What is Temporomandibular Joint/Muscle Dysfunction (TMJ)?

Temporomandibular joint syndrome (TMJ), temporomandibular disorders (TMD) and craniomandibular disorders (CMD) are some of the more modern terms currently used to identify this myriad of illness's. TMD, as it is most often referred to, is a complex, multifaceted disorder of the jaw joint, in which there is derangement of the internal workings of the jaw joint and potential affiliated masticatory muscle pain and dysfunction. Patients may experience only the internal derangement, only the muscle pain and dysfunction, or both simultaneously.

How common is TMD, who gets it and how? In a pamphlet written by the National Institute of Dental Research (NIDR), studies are cited showing a range of 10 to 77 percent of the population suffering some form of TMD. Literature yields figures of 20 to 60 million Americans having TMD. These ranges are unscientifically broad, and NIDR admits that the "Discrepancies in these test results are owing, in large measure, to dental science's lack of a single definition to characterize the problem."

Women account for 80 to 90 percent of TMD patients and they generally range in age from 20 to 40 years. However, fellow professionals tell Dr. Thomas that recently they are seeing an increasing number of teenage female TMD patients. The women in these study's represent all socioeconomic levels.

The approximately 10 to 20 percent of patients who are male and who complain of having TMD symptoms, almost always experience what is called macrotrauma. This is - a blow to the joint, whiplash, intubation, etc. These events can precipitate the joint derangement and pain. TMD's celebrity patient, Burt Reynolds, was hit in the jaw with a chair while filming a movie. This accident initiated two years of pain, vertigo, nausea and substantial weight loss.

While in women this disorder can also be triggered by macrotrauma, the majority of female patients note gradual onset resulting from microtrauma, e.g., bruxism, clenching, malocclusion, etc.. Jenny Craig herself struggled thru years of debiliating TMD pain and is well doccumented in a her book: "The Jenny Craig Story".

A paper published in the mid 1980s reveals that TMD patients see on average 6.9 specialists before receiving a definitive diagnosis. The fortunate ones see only one professional. Others, like Burt Reynolds and Jenny Craig see more than 10!. The most obvious symptoms such as joint, face, neck, back and shoulder pain; joint clicking; popping when opening or closing the mouth, lend themselves to a fairly direct diagnosis - one that Dr. Thomas is well trained to identify and treat.

However, remote symptoms, including visual disturbances, ataxia, hearing loss, and vertigo, can lead a patient from one doctor to another to undergo expensive batteries of tests that yield negative results and leave the patient increasingly frightened and frustrated.

TMD is highly complex and involves more than one single causitive factor. In fact, more than 100 different causes may be involved ranging from hormones, stress, illness, trauma, parafunctional habits, inherited joint/ligament disease's, occlusion/bite, ect. ect..

Determining an accurate diagnosis may be ellusive. Dr. Thomas is highly trained to recognize the causes when they are related to the jaw joint, facial muscles, and to the occlusion (bite). If the cause appears to be unrelated to the jaw joint, facial muscles, or the occlusion, Dr. Thomas will refer you in the appropriate direction - Medical Doctor, Physical Therapist, or other health related professional.

The literature is filled with statements such as the following: "Rarely in the history of dentistry have so many labored so long only to end with such extreme disagreement. "Few afflictions have spawned so much vocal controversy within the scientific community, where available treatments - some grounded in science, others of questionable value - are more numerous than symptoms.

An inherent dilemma of TMD is that it crosses the boundaries of two disciplines - dentistry and medicine. Greater interaction between the two professions is necessary in both the treatment and research of TMD if progress is to be made on all fronts.

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