Temporomandibular Disorder

Millions of Americans suffer from chronic facial and neck pain as well as recurrent headaches. In some cases this pain is due to Temporomandibular Disorder, or TMD. In today's modern lifestyle, stress often presents itself as chronic myofacial fatigue and jaw pain. The Temporomandibular joint and supporting ligaments often are placed under great stress and fatigue in our modern and very demanding lifestyle. The fact is TMD has become quite common.

Your temporomandibular joints, or jaw joints, connect your lower jawbone to your skull. As you may imagine, these joints get quite a lot of use throughout the day as you speak, chew, swallow, and yawn. Pain in and around these joints can be unpleasant and may even restrict movement.

Symptoms of TMD include:

• Pain in the jaw area
• Pain, ringing, or stuffiness in the ears
• Frequent headaches or neck aches
• Clicking or popping sound when the jaw moves
• Swelling on the sides of the face
• Muscle spasms in the jaw area
• A change in the alignment of top and bottom teeth
• Locked jaw or limited opening of the mouth

Should you notice any of these symptoms, let us know! We can help advise you as to whether they indicate the presence of TMD, and what sort of treatment is appropriate for you.

Our approach to TMD is primarily non-pharmacological. We start with a thorough screening process. Identify the severity of the symptoms, and begin treatment with the least invasive techniques.

Our TMD exam is as follows:

• Specialized health history form for addressing TMD symptoms
• Physical exam of the jaw joint, supporting ligaments and surrounding muscles. This is performed by manual palpation.
• Pan radiograph to exam the condition of the chondyle, disc and eminence. This depicts the current condition of the bone and cartilage structures of the TMJ.
• Acoustic exam of the TMJ. Clicking and popping also referred as crepitous are listened for.
• Oral exam of patient's natural bite and tooth wear. Many times wear on teeth can be quite severe.

We treat TMD if diagnosed with the least invasive technique possible. Each patient is unique and requires a tailored treatment. Examples of our more common treatment options follow:

• Behavior modification. Eliminating habits that exacerbate the problem.
• Night guard to reduce TMJ fatigue over night.
• Mandibular Repositioning Devices. This can help release pressure on the TMJ disc and associated ligaments.
• Manual muscle stretching and relaxation. This can sometimes require physical therapy and chiropractic services.
• Adjustment of bite.

In some rare cases, the jaw pain is multifactorial and will require specialized treatment outside the scope of Doctor Ali' practice. Dr. Ali uses several practitioners in the Bay Area that utilize additional modalities such as medications to modify the pain response. Additionally, sometimes TMD is part of a larger health issue that requires a multidisciplinary approach that must include your medical doctor.

There are some simple things you can do at home or work to prevent TMD from occurring in your jaw joints:

Ask us what may be used to help reduce sensitivity. Some of the most common treatments are:

• Relax your face - remember the rule: "Lips together, teeth apart"
• Avoid grinding your teeth
• Avoid constant gum chewing
• Don't cradle the phone receiver between your head and shoulder - either use a headset or hold the receiver to your ear
• Chew food evenly on both sides of your mouth
• Do not sit with your chin rested on your hand
• Practice good posture - keep your head up, back straight, and shoulders squared