Temporo Mandibular Joint Dysfunction (TMD)

Also known as jaw-joint problems, TMD consists of:

Overview

Extra-capsular problems are caused by biting interferences due to malaligned teeth, poor restorations (fillings, crowns or dentures), or due to clenching or grinding of the teeth. This leads to excessive contraction of the closing muscles, which results in headaches and jaw aches.

Treatment is aimed at removing the biting interferences and reducing the closing muscles from excessive contractions.

Intra-capsular problems are caused by the dislocation on the disc within the joint between the head (temporal bones) and the lower jaw (mandible). The disc is no longer sitting within the joint but at the front of the joint, which results in the clicking of the jaw, potential crepitus (bone rubbing on bone), with restricted mouth opening and limited range of motion.

Left untreated, the lower jaw is pushed back and upwards, compressing the nerve and blood vessels which puts a strain on the muscles and other joints. It can lead to headaches, pain in the neck and shoulder, facial asymmetry, numbness in arms and hands, postural issues and uneven shoulders.

Treatment is aimed at decompression of the nerve and blood vessels and to restore the joint to a more physiological position. The aim is to bring the lower jaw downwards and forwards to eliminate the clicking by recapturing the dislocated disc. This will greatly reduce the symptoms of TMD.

When the head is shifted off the centre of the top of the neck, the rest of the body will compensate for the shift of weight. The spine and pelvis will twist, causing one shoulder to drop down, one hip to be pulled up, bringing the leg with it to create body imbalance. The stress and tension on the muscles can cause pain anywhere in the body. This is demonstrated in the diagrams below.

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