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The TMJ section used to occupy a single page on this website,
but due to its extreme length, it has been broken up into seven separate pages.
A good understanding of the Temperomandibular joint, occlusion and their
associated disorders may be gained by reading them in order.
Index
| Dental students, hygiene students and
assistants who want to know more about the technical aspects of
occlusion should also see my companion page on
occlusion
and the internal arrangement of the TMJ. |
| The term "TMJ" is the
acronym for "TemperoMandibular Joint". This is the ball and socket
joint that allows the lower jaw to open, close and move sideways when
chewing and speaking. Everyone, of course, has two of them, and
they are located about one centimeter in front of the ears. They
are the only joints in the head, and if something goes wrong with either
one of them, you can have real problems.
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You may have pain on
opening or closing your mouth, eating and chewing food, and even speaking. Problems of this nature are what the public generally
associate with the term "TMJ".
 In
the
panoramic x-ray above, the
TemporoMandibular Joints (TMJ'S) are visible in the upper right and upper
left corners of the film. The TMJ is typical of the type of joint
called a "ball and socket". The ball is the rounded eminence visible
in the detail to the right and is technically known as the "condyle"
of the joint. The ball rotates in a cuplike depression (the socket)
technically known as the "fossa". Although the joint looks like it is
attached directly to the sinuses, it is actually separated from them by soft
tissue ligaments which entirely enclose the joint, but are not visible on an
x-ray. Also not visible is the meniscus which is a disk of
cartilage which lives in the space between the condyle and the fossa and is
capable of moving forward and backward as the jaw opens and closes.
The condyle and the fossa are each covered with a thin layer of non movable
cartilage of their own. All three layers of cartilage help to provide
smooth, frictionless surfaces for comfortable joint operation.
When a dentist thinks of TMJ, he or she tends to
think more globally than just the anatomy of the joint. The joint is
really a part of the larger system that makes the jaws work. To a dentist,
TMJ problems include not only the joints themselves, but also the muscles,
tendons and ligaments that allow them to move, and in fact, it is usually
pain in these structures that drives most patients toward TMJ treatment. In
dentistry, there are several different terms used to describe the problems
associated with the "syndrome" (defined as a group of symptoms which have a
common origin). Each term generally corresponds to a particular
"era" in the history of the study of the illness, but all are still in common
use and mean much the same thing with emphasis on slightly different
aspect of the syndrome. They include MPD (MyoFascial Pain dysfunction),
MFPDS (MyoFascial Pain dysfunction Syndrome), the more general TMD (TemperoMandibular
Dysfunction) and the latest in a long line,
Craniomandibular Disorders
(CMD).
For the purposes of this discussion, I will use
the term TMD to distinguish the painful symptoms of the disease from "TMJ", the
name for the joint itself.
The symptoms and
duration of TMD (an overview)
The symptoms of TMD include the following:
Headaches, neckache or stiff neck, earaches (actually pain in
front of the ears), jaw aching,
difficulty opening or staying
open at the dentist's office,
pain in the joint
on opening the mouth,
inability
to open the jaws wide, especially at the dentist's office,
and sometimes an
inability to open the mouth at all,
pain on chewing, sensitive teeth, phantom tooth pain, a tendency to
dislocate the jaw, and
clicking, popping
or
grinding noises
when opening or closing the mouth. Finally, TMD sufferers are prone to many more
than the average number of complications from routine dental treatment.
All of these symptoms can range in severity from
mild to devastating. The most prominent case of TMD that I am aware of was
that of the actor, Burt Reynolds. His pain derailed his career,
brought about drug addiction, and was a factor in his several divorces.
A great deal of his suffering was due to the fact that TMD was only beginning to
be understood as a disease entity at that time. Even today, there is still
a great deal of misunderstanding about the true causes of this syndrome, even
among dentists, and thus you will find a great deal of disagreement about the
correct treatment. This is slowly changing as dental schools are
now teaching relevant courses in
occlusion.
The TMJ section used to occupy a single page on this website,
but due to its extreme length, it has been broken up into seven separate pages.
A good understanding of the Temperomandibular joint, occlusion and their
associated disorders may be gained by reading them in order.
Next page ===>Predisposing
factors
TMJ Pages
1, 2,
3,
4, 5,
6,
7 |
