Healthy Smile: What’s the Difference Between TMJ and TMD?

by Jeffrey Gross, DDS, FAGD of The Healthy Smile

Temporomandibular disorders, often called “TMJ” by doctors, patients, and insurance companies, are a group of diseases. The temporomandibular hinge joint connects the lower jaw to the skull’s temporal bone, located in front of each ear. That’s a lot of big anatomical words. Suffice it to say that the joint connects the lower jaw and the head. These joints are flexible, allowing the jaw to move smoothly up and down and side to side, enabling you to talk, chew, and yawn. Muscles attached to and surrounding the jaw joint control the position and movement of the jaw. TMD stands for Temporomandibular Disorder. TMDs result when the working relationship of the jaw and skull with the muscles that move the jaw and the nervous system cause muscle fatigue, spasm or joint dysfunction, and even changes in the teeth. Each person may exhibit different symptoms that can gradually appear with no apparent cause or occur after a facial trauma or from clenching the teeth, excessive gum chewing, nail-biting, or cradling a phone between your shoulder and the side of your head. They can also be caused by a bad bite, systemic diseases, or developmental abnormalities. Stress alone does not cause the disorder, but it can awaken an asymptomatic TMJ or aggravate an existing condition.

People with joint problems can experience severe pain and discomfort that may be temporary or can last for years. The symptoms can change over time, and more women than men experience it. It is most commonly seen in people between the ages of 20 and 40. This age parameter is not a hard and fast rule as I have treated teenagers and many seniors with that issue. Symptoms can include pain or tenderness in the face, jaw joint, neck, and shoulders. The discomfort may appear in or around the ear when you chew, speak, or open your mouth wide. We see limited ability to open the mouth wide and jaws that get “stuck” in the open- or closed-mouth position. Some patients complain of clicking, popping, or grating sounds in the jaw joint when opening or closing the mouth. A tired feeling in the face, difficulty chewing, or an uncomfortable bite may also result.

I saw a patient this week who came in for a toothache on a tooth with a filling from six months ago. He thought that there was a problem with the filling. His main complaints were soreness around the tooth and the inability to open his mouth. I took an x-ray to rule out the tooth and found that I was correct and that we were not dealing with a tooth problem. When I examined the muscles and ligaments around his TMJ, he felt discomfort similar to the pain that brought him to see me.

I asked him what was going on in his life and he told me that he was getting married soon. All the wedding preparations and his fiancé were causing a lot of stress. Some patients develop an irritable stomach with stress. Others may develop headaches. He took out his stress by gritting and clenching his teeth. When we grit our teeth together, we cause the lower jaw to press against the upper jaw via our TMJ. Excessive pressure produced by this action causes inflammation in the TMJ, resulting in various complaints.

As you can see, when a patient comes in with a jaw complaint, a thorough dental exam is necessary, including the history of the problem. Many other conditions can cause similar symptoms – including toothache, sinus problems, arthritis, or gum disease. Panoramic X-rays may be taken to allow your dentist to view the area to ensure other problems aren’t causing the symptoms. Other imaging tests, including an MRI or a CT scan, may also be needed.

If you are experiencing symptoms and think you might have TMJ/TMD, call my office at 440-892-1810 for a consultation. Often the way to relieve the pain and associated issues is simple. There is no need for you to suffer. I look forward to meeting you and helping you.

Jeffrey Gross, DDS, FAGD is an Ohio licensed general dentist and is on the staff of Case Western Reserve School of Dental Medicine.

The Healthy Smile • 27239 Wolf Road, Bay Village, OH 44140 • 440-892-1810 • www.jeffreygrossdds.com

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