What is the “TMJ” or Temporomandibular Joint?
TMJ stands for temporomandibular joint. TMJ commonly refers to a painful condition in the teeth, jaws, neck, chewing muscles, neck and upper back. TMJ pain is causes by a bad bite and poor upper and lower jaw alignment. There are many treatments for TMJ such as bite splints and adult palatal expanders.
TMJ technically refers to the joint that connects the lower jaw to the skull. It is a small joint located in front of the ear on either side of the head. The TMJ is responsible for allowing the jaw to move up and down and side to side. The joint performs activities such as speaking, chewing, breathing and yawning.
TMJ or TMD
TMJ can sometimes become painful and dysfunctional, leading to a condition known as temporomandibular disorder (TMD). People commonly refer to pain in the jaw, neck and upper back areas as “TMJ” instead of “TMD.” So TMJ and TMD are sometimes used interchangeably. People who have jaw pain and clench their teeth at night often say they have “TMJ” when going to the dentist. TMD is a broad term used to describe a range of symptoms that can affect the TMJ and many other muscles and bones in the head, neck and spine. These issues can cause pain and discomfort in the jaw, face, neck, shoulders, back, pelvis, knees and feet. TMJ is also associated with problems chewing, speaking, swallowing, breathing and sleeping. There is a strong link between mouth breathing and TMJ.
Treatment Options for TMJ and What Causes it
Common Symptoms of TMD
- Pain or tenderness in the jaw, face, neck, or shoulders
- Obstructive airway conditions such as UARS and Sleep Apnea
- Mouth Breathing
- A clicking or popping sound when moving the jaw
- Difficulty or discomfort when biting or chewing
- A feeling of the jaw getting “stuck” or “locked” in place
- A change in the way the upper and lower teeth fit together
- Swelling on the side of the face
- Headaches or earaches
- Dizziness or ringing in the ears
- Bad posture
What Causes of TMD
The exact cause of TMD is not always clear, and it can be caused by a combination of factors. Some common causes of TMD include:
- Bad head, neck and back posture related to an obstructive airway condition
- Teeth grinding or clenching (bruxism): This can put a lot of strain on the TMJ and cause pain and discomfort.
- Arthritis: Osteoarthritis or rheumatoid arthritis can affect the TMJ and cause pain and inflammation.
- Trauma: An injury to the head or neck, such as a car accident or a blow to the jaw, can cause TMD.
- Misalignment of the teeth or jaw: If the teeth or jaw are not aligned correctly, it can put extra strain on the TMJ and cause TMD.
- Stress: Stress and tension can lead to teeth grinding and clenching, which can cause TMD.
Diagnosis of TMD
If you are experiencing symptoms of TMD, it is important to see a healthcare provider for a proper diagnosis. Your provider will ask about your medical and dental history prior to conducting a physical exam. The exam should include an evaluation of your head, TMJ, neck, back, airway and posture. A 3D X-ray called a CBCT or cone beam X-ray should be taken for proper evaluation of your jaw structures, tongue posture and upper airway. The may be other imaging tests to get a better look at the TMJ in cases where there is a history of trauma. The best starting point for TMJ evaluation is a dentist who specializes in TMJ and sleep and airway related problems. Other professionals may may assist in TMJ diagnosis, including physical therapists, chiropractors, and ENT and Sleep doctors.
Common Treatments for TMD
Treatment for TMD will depend on the severity of the condition and the specific symptoms you are experiencing. In some cases, TMD may resolve on its own with self-care measures, such as over-the-counter pain medication and avoiding activities that strain the jaw. In most cases TMD will not resolve on it’s own. It will usually wax and wane and eventually reach a painful breaking point. TMJ is usually caused by long standing structural issues stemming from childhood growth and development, that have now become unstable and symptomatic.
Treatment options for Managing TMD:
- Physical therapy: Exercises and stretches can help to strengthen the muscles around the TMJ and alleviate pain.
- Splints or mouthguards: These devices can help to prevent teeth grinding and clenching, which can reduce strain on the TMJ.
- Medications: Nonsteroidal anti-inflammatory drugs (NSAIDs) or muscle relaxants may be prescribed to help reduce pain and inflammation.
- Surgery: In severe cases, surgery may be necessary to repair or replace the TMJ.
How to Permanently Cure TMJ
Most chronic cases of TMJ are structural issues in the head, neck and back stemming from childhood growth and development. The root cause of the problem is related to airway obstructive conditions from childhood underdevelopment in the mouth, jaws and nasal passageways. Conditions such as a small upper airway, tied tongue, mouth breathing and poor tongue posture need to be corrected to cure chronic TMJ pain.
A combination of orthodontic expanders, myofunctional therapy, breathing exercises and posture correction can permanently cure TMJ in adults. The most popular adult palatal expanders for curing TMJ are the DNA appliance and the Homeoblock device. In rare cases surgery may also be necessary including tongue advancement, UPPP and nasal turbinate reduction and sinus ablation.
How TMJ the Tongue and Airway are Related
The tongue is a muscular organ located in the mouth that is responsible for various functions such as taste, swallowing, and speech. While the tongue is an important part of the body, it can also cause airway obstruction if it is not properly positioned. Tongue related airway problems usually occur during sleep. During deep sleep the tongue relaxes and can fall back into the throat. It is common with people who have small mouths, large tongues and narrow and high palates.
Obstruction of the airway can occur in people of all ages, but it is more common in adults older than 25. It is also more common in people who have certain medical conditions such as mouth breathing, obesity, sleep apnea, or a small jaw.
There are several different types of airway obstruction caused by the tongue, including:
- Tongue-based airway obstruction: This occurs when the tongue falls back into the throat and blocks the airway. This is the most common type of airway obstruction caused by the tongue.
- Tongue-tie: This is a condition in which the tongue is attached too tightly to the bottom of the mouth, making it difficult to move. This can lead to airway obstruction, because the tongue is supposed to rest in the palate.
- Macroglossia: This is a condition in which the tongue is larger than normal, which can cause airway obstruction.
Symptoms of airway obstruction caused by the tongue:
- Teeth Clenching
- Mouth breathing
- Neck and shoulder tension
- Snoring
- Gasping for air during sleep
- Difficulty breathing
- Restless sleep
- Daytime sleepiness
- Bad posture and alignment
Treating Airway Obstructive Conditions Caused by the Tongue
Treatment for airway obstruction caused by the tongue will depend on the severity of the condition and the specific cause. In some cases, self-care measures such as losing weight or sleeping on your side may be sufficient to alleviate the problem. Other treatment options may include:
- Oral appliances: These devices, such as a mandibular advancement splint, and adult palatal expanders can help to keep the tongue in place and prevent it from falling back into the throat.
- Surgery: In some cases, surgery may be necessary to remove excess tissue from the tongue or to repair a tongue-tie.
- Continuous positive airway pressure (CPAP): This treatment involves using a machine to deliver a continuous flow of air to help keep the airway open during sleep.
It is important to address airway obstruction caused by the tongue as soon as possible to avoid complications such as sleep apnea or other respiratory problems. By taking steps to prevent or treat airway obstruction, you can help ensure that you are getting the proper amount of oxygen and maintaining good overall health.
