Symptoms

What Are the Symptoms?

TMD often causes severe pain and discomfort. It can be temporary or last many years. It might affect one or both sides of your face. More women than men have it, and it’s most common among people between the ages of 20 and 40.

Common symptoms include:

• Pain or tenderness in your face, jaw joint area, neck and shoulders, and in or around the ear when you chew, speak, or open your mouth wide
• Problems when you try to open your mouth wide
• Jaws that get "stuck" or "lock" in the open- or closed-mouth position
• Clicking, popping, or grating sounds in the jaw joint when you open or close your mouth or chew. This may or may not be painful.
• A tired feeling in your face
• Trouble chewing or a sudden uncomfortable bite -- as if the upper and lower teeth are not fitting together properly
• Swelling on the side of your face

You may also have 

• toothaches, 
• headaches,
• neck aches, 
• dizziness, 
• earaches,
• hearing problems,
• upper shoulder pain, and 
• ringing in the ears (tinnitus).

Causes and Diagnosis

What Causes TMD?

Traditional Allopathic Doctors don’t know what causes TMD. Dentists believe symptoms arise from problems with the muscles of your jaw or with the parts of the joint itself.  Consider Dr. Huntoon’s Alternative explanation below.

Injury to your jaw, the joint, or the muscles of your head and neck -- like from a heavy blow or whiplash -- can lead to TMD. Other causes include:

• Grinding or clenching your teeth, secondary to having a parasite, which puts a lot of pressure on the joint
• Movement of the soft cushion or disc between the ball and socket of the joint
• Arthritis in the joint
• Stress, which can cause you to tighten facial and jaw muscles or clench the teeth
• Holding the jaw open for extended periods of time, usually when receiving dental care, as the stress of the dental work and the time having the jaw open during the treatment.

How Is TMD Diagnosed?

Many other conditions cause similar symptoms -- like tooth decay, sinus problems, arthritis, or gum disease. To figure out what’s causing yours, the dentist will ask about your health history and conduct a physical exam.

He’ll check your jaw joints for pain or tenderness and listen for clicks, pops, or grating sounds when you move them. He’ll also make sure your jaw works like it should and doesn’t lock when you open or close your mouth. Plus he’ll test your bite and check for problems with your facial muscles.

Your dentist may take full face X-rays so he can view your jaws, temporomandibular joints, and teeth to rule out other problems. He may need to do other tests, like magnetic resonance imaging (MRI) or computer tomography (CT). The MRI can show if the TMJ disc is in the proper position as your jaw moves. A CT scan shows the bony detail of the joint.

You may get referred to an oral surgeon (also called an oral and maxillofacial surgeon) for further care and treatment. This doctor specializes in surgery in and around the entire face, mouth, and jaw area. You may also see an orthodontist to ensure your teeth, muscles, and joints work like they should.

Traditional Medical Treatment Options and Home Treatments

Traditional Medical Treatments

Talk to your dentist about these treatments for TMD:

• Medications. 

Your dentist can prescribe higher doses of NSAIDs if you need them for pain and swelling. He might suggest a muscle relaxer to relax your jaw if you grind or clench your teeth. Or an anti-anxiety medication to relieve stress, which may bring on TMD. In low doses they can also help reduce or control pain. Muscle relaxants, anti-anxiety drugs, and antidepressants are available by prescription only.

• A splint or night guard. 

These plastic mouthpieces fit over your upper and lower teeth so they don’t touch. They lessen the effects of clenching or grinding and correct your bite by putting your teeth in a more correct position. What’s the difference between them? You wear night guards while you sleep. You use a splint all the time. Your dentist will tell you which type you need.

• Dental work. 

Your dentist can replace missing teeth and use crowns, bridges, or braces to balance the biting surfaces of your teeth or to correct a bite problem.

Other Medical Treatments

If the treatments listed above don’t help, your dentist may suggest one or more of the following:

• Transcutaneous electrical nerve stimulation (TENS). This therapy uses low-level electrical currents to provide pain relief by relaxing your jaw joint and facial muscles. It can be done at the dentist's office or at home.
• Ultrasound. Deep heat applied to the joint can relieve soreness or improve mobility.
• Trigger-point injections. Pain medication or anesthesia is injected into tender facial muscles called "trigger points" to give relief.
• Radio wave therapy. Radio waves stimulate the joint, which increases blood flow and eases pain.
• Low-level laser therapy. This lowers pain and inflammation and helps you move your neck more freely and open your mouth wider.

Surgery for TMD

If other treatments can’t help you, surgery is an option. Once it’s done, it can’t be undone, so get a second or even third opinion from other dentists.

There are three types of surgery for TMD. The type you need depends on the problem.

• Arthrocentesis is used if you have no major history of TMJ but your jaws are locked. It’s a minor procedure that your dentist can do in his office. He’ll give you general anesthesia, then insert needles into the joint and wash it out. He may use a special tool to get rid of damaged tissue or dislodge a disc stuck in the joint, or to unstick the joint itself.
• Arthroscopy is surgery done with an arthroscope. This special tool has a lens and a light on it. It lets your doctor see inside your joint. You’ll get general anesthesia, then the doctor will make a small cut in front of your ear and insert the tool. It’ll be hooked up to a video screen, so he can examine your joint and the area around it. He may remove inflamed tissue or realign the disc or joint. This type of surgery, known as minimally invasive, leaves a smaller scar, has fewer complications, and requires a shorter recovery time than a major operation.
• Open-joint surgery. Depending on the cause of the TMD, arthroscopy may not be possible. You may need this type of surgery if:
• The bony structures in your jaw joint are wearing down
• You have tumors in or around the joint
• Your joint is scarred or full of bone chips

You’ll get general anesthesia, then the doctor will open up the entire area around the joint so he can get a full view and better access. You’ll need longer to heal after open-joint surgery, and there is a greater chance of scarring and nerve injury.

