TMJ stands for the Temporo Mandibular Joint. The temporal bone is a portion of the skull bone, the mandible is the lower jaw bone and the TMJ is the joint that connects the two. TMJ disorders consists of pain, dysfunction or derangement of this joint and it's associated muscles. Because many of the symptoms of this problem are not in the joint itself the condition is more accurately referred to as TMD which stands for TemporoMandibular Disorder. Signs and symptoms of TMD include but are not limited to the following:

• Pain in muscles of the head, face, jaws and neck
• Pain in the jaw joint
• No comfortable place to hold or position the jaw
• Clicking, popping or grinding of the jaw joints
• Jaw locking or sticking open or closed
• Awareness of a change in one's bite
• Crookedness of one's smile/jaw
• Abnormal wearing and attrition of one's teeth
• Unexplained dizziness
• Unexplained pressure changes or pain in your ears

Common misconceptions about TMD:

• Nothing can be done about it.
• The problem will eventually go away on it's own.
• The problem is completely psychological.

Common questions patients ask that we can answer for you:

• My jaw joint clicks or pops. Is this a problem and is it going to get worse?
• I had a bite splint made for my TMJ problem, but why does it not relieve my symptoms?
• Is my headache or jaw pain caused by a TMJ problem, some other disorder or a combination of problems?
• Why does my bite feel uncomfortable like there is no proper spot to hold my jaw?
• Will getting braces fix my TMJ problem?
• What are my options for treatment and what is the prognosis and success rates for my problem?

The majority of TMD related pain is caused by muscles that are in hyper-contraction or spasm. This is usually caused by discrepancies in the way a person's teeth come together in relation to where their jaw joint wants to be. In other words, most TMD problems are caused by bite problems that result in muscle pain. This muscle pain can be severe and debilitating. It is often mistaken and misdiagnosed as common headache or migraine headache pain.

Some patients however, have pain or dysfunction that is caused by an internal derangement of the actual jaw joint. These are the patients that can have the clicking, popping or grinding noises in their joints. These patients usually also have muscle related pain and the bite discrepancies mentioned previously. Internal derangements of the joints can be caused by a bite problem, traumatic injury to the jaw or head or independent pathology. Traumatic injury such as whiplash or a physical blow to the mandible can cause damage to the delicate supporting ligaments of the joint. Some of the symptoms of a TMD that were caused by a traumatic event may not develop until months after the incident. There are many stages of joint derangement and it is important to establish the exact diagnosis for a patient before treatment is begun because the treatment and prognosis of different stages can vary greatly.

Dr. Morgan is trained and knowledgeable in the subject of contemporary diagnosis and treatment of TMD. By performing a very detailed clinical examination of the patient and interpreting radiographs, he is able to determine an accurate diagnosis for the patient and a establish a definitive prognosis and course of treatment.

Treatment Treatment of TMD consists of a wide range of possibilities. We treat our TMD patients in one or two phases depending on their initial diagnosis.

Phase 1 consists of the elimination or significant reduction in pain by relieving muscle spasm and inflammation. Phase 1 treatment is conservative in nature producing no irreversable changes This can accomplished by alteration in dietary habits, medications, bite splints, anesthetic, physical therapy, biofeedback and life style changes. This phase usually takes between one to twelve weeks for resolution of symptoms depending on the initial severity of the problem. Other disorders which mimic TMJ (for example, temporal tendinitis or Earnst syndrome) are often treated with phase 1 therapy including medications, injection of local anesthetics and physical therapy. Many times a “weaning away” of the bite splint to only night time wear can be utilized to maintain pain elimination.

Phase 2 is the correction of the underlying anatomical or physical cause of the patient's TMD. For example, if a bite splint were used successfully in Phase 1 to alter a patient's bite and relieve pain then Phase 2 would be the permanent alteration of the patient's teeth or jaws to reproduce the bite created by the splint and thus eliminate the need for the splint. This can be accomplished a variety of ways and it depends and the severity of the individual's problem. It is most important that no patient undergoes Phase 2 treatment until a correct diagnosisis established and proven as the cause of the symptoms (Phase 1 Treatment) Methods we consider in Phase 2 are reshaping the teeth, restoring the teeth, orthodontic movement, jaw surgery and sometimes a combination of these options.

It is important that if a TMJ sufferer is experiencing severe emotional and/or psychological problems, failure to address these issues will virtually guarantee a failure in treatment. Psychological as well as physical problems must be considered as sources of unresolved pain complaints involving the TMJ or associated structures.

It is important to understand that when TMD symptoms are caused by bite problems, the solutions are fairly straightforward. Therefore, even if your symptoms are currently minor it is important to be proactive and follow through with any recommendations we have to equalize your bite so that major, debilitating complications are less likely to occur in the future.

There are many other disorders that either mimic TMD or are present in conjunction with TMD. Examples of some but not all of these other common problems are; fibromyalgia, cervical spine disorders, postural problems, dental pain, neuralgias, RSD, migranes, and ear/nose/throat disorders. We can help in determining if an additional source is wholly or partially responsible for your head and neck pain and if so refer you to the appropriate specialist for treatment. The many possible sources, stages and treatment options of TMD make it imperative that an accurate diagnosis, prognosis and plan be established before any treatment is begun so that the patient has every opportunity for a direct, timely and successful solution.