This condition is also sometimes called Temporomandibular Joint and Muscle Disorder (TMJMD) or may be erroneously referred to as TMJ.
TMD is a common condition although the exact prevalence in the community is not known. It is estimated that TMD may affect up to 25% of the population.
This disorder involves the jaw joints (temporomandibular joints - TMJ) the muscles of mastication (those muscles used for chewing), as well as other muscles and soft tissues of the head and neck. Symptoms are felt or referred around the jaw joints and diffusely around the head and neck.
TMD is clinically challenging and it is unusual because of the very wide range of signs and symptoms associated with the disorder. Patients may present, for example, with temporal headache as the primary symptom, or inability to chew without pain, or clicking or grinding in the jaw joints, or waking in the morning with jaw or facial pain, or with dizziness. These are just a few of the many symptoms associated with TMD.
A partial list of the signs and symptoms of TMD includes:
What this means is that patients with TMD may experience one or any number of these signs and symptoms and because of the diverse nature of these symptoms, will consult an equally diverse range of health care professionals in order to try to address the problem.
Patients will consult their GP, dentist, orthodontist, neurologist, osteopath, physiotherapist, chiropractor, pain specialist, maxillofacial surgeon, rheumatologist, orthopaedic surgeon, acupuncturist, psychologist, psychiatrist, audiologist, ENT specialist and others.
This makes it very confusing for the TMD sufferer because practitioners tend to view problems through the lens of their own specialty. This means that the patient gets a huge range of opinion about the cause of the problem and the best way to manage it.
For many people with TMD the cause is unknown. There are however some identifiable causes of TMD. These include:
While there are many interventions that have been shown to be helpful in TMD treatment, there is unfortunately no single evidence-based strategy that has been shown to be effective in the management of TMD. Much of the reason for this is that the factors that contribute to the disorder are generally different for each person.
Each TMD sufferer is unique.
This is the assumption I start with in the treatment and management of TMD. Each patient is assessed to determine firstly if their symptoms are associated with TMD, and if so, what factors can be addressed to manage the problem.
I use a range of clinical interventions to treat TMD. These include:
Effective management of the complex problem of TMD often involves collaboration between a number of different health care professionals. Referral for investigations, or for the opinions, expertise or treatment interventions of other health care providers may be necessary.