Medicines Two Choices for You

Home Treatments for TMD

There are things you can do on your own to help relieve TMD symptoms. Your doctor may suggest you try some of these remedies together.

• Take over-the-counter medications. Nonsteroidal anti-inflammatory drugs (NSAIDs), like naproxen or ibuprofen, can relieve muscle pain and swelling.
• Use moist heat or cold packs. Apply an ice pack to the side of your face and temple area for about 10 minutes. Do a few simple jaw stretches (if your dentist or physical therapist OKs them). When you’re done, hold a warm towel or washcloth to the side of your face for about 5 minutes. Perform this routine a few times each day.
• Eat soft foods. Add yogurt, mashed potatoes, cottage cheese, soup, scrambled eggs, fish, cooked fruits and vegetables, beans, and grains to your menu. Cut foods into small pieces so you chew less. Skip hard, crunchy foods (like pretzels and raw carrots), chewy foods (like caramels and taffy), and thick or large bites that require you to open wide.
• Avoid extreme jaw movements. Keep yawning and chewing (especially gum or ice) to a minimum and don’t yell, sing, or do anything that forces you to open wide.
• Don't rest your chin on your hand. Don’t hold the phone between your shoulder and ear. Practice good posture to reduce neck and facial pain.
• Keep your teeth slightly apart as often as you can. This will relieve pressure on your jaw. Put your tongue between your teeth to control clenching or grinding during the day.
• Learn relaxation techniques to help loosen up your jaw. Ask your dentist if you need physical therapy or massage. Consider stress reduction therapy as well as biofeedback.

Dr. Huntoon's Alternative Medical Treatment Options

Dr Huntoon’s Alternative Perspective and Treatment

Having taught anatomy for 5 years at both the college and grad-school level, Dr. Huntoon has seen up-close the inner workings of all the muscles, joints, nerves and tendons, along with each disc associated with the TMJ.  And in the course of teaching anatomy to others, he developed quite an accurate and complete understanding of this interesting pair of joints, what controls them and how they go out of balance.  He also developed a very effective solution to TMJ-D and has successfully applied it to hundreds of practice members for over 27 years.

Assessment involves determining if the problem is with

• opening the jaw or
• closing the jaw. 

Each has a different CAUSE and each would also have a different solution. 

Usually associated with the TMD is an imbalance between what one is thinking (upper jaw) and what one is feeling (lower jaw) creating the tension within the joint(s) itself. 

Most times, it starts on one side versus the other and the pain associated with the imbalance can be from the primary side or the secondary side of dysfunction. 

Having the ability to determine where the CAUSE is coming from and properly addressing this is not difficult when you have seen as many as Dr. Huntoon has over the past 27 years. 

Correction involves a simple manipulation of the primary TMJ, massaging the appropriate muscles associated with the mechanism of dysfunction and advising what the person needs to be aware of for the next 24 to 48 hours.  And in greater than 95 % of the people Dr. Huntoon has seen for this concern, all have full resolution to their TMD and can go back to their normal life after ONE visit.  A couple of them have required 2 visits, but never any more than that.

Thanks Again,
Kimberly Patenaude

What is Your Prognosis

Prognosis

In greater than 95 % of the people Dr. Huntoon has seen for this concern, all have full resolution to their TMD and can go back to their normal life after ONE visit.  A couple of them have required 2 visits, but never any more than that.  

Certainly consider this first BEFORE agreeing to expensive dental treatment like grinding your teeth down, having surgery or having teeth extracted.  All of these will only lead to further complications and a long road to getting back to some semblance of normalcy. 

Prevention and Quick Tips

To prevent TemporoMandibular Joint Dysfunctions (TMDs),

try to reduce muscle tension in your jaw. You can reduce muscle tension in these ways:

• Relax. If you have a lot of stress and anxiety in your life, try relaxation techniques. See the topic Stress Management.
• Learn to recognize when you are clenching your teeth.  Practice keeping your teeth apart, bringing them together only when swallowing or eating. When driving, avoid clenching the wheel with both hands, because often your teeth will be clenched also.
• Do not overuse and stress your jaw muscles. Avoid constantly chewing gum, biting your nails, resting your chin on your hand, or cradling the telephone receiver between your Shoulder and jaw.
• Change your diet. Eat softer foods, and use both sides of your mouth to chew your food. Avoid hard or chewy foods, such as popcorn, apples, carrots, taffy, hard bread, and bagels.
• Maintain good posture. Poor posture may disturb the natural alignment of your facial bones and muscles, causing pain.

In the past, various procedures such as dental restoration and orthodontic treatment were used to prevent joint sounds from developing into TMDs. Such measures are not only unneeded but also potentially damaging to a joint that may never become painful on its own.

If you have any questions, please do not hesitate to call the office and speak to Dr. Huntoon.  Our phone number is (845)561-2225.