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The temporomandibular joint is a hinge connecting the jaw to the rest of the skull at the temporal bones at the front of the ear. The joint enables mandibular movement which allows for the performance of every-day tasks like chewing, talking and yawning.

Temporomandibular joint disease (TMJ or TMD) is normally the umbrella term representing a number of conditions affecting the jaw. The musculoskeletal conditions include functional and morphological deformities. A person affected by the disorder may experience joint and muscle pain when moving the jaw and
have limited movement of the jaw.

According to research by Nilner M et al.(1981),TMD affects a wide range of patients of all ages and genders and the variety of symptoms is wide-ranging. This has made the diagnosis of the condition is quite hard since symptoms often vary between patients and even in one specific person at different
times.

The disorder has a really prevalence among the American public as 33% of the population suffers from at least one of the symptoms related to TMD. Among them, 3.6% to 7% experience severe symptoms that cause them to seek medical advice (Okeson JP, 2008). According to findings by Godoy F et al., (2007) the
condition mostly affects people with low self-esteem. In other findings, emotional factors were also observed to play a role in the occurrence of the condition (Manfredini D et al. 2003).

Causes of TMD

The causes of the condition are not fully understood. However, changes in occlusion have been shown to influence the onset of the condition. TMD could be triggered or perpetuated by changes such as open bite, cross bite, midline discrepancies, occlusal interference, crowding and missing teeth (Poveda Roda R et al. 2007).

Tendencies which affect the mandibular motion or cause stress to the joint such as prolonged nail biting, gum chewing, teeth clenching, bruxism and biting foreign objects could also be
predisposing factors for developing TMD (Magnusson T et al. 2005).

Such tendencies are usually harmless until they exert too much pressure on the joint, weakening its structural tolerance. Clenching and bruxism are apparently problematic parafunctional activities as they lead to disc compression and reduction of the joint space which results in pain in the muscles. Depression and anxiety were also found to be part of the causative factors (Ferrando M et al. 2004).

Symptoms of TMD

Patients suffering from TMD have different types of pain. The pain is generally experienced on the prearicular area, masseter muscle, and frontal temoralis muscle regions. Patients who uffer from the condition usually describe the pain as pressure, an ache or a dull pain with a burning sensation from the background. Such pain may be intensified by activities like clenching, eating and stress and is alleviated by applying heat on the affected area, relaxing affected muscles and using over-the-counter analgesics. Pain from TMD also comes in waves as patients describe episodes of acute pain which when intensified becomes a throbbing sensation.

The severity of orofacial pain that comes with TMD is usually the driving factor that causes patients to seek medical attention. The pain is usually localized to particular areas and chronic. In a study, patients reported that the pain came when opening the mouth, chewing and resting. The pain was accompanied by headaches and earaches.

TMD also exhibits a range of aural symptoms. It is not yet established what causes the emergence of such signs.They are are however almost always noticeable. The symptoms include;

  • Tinnitus·
  • Vertigo or dizziness·
  • A sensation of otic fullness·
  • Otalgia·
  • Hyperacousia·
  • Hypoacousia

While the reason for aural symptoms for the condition is not known, research shows that the problems have no otic origin (Wright EF. 2007; Myrhaug H.1964).

Western medical treatments of the condition

TMD is typically treated with non-invasive modes which offer relief and allow patients to continue with their normal lives. Even so, there are situations where the condition has continued for a protracted time where invasive methods are required due to the pain and debilitating nature of the condition.

Being a musculoskeletal condition, TMD can be treated as any other condition of the kind. The most common therapy used for the condition is the use of a splint, also known as an occlusal orthotic. The appliance is used to cover the occlusal surface so as to stop the patient from clenching. A splint is made from a variety of materials which can give it different types of textures according to the patient’s preferences. The splint is not a favorite form of treatment for many people as it is not attractive to wear in public and also hinders speech. The appliance is, therefore, best worn at night and very few hours of the day for people who have a habit of clenching. Other medical problems related to the condition are treated accordingly, focusing on each problem individually.

Research supporting efficacy of acupuncture in treatment of TMD

In their research, Wen Long-Hu et al. 2014, showed that laser acupuncture could be used to reduce the pain associated with TMD. The technique is non-invasive and uses low-intensity laser which is non-thermal to stimulate traditional acupuncture points. In the study, subjects recorded significant reduction of pain after short therapies done 3 times a week for 4 weeks.

One study focused on previous credible research about the efficacy of acupuncture for treatment of TMD and found that there was pain reduction. The study, conducted by Jun-Yi Wu et al. 2017, showed that invasive acupuncture that penetrates the skin has more effective results in comparison to sham or laser acupuncture even though the latter also showed results. Acupuncture that penetrates the skin was especially effective when it comes to myofascial symptoms.

Mario Vicente-Barrero et al. 2012 also investigated the use of acupuncture and splints in alleviating the various symptoms of the problem. The study, carried out over 5 weeks, showed reduction of pain, especially myofascial pain. A combination of acupuncture and splints showed a much improved pain reduction in localized areas such as masseter, temporal and trapezuis muscles.

More research is underway. Although a lot of encouraging data has been shown from multiple research studies, more intensive and wide-spread studies are constantly being undertaken.

Learn how acupuncture works by clicking here or call us to schedule a free consultation and get started today. Boca Raton Acupuncture has been successfully treating TMD at our Boca Raton clinic and we’re confident w can help you too!

 

References –

Jun-Yi Wu, MD, Chao Zhang, MD, Yang-Peng Xu, MM, Ya-Yu Yu, MD, Le Peng, PhD, Wei-Dong Leng, PhD, Yu-Ming Niu, PhD, and Mo-Hong Deng, PhD 2017. Acupuncture therapy in the
management of the clinical outcomes for temporomandibular disorders.

Mario Vicente-Barrero, Si-Lei Yu-Lu, Bingxin Zhang, Sacramento Bocanegra-Pérez, David Durán-Moreno, Adriana López-Márquez, Milan Knezevic, José-María Castellano-Navarro, and José-María Limiñana-Cañal 2012.The efficacy of acupuncture and decompression splints in the treatment of temporomandibular joint pain-dysfunction syndrome.

Wright EF. Otologic symptom improvement through TMD therapy. Quintessence Int. 2007;38(9):e564–71.

Wen-Long Hu, Chih-Hao Chang, Yu-Chiang Hung, Ying-Jung Tseng, I-Ling Hung, Sheng-Feng Hsu, and Jan P. A. Baak.2014. Laser Acupuncture Therapy in Patients with Treatment-Resistant Temporomandibular Disorders.

http://www.webmd.com/oral-health/guide/temporomandibular-disorders-tmd#1

http://www.colgate.com/en/us/oc/oral-health/conditions/temporomandibular-disorder/article/what-is-temporomandibular-joint-disorder-tmj

http://www.nhs.uk/conditions/temporomandibular-joint-disorder/Pages/Introduction.aspx

Magnusson T, Egermarki I, Carlsson GE. A prospective investigation over two decades on signs and symptoms of temporomandibular disorders and associated variables. A final summary. Acta Odontol Scand. 2005;63:99–109.