This information has been produced to provide you with information about Temporomandibular Disorder (TMD) and aims to answer any questions that you may have. If you require anyfurther information please do not hesitate to ask the medical and nursing staff caring foryou.

What is TMD?
TMD describes a variety of conditions which affect the jaw joints and muscles. Problems may occur on one or both sides. It is very common. Many people have some sign of TMD but only a small number suffer pain.

What causes TMD?
We do not know exactly what causes TMD. For years dentists thought that TMD was caused by the way the jaws and teeth lined up. However, research has shown that misalignment of the jaws and teeth is not a major cause of TMD. Today we believe that TMD is caused by many things acting together, some of which may have little or nothing to do with your teeth. Most discomfort is from overuse of the joints and muscles. There are many ways this can occur:

• Clenching the teeth together. This may be brought on when you are concentrating or extra busy, worried, annoyed or even by cold winds.
• Grinding the teeth together. This often occurs at night but can also be during the day.
• Straining the joints and muscles by chewing pencils, biting nails, holding things in your mouth, holding the telephone between your neck and shoulder.
• Overworking the muscles by constant chewing, e.g. chewing gum etc.

Will it get worse?
TMD does not usually keep getting worse. The problem tends to come and go, often feeling worse during times of stress. Studies demonstrate that it does not get worse with age but is one of the few conditions which seem to get better as you get older.

What problems may I experience?

• Jaw pain or soreness that may be worse either on waking or in the evening
• Jaw pain when biting, chewing or yawning
• Clicking from the joint when moving your jaw
• Stiffness or locking of the jaw joint.
• Earache without an infection
• Difficulty opening or closing your mouth
• Frequent headaches

There are many effective and simple treatments although there is no one single cure. Studies have shown that up to 90% of all patients will get better with some self-care, exercises and the use of a splint (bite guard) to reduce the tension in the muscles around the face. Occasionally other forms of treatment can be of benefit, e.g. physiotherapy, adjustment of the biting surfaces of the teeth or a course of medication. Only very rarely is orthodontics or surgery indicated for the treatment of TMD.

You are the key - without your help the treatment will not be as effective.

• Keep your teeth apart. Do this when you are not wearing your splint. The proper resting position for your jaw is with the teeth slightly apart and your tongue resting gently on the floor of the mouth. This allows your jaw joints and muscles time to rest and heal. Your teeth should only touch during chewing, swallowing and sometimes speaking.
• Avoid opening your mouth very wide.
• Avoid habits like chewing fingernails or gum.
• Avoid straining your neck and shoulders by poor posture. This can occur when working at a computer or holding the phone between your neck and shoulder for a long time.
• Eat nutritious meals that do not require hard or prolonged chewing.
• Avoid caffeine and smoking. Both of these are stimulants which excite the nerves of your body. If you are having pain, any stimulants can make the pain seem worse and increase muscle fatigue.
• Follow your personal treatment programme. This will be developed specifically for your needs by a dentist in the clinic.
• Try to give yourself 10-15 minutes each day to relax.

Remember - be patient - nine out of ten TMD patients will get better by simple methods alone.

Further Information
If you have any problems or require further information, please telephone 0191 2325131 and ask the switchboard to transfer you to the Restorative Dentistry Department, Dental Hospital, (between 9.00 am - 5.00 pm). At all other times, please contact your own Dentist