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Causes Of TMD
Causes Of TMD
In most cases, trauma is the main cause for the TMD. Trauma can be just a simple matter of injury of any kind to the joint. It can be as obvious as blow to the face or as hidden as a low velocity whiplash in a car accident. They can have the same outcome and same treatment plan to follow.
Most Common Causes of TMD
Cervical acceleration/deceleration (whiplash), deployment of the air bag in a car accident, opening or stretching the jaw too much, malocclusion, grinding, some orthodontics, ligament sloppiness, stress, and some systemic diseases are among the most common causes of TMD.
In this type of injury, the soft tissue of the neck, back and TMJ are usually involved. Consider the balance motion of the head going back first and immediately going forward from a relatively still position. This movement will cause the jaw to open and the ligaments holding the jaw in place to be stretched and possibly torn, which adds to the complexity of TMJ issues and problems. In some cases, the disc can become displaced or there may be internal bleeding in the joint or joints.
In the case of a whiplash injury, patients most often suffer from neck pain, and restricted range of motion (ROM) in the jaw. Sometimes TMJ will start producing noise. Ear pain, neck pain and headache are also common symptoms. The victim often discovers that a natural bite has become painful to achieve. Vertigo, dizziness and blurry eyesight, not being able to swallow easily, and getting hoarseness in the voice are other well documented symptoms.
There is no doubt that air bags have and will continue to save lives, but at the same time can cause the TMJ problem following deployment. Symptoms following air bag deployment can include, but are not limited to the following:
Burned chin skin, TMJ problems, limited jaw opening and even malocclusion.
Over Extending the Opening of the Mouth
All the joints in our body have a limited range of motion. If that joint is pushed over its limit for any reason, it will get injured and TMJ is no exception. In the event of over extending the mouth opening either by force (during intubations for Anesthesia or a yawn) or by accident, the joint will get injured and will show some or even all of the symptoms we have discussed.
Unusual grinding of the teeth during sleep is called Bruxism. Since it happens during sleep most patients are not aware of it and if not addressed promptly, it can cause TMJ problems in the long run. It is easy to find out if you are grinding your teeth during sleep at night. Evaluate the level of tenderness of the jaw muscles after you wake up, as well as teeth sensitivity. Watch for worn teeth, damaged jaw ligaments, and of course pain.
Poor alignment of the jaw or poor development of jaws during growth; badly manufactured dentures, partial plates or even fixed bridges which have been applied without any consideration to the TMJ, can contribute to a bad bite and eventually to malocclusion and of course TMD (temporomandibular joint dysfunction).
Some dentists believe that orthodontic treatment can cause jaw joint problems. I think if we do not pay attention to the health of the TMJ and concentrate only on moving the teeth to get them straight, one can contribute to the mal-positioning of the joint or maintain it at the same mal-position as before treatment began and cause TMD.
Some individuals, in particular women who have plenty of relaxon hormones in their system (crucial at the time of giving birth) can appear to be double-jointed and therefore get injured due to the laxity of their ligaments. The TMJ in this individual is no different from the other joints.
The effect of stress on our body includes good and bad outcomes. In response to changes that stress can physically impose upon us, our muscles can go through tightness and pain. If this stress gets to an extreme level it will produce chronic pain. An individual exposed to this harmful atmosphere will show many different results. Now, in the TMJ matter, we can compare the TMJ to the fuel that is waiting for a spark of the stress so it can burn the entire body. As you see, fuel cannot start the mayhem of fire but is always ready to be the source of mayhem. We have to keep in mind that TMD can be the sleeping giant and we have to keep it that way. If this giant is awakened it will take a long time and much effort to put it to sleep.
Disease Can Cause TMJ Problems
Systemic diseases such as Auto-Immune Disorder, Rheumatoid Arthritis, and Lupus can cause TMJ to become inflamed. Viral infections, Mumps, Measles and Mononucleosis also can cause TMD. Other illnesses that cab cause TMD or have the same symptoms as TMD are:
- Trigeminal Neuralgia
- Occipital Neuralgia
- Atypical Trigeminal Neuralgia
- Ernest Syndrome
- Atypical Face Pain
- Neuralgia Inducing Cavitational Osteonecrosis (NICO)
- Temporal Tendonitis
In French it is called Tic Douloureux and is the fifth cranial nerve in disarray and mostly involves the maxillary branch of Trigeminal nerves. It is known by its characteristically sharp and electrical pain which can last for a second. This type of pain is severe and can drive the patient to insanity. Often a simple touch such as a soft kiss or just a refreshing cold drink can be the stimulant that triggers the attack.
This neuralgia has radiating pain characteristically at one or both sides of head, cheek, temporal, front of head and/or above and behind the eyes.
The difference between Typical and Atypical Trigeminal Neuralgia is the continuity of pain in Atypical and the fact that its level increases or decreases during the attack but never leaves the patient with anything less than a dull sensation of pain. This neuralgia is often noticed after a trauma to the face or surgical incision.
The characteristic of this disorder is presented the same as TMJ Dysfunction and involves small thin ligaments that connect the base of the skull to the corner of the mandible (lower jaw). Treatment requires an oral splint and sometimes injecting of a local anesthesia combined with cortisone in the area. Physiotherapy is also used to increase the range of motion.
This pain involves the fifth Cranial nerve, and the Trigeminal Nerve. Stress and history of psychiatric problems have a role in triggering this dysfunction.
Also known as Ratner’s Bone Cavities or Osteocavitational Lesion, this disorder impersonates the pain prototype of Typical and Atypical Trigeminal Neuralgia and has the same referred pain patterns. A trigger point is present and is right above the affected bone. In general we see the involvement of the lower jaw more than the upper jaw.
This is also known as The Migraine Impersonator due to the amount of symptoms being similar to the migraine. The pain is characterized by temporal headache, ear pain and pressure, also TMJ, cheek, neck and even teeth sensitivity. Treatment involves anti-inflammatory medication, muscle relaxant and physiotherapy. In rare situations surgery can help.