By Larry Pribyl, DDS
Any condition that places excessive stress on the TM joint, or the muscles that work the jaw joint, can predispose a person to TMJ disorder (TMD). In many cases, trauma can initiate TMD. Not all trauma—even severe trauma to the jaw joint—will result in TMD. Much depends on the person’s capacity to heal.
Factors that Contribute to TMD
Factors that deal with the alignment and contribute to TMD include:
• Traumatic injuries to the jaw, head or neck, including blows and whiplash like a blow to the chin can cause damage to the joint or ligaments that hold the joint in place. A whiplash injury causes the head to jerk back while the jaw is thrust forward. The neck and cervical muscles can become strained or sprained. This sudden thrust can even tear or strain the ligament and disc of the jaw joint.
• Malocclusion occurs when the teeth do not fit together well or when the position of the teeth is not in harmony with the TM joint.
• Jaw abnormalities: if the jaw is not able to develop normally due to genetic or bad habits like thumb sucking, grinding teeth, tongue thrusting, mouth breathing, etc., it can place stress on the TM joint and the entire chewing mechanism.
• Orthodontics can be a detriment to the patient unless the orthodontist emphasizes jaw treatment and understands the significance of placing the jaw in the “correct” position first, and later moving the teeth into position to support the jaw. Many past orthodontic patients have future TMD problems. If the teeth are beautifully aligned, but not in harmony with the jaw joint, the patient may have severe problems later on—most likely with pain.
Habits to Relearn or Control
Destructive oral habits can adversely impact proper growth and development and put strain on the jaw joint, muscles and head and neck structures. The child or adult is often unaware of these habits. This list of habits should be relearned or controlled when treating TMD:
• Grinding, clenching or nighttime bruxing (grinding)
• Tongue thrusting when swallowing which impacts teeth eruption.
• In children, other destructive habits are thumb sucking and pacifier use, which may impact the eruption of teeth, jaw formation, and place posterior strain on the developing TM joint. In adults, pencil biting and pipe smoking can be problems. For adolescents, the familiar habits of propping the head on the hands while studying or watching T.V. on the floor are common triggers for TMD.
Muscles Spasms and TMD
Muscle spasms in the head and neck can result in muscle tension headaches. Although spastic muscles can be a primary cause of TMD, often they are actually a secondary problem reacting to a structural, postural, or joint dysfunction. Muscles can become trapped in a cycle of spasms producing pain, muscle tenderness and possible tissue damage. Referred pain from trigger points is a phenomenon that is quite common in the head and neck regions, becoming worse the longer the problem exists. Muscles always function in groups which form a complete interrelationship. When one muscle or group goes into spasm, the associated muscles are often affected.
A Customized Treatment Approach
Other contributory factors include nutrition, toxicity, hormonal imbalances and stress. Our office works together with other health care professionals to identify contributing factors causing your TMD. A treatment approach that can eliminate or manage symptoms can then be more successfully developed. Call our office at (816) 795-1000.