Temporomandibular dysfunction (TMD) or disorder of the temporomandibular joint (TMJ) are common terms for Craniomandibular Dysfunction, a collection of symptoms which result when the chewing muscles and jaw joints do not work together correctly.  Many chronic suffers are misdiagnosed with neuritis, neuralgia, stress, or tension headache, even labeled as neurotics or hypochondriacs!  The simple fact is that your teeth must come together in a bite that supports a healthy normal jaw joint relationship with the joint discs in place between the condyles of the jaw and the fossae of the skull in order that the muscles of the jaw, head and neck work properly.

How do you know if you have TMD?  It's not always obvious!  TMD can generate referred pain, manifesting in areas other than the jaw but still intricately related to an unstable bite.  Do you suffer from migraines or headaches, pain behind the eyes, earaches, ringing or buzzing in the ears, loss of hearing, dizziness, clicking, locking of your jaw, grinding, clenching, unusual wearing or cracking of your teeth, jaw soreness upon awakening, difficulty swallowing, facial pain, neck pain, shoulder pain, or numbness/tingling in the fingers?  You may have a compromised bite!

Maybe you've tolerated symptoms for years. Your malocclusion (bad bite) might be inherited – crowded or overlapped teeth, poorly aligned teeth, extra or missing teeth, irregularities of jaws or face – or it might have resulted from habits like thumb/finger sucking, mouth breathing and poor tongue functioning.  Your bad bite may be the consequence of a single missing tooth, an improper restoration, or ground down or broken back teeth.  The onset of symptoms may have been sudden and intense, as in after an accident, whiplash, or a blow to the face.  Regardless of cause, jaw joint disorders tend to worsen over time if left untreated.

How is TMD treated in our office?  Your initial appointment will be a visual temporomandibular joint dysfunction examination and consultation.  This appointment will take about 45 minutes to one hour and at the completion of this initial visit a tentative diagnosis will be established.  You will find the doctor to be conscientious and thorough in his examination.  You will have an opportunity to have your questions and concerns answered and proposed treatment and costs will be discussed with you at this time.

If you wish to proceed, the second appointment will involve diagnostic records and consultation, confirming the initial examination and diagnosis. The records appointment involves panoramic and transcranial digital radiography and digital photographs to document where you are before treatment begins.   If appropriate, and you wish to proceed with treatment, impressions will be taken to have an orthotic appliance constructed and programmed by the doctor as a first step toward symptom relief and jaw joint disc recapture.  This will help your jaw joints to realign and then the muscles to relax. 

Treatment length will vary from individual to individual and severity of the case but on average you will return to our office on a monthly basis for 6 - 12 months.  Each month adjustments will be made to the splint in order to realign the jaw joint into a normal relationship with the discs interposed between the condyles of the mandible and the fossae of the skull.   Some conditions will benefit most from multidisciplinary treatment, and in those cases the doctor will work closely with a craniosacral massage therapist, chiropractor, physical therapist or other practioners to help in your healing.

During the initial treatment phase, the lower jaw is repositioned, thus creating a space between the back teeth when the splint is not in place.  Phase II treatment will be necessary following the splint phase, with the purpose of aligning the teeth to support the jaw in its new and comfortable position. Phase II treatment may include – orthodontics, crown and bridge, restorations, new complete or partial dentures, implants or a combination - to reposition your teeth to maintain the newly created and healthy jaw joint relationship established with the Phase l splint. 

As your joints begin to heal and your initial symptoms improve, the Phase II treatment plan will be determined by the doctor and discussed with you at that time with regards to an estimated cost and time line.  If any questions or concerns arise during treatment, please do not hesitate to contact our office.  Ultimately you deserve to live free from chronic pain!

For more information on CMD, visit the website of the American Academy of Craniofacial Pain at www.aacraniofacialpain.org