TMD and TMJ : Decoding the Medical Terms for Better Understanding
Are you suffering with head, ear, neck, jaw joint pain? Are you confused as to which acronym, TMD vs TMJ, to use in doing an Internet search? While these acronyms are often used interchangeably, they refer to two very different things. The purpose of the blog is to clear up the confusion and explain the proper name for your pain. Here is a big hint, the proper name is not TMJ.
TMJ, is an acronym for the name of the Temporo Mandibular Joint itself. TMJ is just a joint, not a condition. TMJ is not the name of the painful condition whose symptoms are broader than just the joint. These other painful episodes include the head, neck, ear, eye, and yes, sometimes joint pain. The TMJ sits right in front of the ear canals. Everyone has two TMJs, one on each side of the face. Put your finger right in front of the ear canals and open and close your mouth; you can feel both TMJs move. Calling this set of horrible pains TMJ is like calling tennis elbow just elbow. The proper term for the condition is Temporomandibular Dysfunction (TMD), not TMJ.
TMD vs TMJ: History Behind The Name
The history of naming the condition is interesting. The pain syndrome was first scientifically named in 1934 by an MD, James B. Coston. It became known as Coston Syndrome. He published a paper in the Annals of Otology, Rhinology, and Laryngology entitled “A syndrome of ear and sinus symptoms dependent upon disturbed function of the temporomandibular joint.” He thought that symptoms such as ear pain, tinnitus, and vertigo, were related to dysfunction of the temporomandibular joint (TMJ). He was only somewhat correct. Dr. Coston was not a dentist, yet he was the first to write a paper on the temporomandibular joint being the possible source of ear pain. It’s too bad the ENT community did not follow Coston’s recommendation. ENTs, who are unaware of TMD, order unnecessary MRIs when they don’t have a clue as to where the pain is coming from. The pain is coming from the joint, not the ear.
The name Coston Syndrome was not an accurate description the painful set of symptoms that vary as much as the stars in the sky. These painful symptoms can come from the muscles, tendons, ligaments, fascia, teeth, and joints. The pain can be coming from one or a combination of all the body parts of the head and neck and not just from the joint. The signs and symptoms of TMD include much more than just joint pain. Since pain in the joint is not a standalone symptom of this life-robbing pain condition Coston’s description was incomplete, so it fell out of favor. In fact, people can have life-robbing pain in the head and have zero pain in the jaw joint (TMJ). It started being referred to as TMJ/TMD to cover all bases. This just added to the confusion in naming this painful syndrome.
In the 1980’s the National Institute of Dental Research officially named the condition TMD. TMD stood for Temporomandibular Disorder or Temporomandibular Dysfunction. No matter if it is called a disorder or dysfunction, the symptoms of TMD can be severe. The following are just some of the confusing symptoms. One can have head and neck pain and the joint be normal. Another can have severe pain of just the joint. Another can have pain in the joint, head, and neck. Pains occurring in the back of the neck, top of the head, around the eyes, temples, under the chin, in the cheeks, in the ears, can all be due to TMD and not due to TMJ.
Signs and Symptoms of TMD
TMD is divided into signs and symptoms. Symptoms usually involve pain. Signs of TMD are usually pain-free. Some can be both. A non-painful popping joint is both a sign and a symptom of TMD. A painful popping joint is a symptom of TMD. Some jaw joints (TMJ) are noisy on opening. They may sound if the joint has gravel in it or it may feel like “itchy” ears. Pain is not an indicator of health so if you have a non-painful, noisy joint, know that it can get worse.
The reason the TMJ (the jaw joint itself) “pops” or makes noise is because the tiny disc that is supposed to sit on top of the condyle, is no longer there. It can be forced off by compression of the joint. The compression is caused by the teeth in grinding, clenching, and the jaw fighting to find its correct fitting with the upper jaw. The disc can be Infront, on either side, or behind the condyle. The purpose of the disc is to act like a ball bearing and help the condyle slide down the joint complex. This common joint syndrome is what Dr. Coston discovered and wrote about in 1934. He didn’t realize the syndrome also included all the pain that was confused with migraines, tension headaches, etc.
The cause of TMD is due to functional issues within the chewing complex. When the upper and lower jaws are not lined up correctly, pain can be the result. When the teeth are not lined up correctly, pain can be the result. This misalignment compresses the TMJ which leads to a crescendo of pain issues in the joint, muscles, tendons, ligaments, and fascia of the head and neck. The combination of all these pains is now classified as TMD.
Neuromuscular dentists are trained to treat painful and non-painful TMD. They use a special a FDA approved TENs unit to relax the muscles of the head and neck, they have equipment that measures muscle activity and can track the jaw in space. They find the jaw position where the chewing muscles are in harmony and build a removable, neuromuscular, plastic overlay over the bottom teeth. The overlay is called an orthotic which is totally different than a dental night guard or splint.
Use the search engine at ICCMO.org to find a neuromuscular trained dentist.