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Writer's pictureDr. Melissa Adams

Let's Talk Temporomandibular Joint Dysfunction (TMD)





Skull showing the Temporomandibular Joint (TMJ), including the condyle of the mandible, mandibular fossa, and articular tubercle.

The Temporomandibular Joint (TMJ) is the joint that, when it moves, opens and closes your mouth. It is an incredibly complex joint for many reasons.


The TMJ is made up of the Condyle of the Mandible (the part of your bottom jaw the curves up toward your ear), the Mandibular Fossa (a little divet where the condyle fits), and the Articular Tubercle (a little projection in front of the fossa). There is also a little disc which is not pictured.


This joint is complex not only because of all the things that make it up, but because it also both rotates and translates which are movements required for proper talking, chewing, and breathing.


Temporomandibular Joint Dysfunction (TMD for short) is an issue many people face and it can be horrendously painful.


There are a variety of reasons why someone's TMJ can become painful, trauma to the joint is one, bruxism (clenching or grinding teeth), and malocclusion (improper bite) are also possibilities. No matter the cause of the pain, TMJ pain is often chronic and typically worsens with time.


Some of the things someone can do to help with this kind of pain is - heat, ice, various stretches or strengthening exercises, acupuncture, wearing a night guard to limit clenching/grinding of teeth at night, chiropractic care, injections, surgery, reducing stress, orthodontic care ... it's a fairly lengthy list of options and those suffering with TMJ pain have often tried them all.


Unfortunately, if the cause of the pain is not properly dealt with (at the source), the pain can and often does, exacerbate with time and can easily irritate the Trigeminal Nerve, which as you can see, is VERY close to the TMJ.

Skull with an orange dot to show the trigeminal nerve location just above the temporomandibular joint. The branches of the nerve are shown in orange, with 2 going to the eye (the top branch) the next branch to the nose and upper jaw and teeth, and the bottom branch to the lower jaw and teeth.

The Trigeminal Nerve has connections starting just above the TMJ and those connections create 3 branches. One goes to the eye, another to the nose and upper jaw, and the last to the lower jaw. The Trigeminal Nerve also has connections to your upper neck.


Once the TMJ pain has involved the Trigeminal Nerve, the individual suffering can experience extreme and intense pain that can vary widely. This can include pain in the joint, and/or the muscles of the jaw, around their eye, nose, upper jaw, lower jaw, teeth, neck ... and unfortunately can further radiate down their neck, into their shoulder (front and back) and down their arm. This pain can present as a migraine, can include eye disturbances (including dry eye), and so much more.


As some of you know, I (Dr. Adams) have been dealing with what I just described in that last paragraph. I have attempted to manage it for many years, however, more recently the pain became unbearable and I began seeking out answers as well as help outside of the seemingly five million and one things I already tried.


Although I help many people with TMJ pain and even Trigeminal Neuralgia in the office, the true solution for my own pain has alluded me ... until now. I'll continue to share more in future blogs, as I am now finding relief but the journey is far from complete.


Dr. Adams is receiving care from the amazing doctors as Hamer & Glassick Orthodontics (www.cvillebraces.com) & would highly recommend them!

If you'd like to learn more about the TMJ joint, here is a great YouTube video https://youtu.be/P0TqzSFqQfc



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