TMJ & TMD

The temporo-mandibular joint (TMJ) connects your mandible (jaw bone) to the temporal bone of your skull i.e. your jaw joint. We have two TMJs and they are located in close proximity to each ear. Between your mandible and your skull we have a meniscus (cartilaginous disc) acting as a cushion to prevent bone on bone contact, facilitate joint movement and absorb the forces endured during eating, drinking, yawning etc. Lots of muscles are responsible for producing movement of the TMJs and are activated most of the day during yawning, speaking, feeding and breathing. Thus, the TMJ is one of the most used joints in the body and can be predisposed to injury/disorder. 

‘Temporomandibular disorders’ (TMD) is a collective term embracing a number of clinical problems that involve the muscles of mastication (feeding), the TMJ and associated structures, or both (Jeffrey Okeson, 1996). 

It is estimated that approximately 550,000 people in Ireland suffer from TMD making this condition a significant public health problem. In fact it is the second most common musculoskeletal condition causing pain and disability. 

TMJ: The temporomandibular joints. Healthy occlusion anatomy. Medically accurate 3D illustration of human teeth and dentures concept

Signs & Symptoms of TMD 

TMJ related pain can be varied, diffuse and debilitating. Symptoms can include: 

1. Pain and tenderness on palpation in the muscles of mastication, or of the joint itself. 

2. Pain when chewing, clenching, or yawning 

3. Facial pain or headache that is often worse upon waking 

4. Limited range of movement of the jaw 

5. Jaw clicking, popping, graunching, locking and/or stiffness in the joint 6. Incoordination, asymmetry or deviation of jaw movement 

7. Headache

8. Nonodontogenic Toothache (toothache not originated from pathology of the teeth) 

9. Earache 

10.Sinus pain/facial pressure 

11.Associated neck/shoulder pain and stiffness 

12.Diminished auditory acuity (hearing loss) 

13.Tinnitus (occasionally, note that there are many causes of tinnitus).

14.Dizziness 

15.Change in occlusion (feeling that the teeth do not meet together as they should) 

Causes of TMD 

1. Trauma to the joint e.g. a blow to the face 

2. Stretching of the jaw during period of intubation or prolonged dental work 3. Bruxism (clenching and grinding) 

4. Inadequate occlusion or changes in occlusion due to orthodontic treatment/dental restoration 

5. Arthritic conditions 

6. Generalised Hypermobility 

7. Prolonged poor posture 

8. Whiplash Associated Disorder (WAD) 

9. Sleep anoea 

How we treat 

At Faces Physiotherapy we are passionate about addressing the underlying causes of your symptoms, Through thorough assessment and with a combination of education, advice, manual therapy and self care exercises aim to resolve your pain and prevent its recurrence. Should onward referral be necessary we liaise with GPs, ENTs,

Neurologists, Orofacial Pain Specialists etc in order to facilitate appropriate care for all of our clients. 

Our treatments are tailored to each individual client’s needs and can include but are not limited to: 

● Manual Therapy 

● Intra and Extraoral Myofascial Release 

● Dry Needling and Acupuncture 

● Electrical Stimulation/ Electro-Acupuncture 

● Rehabilitation exercises for TMJ and neck range of motion and stability 

● Posture re-education 

● Self management techniques