Integrative Health Blog

Understanding TMJ to Optimize Treatment

Posted by Robert Johnson on Wed, Feb 11, 2015


Do you suffer from problems with your jaw or have pain when you chew or yawn?

Do you hear a clicking or popping sound when you open or close your mouth?

Do you grind or clench your teeth?

People generally do not understand what TMJ Temporo Mandibular Dysfunction is about other than they have pain or poor jaw movement. The cause of TMJ may be difficult to determine. TMJ is comprised of 2 components: Temporo Mandibular Dysfunction (TMD) and Myofascial Pain (MFP).

The concept of TMJ should be understood because the two different components of TMJ must be treated differently.

TMD, Temporo Mandibular Dysfunction, occurs when the jaw joint  (left, right or both) is not functioning well.   The second component, MFP, Myofascial Pain,  exists when the muscles of the jaw are painful or not functioning correctly.

                      TMJ =  TMD  +  MFP

The two components may exist together or exist separately.

It is important to understand how the jaw functions normally to conceptualize how to treat Temporo Mandibular Dysfunction.                    

In a healthy TMJ the lower jaw (mandibular) moves within the bone of the head (temporal bone) to open and close.  The muscles of the jaw provide the force for the mandible to move within the temporal bone.

Between the bones of the mandible and the temporal is a soft tissue disc or “pillow” called the meniscus.   This meniscus should always be situated between the mandible and temporal bones to facilitate movement and reduce wear and tear of the bones.

If there is trauma to the jaw (this includes whiplash) the disc can be expelled from its position between the two bones.  When the disc is displaced it will result in restricted jaw movement  (decreased range of motion-ROM) and / or clicking or grinding in the jaw joint.

The goal of TMD treatment is to bring the disc back to a position between the mandible and the temporal bone.  This includes reducing the inflammation, relaxing the jaw muscles, repairing all the tissues within the TMJ and normalizing the occlusion (bite) of the teeth.

The treatment for MFP (can exist with or without TMD) is to decrease inflammation within the muscles, align the jaws for balanced muscle function and remove any stimulus that results in clenching or grinding of the jaws.   This may include stress, nutrient imbalances or an improper bite.

Treatment of TMD may include:

  • TMJ / customized bite appliance
  • Manual Therapy
  • Trigger point injections
  • Orthodontics
  • Prolotherapy (tightens ligaments in the jaw)
  • Occasionally surgery

Treatment of MFP may include:

  • Customized bite appliance
  • Bite adjustment
  • Osteopathic (cranial) treatment
  • Manual Therapy
  • Trigger Point Injections
  • Nutrition and detoxification therapies

If you have questions please contact National Integrated Health Associates Holistic Family Dental 202-237-7000, ext 2, for a thorough TMJ evaluation.

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Topics: neck pain, pain, holistic dentistry, TMJ, jaw pain