TMJCHICAGO.COM

A WEBSITE ABOUT HEADACHES,
"TMJ" AND FACIAL PAIN

ALLEN J. MOSES, DDS

TMJ / HEADACHES / FACIAL PAIN

"TMD" stands for "temporomandibular disorder" and refers to problems related to pain and improper functioning of:

• The jaw joints (which are among the most complex joints in the human body)

• Muscles surrounding the jaw joints; and/or

• Associated structures in the head, neck and face (including but not limited to the teeth)

TMD is a medical problem, referred to by many as "TMJ," which correctly used is just an abbreviation for "temporomandibular joint." TMD is often a chronic and frequently degenerative disease. It can arise due to problems with one's bite, muscle strain or imbalances, or damage to tissues in the head, neck and facial area, but it often has widespread consequences over the rest of the body. Displacement of the disk in the TMJ can also cause TMD.

TMD is often called "the great imposter" because its signs and symptoms can mimic dozens of other disorders. Women of child-bearing age are most often affected, but men and children can suffer from TMJ-related pain too.
Chronic recurrent headaches are common in millions of people as is chronic jaw pain, facial pain, neck aches, ear aches and shoulder pain/stiffness. These are the major presenting symptoms of TMD, and are frequently misdiagnosed for some condition other than Temporomandibular Disorder.

TMD can have a single cause or many causes. In addition, TMD can often coexist with other potentially related disorders.

Frequent ear symptoms, including aching with occasional stabbing ear pain, ear congestion, as well as, occasional vertigo (dizziness) and tinnitus (ringing in the ears) are also associated with this dysfunction. TMD sufferers may also experience jaw-joint sounds, including popping and clicking or grinding sounds emanating from the area immediately in front of their ear(s). Stiffness, catching or locking of the lower jaw (mandible) may also be a sign of TMJ problems. A frequent shifting of the bite (occlusion) may indicate a jaw-hinge problem. Too often patients with TMD are told this problem is based solely on psychological stress or that their problem is "in their head"; and that they may have to simply "live with it". It is now known that many of these signs and symptoms arise from an active Temporomandibular Disorder or TMD.

Treatment of TMD involves the use of an oral device fitted over the lower teeth. This oral device is integrally involved in such functions as respiration, speech balance, posture, mastication and swallowing. In addition to skeletal structures, all the nerves and muscles above the shoulders are involved in these essential functions. Improper jaw relationship can mean impairment in function that produces physiological stress on the whole body. Long-term sufferers of dysfunction of the temporomandibular joint go on to develop anxiety neurosis and depression.

Dr John J. Bonica, author of the classic text, "Management of Pain" stated that, "hundreds of thousands of suffering patients are not getting the relief they deserve. Others are subjected to a very high risk of accidental complications from improper therapy - like narcotic addiction, multiple, often useless, at times mutilating operations. Some of course give up medical care and go to quacks and waste a lot of money, and some even commit suicide." With more than $1.2 billion spent on prescription pain relievers and 700 million man-days of work lost each year, the consequences of failing to accurately diagnose and treat TMD are very significant for patients.
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