119 E. Passaic St Maywood, NJ 07607

TMJ/OROFACIAL PAIN

INTRODUCTION

TMJ pain also known as (TMD) temporomandibular joint disorder is a very complex area- when it is affected individuals may suffer from pain, tightness, weakness and headaches from the functionality of the TMJ joint. The joint coordinates the function of chewing, swallowing, and the stabilization of the cervical spine and shoulder girdle. TMJ pain affects patients in various ways- not being able to chew without pain, cracking or an audible noise when opening/closing the mouth, headaches, migraines, and muscle aggravation throughout the neck, face, and shoulder region.

ANATOMY/FUNCTION

The TMJ joint connects the mandible to the skull. The TMJ joint is composed of very important ligaments and muscles.

MUSCLES:

  • Opening – inferior head of lateral pterygoid, anterior digastric, mylohyoid.
  • Closing – masseter, anterior and middle temporalis, medial pterygoid, superior head lateral pterygoid.
  • Protrusion – bilateral contraction of the lateral pterygoid.
  • Retrusion – middle and posterior temporalis, posterior portion of masseter.
  • Laterotrusion – ipsilateral middle and posterior temporalis, contralateral inferior head lateral pterygoid.

LIGAMENTS:

  • Temporomandibular ligament
  • Stylomandibular ligament
  • Oto-mandibular ligaments
  • Discomalleolar ligament
  • Anterior malleolar ligament

The muscles are responsible for mastification (chewing)- these muscles are one of the strongest muscles in the human body. The load transfer through the TMJ joint exceeds 200lbs when opening and closing the mouth. The TMJ also plays a very important role in balance.

SYMPTONS/CAUSES

TMJ pain is dependent on the area and structures that have been irritated and influenced causing the brain to fire nociception to specific areas of your joint. TMJ pain has been often mistaken to be a tooth issue- where the patient will go to a dentist for relief. The teeth or structural abnormalities of your bite are rarely responsible for TMJ pain. Most research shows stress and tension as a causative factor of the disorder. Symptoms of TMJ pain include but are not limited to:

  • Fatigue in the face
  • Difficulty chewing
  • Pain or discomfort biting
  • Toothaches
  • Headaches
  • Dizziness
  • Earaches
  • Shoulder pain
  • Ringing in the ears
  • Pain, tightness, and tenderness in the jaw, neck of face
  • Clicking, popping or grinding sounds when opening or closing the mouth

DIAGNOSIS

At MPT&Rehab the doctor will begin with a comprehensive examination- which will address the onset, cause, duration, severity, vectors that cause the TMJ pain. TMJ pain rarely if ever requires any radiological referral.

TREATMENT

At MPT&Rehab we have extensive experience treating TMJ pain. Based on a functional evaluation we create an individual treatment plan. TMJ is a muscular joint and muscular dysfunction within the joint causing misalignment. We will treat the TMJ pain both outside the face and intraorally to release specific muscles. TMJ pain has a deep connection with neck muscles and overuse of muscles causing referral pain and headaches- which will all be determined and treated accordingly. Also besides releasing superficial neck muscles the doctors and physical therapists will treat the deep cervical fascia. Through proper joint training the TMJ joint will regain proper balance. The rehabilitation program will be aimed at eliminating pain, increasing range of motion and increasing stability within whole joint.