Hi dunwoody-ga! Thank you for your excellent question. There is a
wealth of information, especially as of late, related to TMJ
dysfunction. The available treatment options are varied as well, so
there are a lot of possibilities for you.
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The Anatomy of the TMJ
(http://www.rad.washington.edu/anatomy/modules/TMJ/TMJAnatomy.html)
There is an excellent site developed by Washington University’s
Radiology Department, complete with schematic drawings and
radiographic images. It gives a very good pictorial description of the
temperomandibular joint (TMJ) along with drawings. I will give you a
brief summary here but refer you to the drawings at the above site.
The TMJ is composed of the single mandible (jawbone) and the paired
temporal bones, two of the bones composing the cranium, or skull. The
uppermost portion of the mandible is called the condyle, and there is
one on either side of the mandible. These condyles articulate (fancy
anatomical term meaning “comes together at a joint”) with the temporal
bones themselves. Within these joints are two menisci (singular is
meniscus) or pieces of cartilage that serve as shock absorbers and
also a means of protecting the condyles and temporal bones from
friction associated with motion. The TMJ exhibits two types of motion:
rotation and translation. Rotation occurs when the jaw rocks downward
as the mouth opens. Translation occurs after rotation and as the
condyle and menisci slide forward underneath the temporal bones,
allowing greater opening of the mouth.
There are four pairs of muscles that serve to keep the jaw closed, and
gravity is the major force that opens the jaw. The temporalis and
masseter muscles are large muscles that extend from the side of the
skull to the condyles of the mandible and are the main muscles
involved in clenching the jaw. The lateral pterygoids are small
muscles that assist in opening the jaw and also producing
“side-to-side” motion. The medial pterygoids work to close the jaw,
and assist the lateral pterygoids with “side-to-side” motion.
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Dysfunction of the TMJ
(http://www.tmj-pain.com/tmj.htm)
There are a number of lists that describe various causes of TMJ
dysfunction and the above link nicely summarizes the major causes.
Dysfunction can occur as an isolated event or as part of a more
complex problem. The major causes include:
--Trauma
--Malocclusion (i.e., improper bite)
--Stress, or other psychosocial problems
--Nervous habits
--Teeth clenching
--Neuromuscular imbalances
--Inflammation of the joint
--Rheumatoid arthritis
--Osteoarthritis (degenerative arthritis)
It requires a physician with some experience with and training in
diagnosing TJM dysfunction to differentiate some of these causes. Any
one or combination of causes can be present in individual patients and
treatment success is dependent upon proper identification of each
patient’s cause of dysfunction.
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Treatment Options for TMJ Dysfunction
There are so many clinics, physicians, dentists, massage therapists,
orthodontists, etc., etc., etc., offering different treatment options
that I decided to go to a subscription-based website to find a
synthesis of information. I use www.uptodate.com, a site used
primarily by physicians and other medical personnel to find succinct
descriptions and treatment options. In their entry regarding TMJ
Dysfunction they list the following treatment options:
--Exclude infections and inflammatory diseases (i.e., Rheumatoid
Arthritis, etc.)
--Recognize aggravating factors (e.g., spasm, jaw muscle fatigue,
dental malocclusion, anxiety, stress) and treat as appropriate
--Dental care if needed
--Jaw exercises
--Muscle relaxants or sedatives at bedtime
--Local anesthetic-corticosteroid joint injections for persistent
symptoms
--Osteopathic manipulative treatment
--Physical therapy with a PT experienced in TMJ disorders
There are plenty of other treatment available, both traditional and
“alternative” in nature. Be sure to seek out the advise of your
primary care physician or other health care provider that you trust,
and ask for appropriate referrals to those who have experience
treating TMJ dysfunction.
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Resources in Atlanta
(http://yp.yahoo.com/py/ypMap.py?Pyt=Typ&tuid=B:AT751164&ck=3644510248&tab=B2C&city=Atlanta&state=GA&country=us&msa=0520&cs=4&ed=9oCgOK1o2Tw_CAxCSzKUEKQF190L8GwsJIsnvsdHPDZe&stat=:pos:0:regular:regT:1:fbT:0)
In order to find resources for you in the Atlanta area I used the
Yahoo Yellow Pages (I know, I could get fired for this!) and looked up
“tmj.” It returned a listing for the Atlanta Center For Cranio-Facial
Pain And TMJ Disorders. Their address and phone number are:
1961 N Druid Hills Rd NE
Atlanta, GA 30329
Phone: (404) 634-1278
I’m sure that they would have any information regarding support groups
in the area and might be a good starting point in obtaining further
evaluation.
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Again, thank you for your excellent question. If you have need of any
further information please let me know.
Boquinha-ga
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Google Search Terms
TMJ + pathophysiology
(://www.google.com/search?sourceid=navclient&ie=UTF-8&oe=UTF-8&q=tmj+pathophysiology)
TMJ + anatomy (://www.google.com/search?sourceid=navclient&ie=UTF-8&oe=UTF-8&q=tmj+anatomy)
TMJ treatment options
(://www.google.com/search?sourceid=navclient&ie=UTF-8&oe=UTF-8&q=tmj+treatment+options) |
