Do You Have TMD?

Do you ever complain that it hurts 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? Does your jaw make loud noises or get stuck or locked as you open it? If so, you may have a temporomandibular joint disorder, or TMD.

What Is TMD?
TMD is a group of conditions, often painful, that affect the jaw joint. Signs 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.

What Causes TMD?

• Severe injury to the jaw is a leading cause of TMD. Anything from a hit in the jaw during a sporting activity to chewing gum excessively or chewing on one side of the mouth too frequently may cause TMD.
• Clenching the teeth during times of stress can be a major factor in the TMD.
• Sitting in a dentist's chair for several hours with the mouth wide open may contribute to TMD
• Women experience TMD four times as often as men. Several factors may contribute to this higher ratio, including prolonged sitting in the workplace, general posture and higher heels.

TMD Diagnosis and Treatment

• To help diagnose or rule out TMD, your chiropractor may ask you to put three fingers in your mouth and bite down on them, or to open and close your mouth and chew repeatedly while the doctor monitors the dimensions of the jaw joint and the muscle balance.
• Sometimes special imaging, an X-ray or an MRI may be needed to help confirm the diagnosis.
• If you have TMD, your doctor may recommend chiropractic manipulation, massage, applying heat or ice and special exercises.
• If your doctor of chiropractic feels that you need special appliances or splints, he or she will refer you to a dentist or orthodontist for co-management.
• In addition to treatment, your doctor of chiropractic can teach you how to:
    - Apply heat and ice to lessen the pain. Ice is recommended shortly after the injury or the onset of pain. Later, you need to switch to heat, especially if you are still experiencing discomfort.
    - Avoid harmful joint movements, such as biting into a hard apple or candy or eating giant sandwiches, which may have a destabilizing effect on the jaw.
    - Perform TMD-specific exercises. Depending on your condition, your chiropractor may recommend stretching or strengthening exercises. Stretching helps to loosen tight muscles and strengthening helps to tighten muscles that have become loose.