Temporomandibular Dysfunction (TMD)

What is TMD?

Temporomandibular Dysfunction (TMD) is a general term that encompasses disorders that affect the jaw joint / tempomandibular joint (TMJ). The TMJ joins the jaw bone (mandible) to the temporal bones of the skull on each side of the head. If you place your fingers in front of your ears and open your mouth, you can feel the joints.

 

TMD

 

A combination of a hinge and sliding motion makes this joint unique and complex. When you open your mouth, the rounded ends of the lower jaw, called condyles, glide forward on the joint socket of the temporal bone. To keep this motion smooth and to act as a “shock” absorber, a soft disc lies in the joint. Muscles attached to and surrounding the jaw joint control its position and movement. Because these joints are flexible, the jaw can move up and down and side to side. act as a “shock” absorber, a soft disc lies in the joint. Muscles attached to and surrounding the jaw joint control its position and movement. Because these joints are flexible, the jaw can move up and down and side to side. Normal function of the TMJ involves talking, eating and yawning. Disorders at this joint affects approximately 33% of the population and can have significant impact on the quality of life. Due to the complexity of the TMJ, a collaborative approach between your Dentist and Physiotherapist can provide the most successful outcome. Physiotherapists are ideally positioned to treat TMD because of their knowledge of muscles and joints combined with hands on skills to treat dysfunction.

Why Does TMD Occur?

Adding to the complexity of TMD, there can be a number of factors contributing to the cause. Non-traumatic reasons can be classified as an overuse syndrome that may be related to “wear and tear” of the joint or to the muscles and relate to repetitive chewing, grinding and clenching. A history of an injury either directly to the jaw or even from a motor vehicle accident can cause dysfunction. Emotional stress causing clenching and increased sensitivity to pain may also play a role, as can postural disorders.

References

  • Wright EF, North SL. Management and treatment of temporomandibular disorders: A clinical perspective. The Journal of Manual & Manipulative Therapy year; 17(4):247-254.
  • Armijo-Olivo S, Pitance L, Singh V, Neto F, Thie N, Michelotti A. Effectiveness of manual therapy and therapeutic exercise for temporomandibular disorders: Systematic review and meta-analysis.
  • Physical Therapy 2016; 96(1):9-25.
  • McNeely ML, Armijo Olivo S, Magee DJ. A systematic review of the effectiveness of physical therapy interventions for temporomandibular disorders.
  • Phys Ther. 2006;86:710–25.