The temporomandibular joint is a unique and complex joint. Not only does is act as a hinge (like your elbow), but it is the only joint in the body that comes out of its socket as a normal part of its movement. In order to function properly, there must be harmony between the eight or more muscles used to chew, nerves from the teeth, lips, cheek, tongue, and other areas, as well as the muscles and nerves controlling the other side of the jaw. So the complexity of the control of jaw movement can lead to a number of possible sources of disfunction and pain.
TMD, temporomandibular disorder, is the accepted term for disorders of the jaw. Symptoms may include any one or a combination of the following: painful joints or sore jaw muscles, headaches, popping, clicking, or locking of the joint, uneven movements opening or closing, nighttime clenching or grinding of the teeth, worn or jagged edges of the front teeth, flattened surfaces of the back teeth, recurring chipping or breaking of teeth, fillings, or crowns, sensitive teeth, especially near the gum line, little grooves or notches at the gum line of some teeth, and even chronic earaches or ringing of the ears. Sometimes we see patients who have had extensive dental problems such as broken teeth, crowns, and root canals on the teeth on only one side of their mouths.
The vast majority of TMD problems begin with an imbalance of the bite. The joint has a certain resting position or comfort zone where the muscles are signaled to relax. Very few of us have perfectly aligned teeth, even after orthodontic treatment. If our closed position where our teeth lock together, does not match our resting jaw position, some of all of the jaw muscles can continue to contract. These muscles can get tired and hurt, begin to spasm, or create grinding motions. This excessive stress can damage the teeth, the joint, and trigger other pain such as headaches.
When we see patients with any of these symptoms, we become suspicious about a bite imbalance. If left untreated, these symptoms can worsen. The first step in diagnosing a bite imbalance is the occlusal analysis.