An Overview
Temporomandibular Disorders or Dysfunctions is one of the trickiest of problems that oral & maxillofacial surgeons are trained to treat. Several conditions may be related to TMD, but they can be quite varied, and they are often difficult to pinpoint. TM disorders can result when the jaw muscles or jaw joints are affected due to presence of osteoarthritis or rheumatoid arthritis in the TMJ. Two joints and several jaw muscles make it possible to open and close the mouth. They work together when you chew, speak, and swallow. These structures include muscles and ligaments, as well as the jaw bone, the mandible (lower jaw) with two joints, the TMJ's. The TM joint is one of the most complex joints in the body. Located on each side of the head, these joints work together and can make many different movements, including a combination of rotating and translocational (gliding) action, used when chewing and speaking. This may be one of the poses you find yourself when in pain, for which treatment may be possible with a chosen dental specialist in India Dental Clinics listing.

It has often been noticed that in some patients the problem may be due to the teeth not being perfectly "straight". There are several muscles that function in tandem to help open and close the mouth. They control the lower jaw (mandible) as it moves forward, backward, and side-to-side. Both TM joints are involved in these movements. Each TM joint has a disc between the ball and socket (see diagram). The disc cushions the load while enabling the jaw to open widely and perform rotating and translocational movements. Any problem that prevents this complex system of muscles, ligaments, discs and bones from working together properly may result in a painful TMJ disorder. Treatment is to get a good occlusion or bite. Problem often specialists encounter is when a patient is seen with the most perfect bite possible with TMJ, and another patient with terrible occlusion without any TMJ symptoms! A truly healthy smile must be functionally sound with an optimal bite (occlusion). When the bite is off (malocclusion), trouble's not far behind most commonly in people between the ages of 20 and 40. That trouble can take the form of TMD or TMJ, or temporomandibular joint syndrome.

Common symptoms of TMJ include:
• Frequent headaches or migraine
• Jaw pain or tenderness of the jaw
• Tooth loss in extraction of gum disease
• Daytime or nighttime clenching or grinding
• Shooting or biting pain
• Pain in the shoulder, neck and back
• Sudden numbness in arms or fingers
• Dull, aching facial pain
• Difficulty or discomfort in biting or chewing
• Clicking sound while chewing or opening the mouth
• Grating sensation while chewing
• Locking or decreased ability to open or close the mouth
• Cracked fillings or tooth chipping
• Swelling on the side of the face

TMJ Diagnosis
The chosen dental specialist, oral & maxillofacial surgeon, may run the diagnostics to help identify the source of the pain. The dentist would thoroughly examine your bite and take various appropriate dental x-rays. Often, it's a sinus, toothache or an early stage of periodontal disease. But for some pain, the cause is not so easily diagnosed. The pain could be related to the facial muscles, the jaw or temporomandibular joint, located in the front of the ear. Treatments for this pain may include stress reducing exercises, muscle relaxants, or wearing a mouth protector to prevent teeth grinding (bruxism). They've been successful for many and your dentist can recommend which is best for you. In general, the diagnostic studies followed for TM Joint diagnosis and evaluation are:

• X-rays of the TM Joints & Skull
• MRI (Magnetic Resonance Imaging)
• Electromyography (studies of muscle function)
• Motion Performance Studies
• Joint Vibration Analysis (a form of ultra-sound sonography)
• A neurological exam (used more frequently for patients with severe or chronic pain)
• Diagnostic Study Casts of the Mandible & Maxilla
• CT scan for bony details of the joint
• X-rays of the Dentition

It is often difficult to pinpoint where actually the problem lies. In the diagnostic stage itself for the complex cases, there may be more than one doctor involved. It becomes more so difficult some times to arrive at a consensus on a treatment. Some TM problems result from arthritis, dislocation, and injury. All of these conditions can cause pain and dysfunction. Muscles that move the joints are also subject to injury and disease. Injuries to the jaw, head or neck, and diseases such as arthritis, might result in some TM problems. Other factors that relate to the way the teeth fit together—the bite—may cause some types of TMD. Stressful social and/or work life (meeting targets in BPO’s, IT sector, software, banking & finance, manufacturing, service sectors, etc) is also thought to be one of the leading factors. TMD affects women of childbearing age more than men, or older men and women. In several cases the dentist may also involve Chiropractor or an Ayurveda stream of specialists as a holistic TMJ treatment approach.