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TMD-Temporomandibular Disorders


A disorder of the jaw that is many times incorrectly labeled as TMJ – Temporomandibular Joint – is TMD – Temporomandibular Disorders.  TMD occur as a result of problems with the jaw, the jaw joint and the surrounding facial muscles that control chewing and moving the jaw. TMJ is the hinge joint that connects the mandible – the lower jaw – to the temporal bone of the skull.

Those with TMD suffer from severe pain and discomfort that can last for a very short time or can last for many years.  This disorder is most commonly experienced by women between the ages of twenty and forty.

Although the cause of TMD is not clear, most dental professionals believe that injury to the jaw or muscles of the head and neck are the main cause of TMD.  This type of injury is usually caused by whiplash or from a heavy blow to the face, head or neck area. Other causes of TMD could be the grinding or clenching of teeth, the presence of arthritis in the TMJ, stress, which causes a person to tighten muscles in the jaw or/face or clench  teeth, and the dislocation of the soft cushion or disc between the ball and socket of the TMJ.

Those suffering from TMD usually feel pain or tenderness in the jaw joint area, face, neck and shoulders, and around the ear when they chew, speak or or open their mouth wide.  A popping, grating or clicking sound may also be heard in the jaw joint when opening or closing the mouth or when chewing, too.  Those suffering from TMD may have difficulty chewing or opening their mouth wide,  may suffer from swelling on the sides of the their face, may have toothaches, head and neck aches, upper shoulder pain, ringing in their ears, earaches and suffer from dizziness, as well.

Many of the symptoms of TMD could also be a sign of other conditions.  To determine if a patient has TMD, a dentist will conduct a thorough examination which includes a physical examine as well as going over the patient’s medical history.

In the physical examination, the dentist will thoroughly examine the TMJ by checking for tenderness or pain, listening while the jaw moves for any abnormal sounds, such as clicking, grinding or popping, and also check the patient’s bite and facial muscle function, as well.

Full face – panoramic X-rays – may be taken, and, at times, MRI or CT scans may be needed, as well.  These types of imaging tests assist the dentist in determining if the TMJ disc is in proper position and lets him view the bony detail of the joint, too.

Treatments for TMD range from at home practices to injections and surgery.  According to the majority of dental experts, treatment for TMD should begin with conservative nonsurgical therapies.

Conservative therapies include the following: the application of moist or cold packs; eating soft food; medications to relieve muscle pain and swelling; low-level laser therapy; wearing a splint or night guard to prevent tooth grinding or clenching; corrective dental treatments, such as replacing missing teeth or correcting a bite problem; avoiding extreme jaw movement; and finally learning relaxation techniques.

When these conservative treatments are unsuccessful in relieving the symptoms of TMD, more aggressive treatment may be suggested by your dental professional.  These more aggressive treatments for TMD include the following: TENS – transcutaneous electrical nerve stimulation; ultrasound treatment that provides deep heat to the TMJ; trigger-point injections of pain medications into tender facial muscles; radio wave therapy which increases blood flow to the joint; and as a last result, surgery. 

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Dr. Mark Gasbara
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    Mark J. Gasbara D.D.S.

    1215 Annapolis Road, Suite 208, Odenton, MD 21113
    Phone: (410) 551-4600
    Fax: 410-674-5551

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