw (especially while chewing), toothache, headache or earache, dizziness, inability to open the mouth widely, plus various sounds described as clicking, popping or grating.
• Essentially a catch-all term, temporomandibular disorder (TMD) is non-specific because it only identifies where the pain is located, not what caused it.

First, a basic distinction is made between whether the condition appears to be following an injury (post-traumatic) or from an unknown source (idiopathic); and whether the pain is intense and short-term (acute) or persistent for six months or more (chronic).

• To do this it’s essential you choose a doctor with extensive experience, since numerous diagnostic techniques including CAT, MRI and bone scans may all be brought to bear to help pinpoint different causes.
• Examining dentition and dental X-rays is also vital; you therefore want somebody with a good handle on all of these.
• Furthermore, TMD symptoms are often mimicked by other conditions such as Lyme disease and sinusitis, so it’s important that they be ruled out before proceeding with treatment.

Different evident causes beget different prospective solutions. Even within the TMD field there are many approaches but little agreement on treatment.

• Experts caution that most cases resolve in time without resorting to irreversible actions such as jaw surgery or permanent bite adjustment.
• Many patients report good success with dental appliances designed to combat jaw clenching, particularly during sleep.

The TMD field is not considered a medical specialty, so you can’t necessarily go that route. What you do want to seek out is a doctor with expertise in skeleto-muscular issues.

• A good place to get a recommendation is the pain clinic in any hospital.

When it comes to TMD, be prepared for extensive examinations but don’t expect miracles. In some instances, less could possibly be the more you're looking for:

• Classic healing treatments like ice, heat, rest and time might be the key to help manage your symptoms while the body heals itself.

If in doubt about what's causing pain in your jaw and what to do, always seek advice from your healthcare provider.