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an article by
Valentina Tkachenko
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Temporomandibular Disorders
Temporomandibular disorders (TMD) are issues with the jaw, jaw joint, and supporting facial muscles. The temporomandibular joint (TMJ), which connects the mandible (lower jaw) to the temporal bone of the skull located directly in front of the ear on both sides of the head, allows individuals to chew, speak, and yawn properly. TMD arises when the TMJ or surrounding muscles are compromised by injury (such as from a heavy blow or whiplash), bruxism, dislocation of the disc protecting the ball-and-socket joint, osteoarthritis or rheumatoid arthritis in the TMJ, or stress which causes teeth clenching or contraction of facial muscles.

Symptoms of TMD include pain or tenderness in the face, jaw joint area, neck and shoulders, and in or around the ear when chewing, speaking, or opening the mouth wide, limited ability to open the mouth very wide, jaws that get "stuck" or "lock" in the open- or closed-mouth position, clicking, popping, or grating sounds in the jaw joint when opening or closing the mouth (which may or may not be accompanied by pain), facial fatigue, difficulty chewing or a sudden uncomfortable bite, swelling on the side of the face, toothaches, headaches, neck-aches, dizziness, earaches, and hearing problems. Professional opinion must be sought concerning the diagnosis because several other oral health issues such as gum disease, and sinus problems have similar symptoms. X-rays, MRI’s, and CT scans may be needed in order to diagnose the problem.

Treatments range from applying ice packs and warm compresses to surgery, and usually the simplest methods are recommended first. A dentist can show a TMD sufferer special stretches for the jaw, or prescribe medications such as muscle relaxants or low doses of anti-anxiety treatments, give Botox injections, or design a splint or night guard which prevents teeth from touching and optimally repositions the jaw. Eating soft foods is recommended, as is cutting food into small pieces in order to minimize chewing time. Hard, crunchy, and chewy foods should be avoided as they cause undue stress on the TMJ and surrounding structures. Yawning, chewing (especially of gum, ice, and non-food items) should be kept to a minimum, and resting the chin on the hand is not advised as it compresses the jaw. Keeping teeth slightly apart can help relax the muscles and relieve pressure. Relaxation techniques, physical therapy, massage, and stress reduction therapy can all help ease tension in the jaw and keep TMD from worsening.

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