The TMD (TMJ) Clinic 

 

We offer a specialised Temporomandibular Joint Disorder (TMD) clinic for those struggling with pain and dysfunction related to the temporomandibular joint (TMJ).

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TMD  is a condition affecting the temporomandibular joint (TMJ), which connects the lower jaw (mandible) to the skull. The TMJ enables jaw movement, allowing for talking, chewing, and yawning. TMD can cause pain and dysfunction in the jaw joint and muscles that control jaw movement.

 

Symptoms may include:

• Jaw pain or tenderness. 

• Difficulty moving the jaw.

• Clicking or popping sounds when opening or closing the mouth.

• Sometimes, headaches or neck pain

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The causes of Temporomandibular Disorder (TMD) are multifactorial and can involve a combination of muscle, joint, and psychological factors. Understanding these causes is essential for effective management and treatment.

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Here are some of the primary factors that can contribute to the development of TMD:

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Muscle Dysfunction

Problems with the muscles of mastication (the muscles that control jaw movement) can lead to TMD. This might include muscle tension, fatigue, or spasms, often resulting from habits such as clenching or grinding the teeth (bruxism), which can occur during sleep or in response to stress.

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Joint Dysfunction

The temporomandibular joint (TMJ) itself can be affected by conditions such as arthritis, disc dislocation within the joint (disc displacement), or injury. These conditions can lead to altered movement patterns, pain, and inflammation in the joint.

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Injury

Trauma to the jaw or TMJ, such as a heavy blow or whiplash, can directly damage the joint or the muscles and ligaments surrounding it, leading to TMD.

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Dental Issues

Misalignment of the teeth or jaw (malocclusion), problems with dental work, or the loss of teeth without adequate replacement can affect how the jaw moves and functions, potentially leading to TMD.

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Connective Tissue Diseases

Certain systemic diseases that affect connective tissue, such as rheumatoid arthritis or fibromyalgia, can involve the TMJ and contribute to TMD symptoms.

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Habitual Behaviours

Chronic gum chewing, nail-biting, or biting on foreign objects can put excessive pressure on the TMJ, leading to discomfort and dysfunction.

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Stress

Psychological factors such as stress and anxiety can lead to unconscious habits like teeth clenching and grinding, which in turn can contribute to muscle tension and TMD.

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Poor Posture

Poor posture, especially in the neck and upper back, can lead to imbalances in the muscle function around the jaw and neck, affecting the TMJ.

                                    

Understanding the underlying cause(s) of TMD in an individual patient is crucial for developing an effective treatment plan. This often requires a comprehensive evaluation by healthcare professionals, including physiotherapists, dentists, or specialists in orofacial pain, to address the specific needs and contributing factors in each case.

 

Physiotherapy plays a significant role in managing TMD, offering a non-invasive approach that can alleviate pain, improve jaw function, and address the underlying causes of the disorder.

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The physiotherapeutic management of TMD may include a combination of manual therapy, exercises, and dry needling, among other interventions.

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Manual Therapy

Manual therapy techniques involve hands-on manipulation and mobilisation of the jaw to increase mobility, reduce pain, and improve function. Techniques may include gentle stretching of the joint, mobilisation techniques to improve the movement of the jaw, and soft tissue therapy to reduce muscle tension.

 

Exercises

Specific exercises are prescribed to strengthen the muscles around the jaw and improve its function. These exercises can help stabilise the joint, increase mobility, and reduce pain. They might include range-of-motion exercises to increase jaw opening, strengthening exercises for muscles that support the jaw, and relaxation exercises to decrease muscle tension.

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Dry Needling

Dry needling involves inserting fine needles into specific trigger points in the muscles around the jaw and neck. This technique can help in reducing muscle tension and pain. It is thought to work by changing the way pain is processed in the nervous system and by increasing blood flow to the area, which aids in healing.

Dry needling can be particularly effective for TMD patients who have significant muscle tightness or trigger points contributing to their symptoms.

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In addition to these specific interventions, we will provide education on jaw function, advice on lifestyle modifications to reduce strain on the TMJ (such as diet changes to avoid hard foods), techniques for stress management, and guidance on proper posture to minimise neck and jaw strain.

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The effectiveness of physiotherapy for TMD depends on a thorough assessment to tailor the treatment plan to the individual's specific needs. We work closely with our patients, possibly coordinating with other healthcare professionals, to address the multifactorial nature of TMD comprehensively.