Temporomandibular Joint Diseases and Disorders - TMD

 Temporomandibular disorders is a collective term used to describe a number of related disorders affecting the temporomandibular joints, masticatory muscles, and associated structures, all of which have common symptoms such as pain and limited mouth opening.  Although specific reasons such as degenerative arthritis and trauma underlie some TMD, as a group these conditions have no common origin or biological explanation and consist of a mixed group of health problems whose signs and symptoms are overlapping, but not necessarily alike.

Depending on the examining dentist and the diagnostic procedures, the term TMD has been used to characterize a wide range of conditions diversely presented as pain in the face or jaw joint area, headaches, earaches, dizziness, limited mouth opening, locking of the jaw (closed or open lock ), unusual  signs of wear and tear on the biting areas of the teeth, clicking or popping sounds in the jaw joint, and other complaints. The severity of these presenting conditions may range from noticeable but clinically insignificant signs to seriously unbearable pain or dysfunction.

An Experienced dentist will sometimes see patients who present with either persistent or recurrent chronic facial pain. Having excluded the likelihood of headache or ear or sinus problems, the next step is to consider the possibility of temporomandibular joint pain, particularly if the pain is accompanied by clicking jaw joints and limited mouth opening.

Bruxism is considered a risk factor for temporomandibular disorders (TMD).  It is Bruxism is the medical term for grinding, gnashing or clenching the teeth. This condition can affect both children and adults at any age.

Many individuals with bruxism unconsciously clench their teeth during the day, often when they feel nervous or tense. Night bruxism is the grinding or clenching of teeth during sleep. In most cases, bruxism is mild and does require treatment. However, it if it is frequent and violent, it can lead to joint and muscle disorders (Temporomandibular Disorders - TMD), headaches, damaged teeth and periodontium and other problems. 

Unfortunately, people with sleep bruxism usually aren't aware of the fact that they grind their teeth in sleep, so they aren’t diagnosed with the condition until complications occur. That's why it's important to diagnose bruxism as early as possible, and seek the appropriate dental treatment.

The mechanism behind bruxism is not completely understood. In some patients, irregular position of upper and lower teeth may contribute to the problem. Often, psychological factors may cause bruxism, including:

• Anxiety, stress or tension

• Suppressed anger or frustration

• Aggressive, competitive or hyperactive personality type

Because bruxism often goes untreated, and the damage is accumulated over time, it is important to suspect and test for bruxism on a regular basis. Any associated clinical evidence such as worn teeth or jaw, facial pain, morning headache should be mentioned and discussed with your dentist at each and every regular dental examination, in order to prevent and limit the future damages.

There is no single solution that can be recommended for Sleep Bruxism treatment. However simple steps such as stress reduction, self-awareness and use of a night guard or protective dental splint can prevent damage to the teeth and gums.

If your bruxism, teeth grinding is linked to a problem with your bite, your dentist can help correct the malocclusion. In some severe cases, when tooth wear has become so extreme that it's difficult for you to chew, your cosmetic dentist may need to perform several corrective procedures. In these cases, bruxism treatment may involve dental inlays or dental crowns to repair the affected teeth.