Temporomandibular Joint Disorder

What are Common Signs and Symptoms of TMD?

• Pain over the jaw and surrounding muscles
• Pain with chewing, mouth opening or yawning
• Jaw noises (clicking, grinding, crunching)
• Locking (while opening or closing your mouth)
• Headaches in the temple area
• Ear pain, fullness in the ear, ear aches
• Neck/shoulder related pain and stiffness
• Pain with kissing/intimacy
• Clenching/grinding of teeth (overnight or during times of stress)

What Can Cause TMD?

Everyday habits of how you chew, which side of your face contacts the pillow at night, history of dental/orthodontic work can all affect the function of the jaw. Facial trauma such as a blow to the face or athletic injury, concussion, and motor vehicle accidents will impact the TMJ. Acute malocclusion or dental problems will stress the TMJ. Non-traumatic injuries or “micro trauma” include poor prolonged posture and computer use with poor ergonomics (a common culprit). Back, shoulder or jaw strains, and repetitive tasks such as singing or playing musical instruments can all stress the TMJ. Sometimes you are simply having a tasty meal at dinner and you ‘tweak’ a muscle in your jaw as you chew on a piece of steak. Your day to day tasks involving the mouth and jaw can all contribute to TMD related pain

What are Different Kinds of Jaw Problems?

• Muscle related pain (myalgia) includes pain related to muscles of the jaw and/or muscles coming from the neck and shoulder. Pain can come from muscles of the jaw and mouth that are sore/tender, but also referred pain into the jaw can come from muscles at the base from the skull, along the length of the neck, and muscles around the shoulder blade and trunk area. A helpful piece to TMD assessment is determining which muscles are contributing to this pattern of pain
• Joint related pain (arthralgia) is pain or discomfort coming from the jaw joint. This could present with pain on chewing, local tenderness on the joint surface (right in front of the ear hole) and limited range of motion. Along with a pain producing joint, a ‘noisy’ joint/TMJ can be present as well; this can sound like a snap/crackle/pop with any mouth movement, especially far into the range of motion (like yawning or opening wide). Noisy joints can be painful but can be pain free as well.

What to Expect with TMD Physiotherapy?

A TMD assessment will include a thorough testing of jaw motion, muscular and joint examination, jaw movement measurement, and assessing contributing factors coming from the neck and shoulder girdle. Just like how your knee joint can be stiff or your hip flexor muscles can be tight, your jaw joint can be stiff and chewing muscles can be tight too! The important piece to assessment being the determination of what are contributing factors to the overall picture

Sometimes assessments can feel overwhelming with finding multiple things to address: muscle, joint, nerve, coordination. This being said, the more there is to address the more room for improvement there is! A weak muscle can get stronger, a stiff joint can loosen up – always room for a step by step change toward the better. Treatment techniques can include: joint mobilizations and stretches to help increase mobility; intra-oral massage to help release tight muscles that are tricky to approach from the outside; and dry needling or acupuncture are both effective ways to manage jaw muscle trigger points and reduce pain.

Jaw related pain can affect your everyday joys: eating, laughing, and smiling. Getting the right care to address the problems specific to your body is paramount. Physiotherapists are well-trained in the assessment, diagnosis, management and treatment of TMJ disorders. Oftentimes a progress report or letter can be sent over to your dentist, orthodontist, oral medicine specialist, or oral surgeon to make sure everyone in your circle of care is aware of the physiotherapy plan.

Not sure if TMD Rehabilitation can help you?

You can book a free 10-minute phone consultation with Patrick Quimio, Physiotherapist, who is dedicated to improving the quality of life for those living with TMJ Dysfunction. Please give us a call at 416-486-4776 or book a 10 min Ask a Physio Complementary Q&A appointment online.