First, what is Temporal Mandibular Dysfunction (TMD) and how many people have it?
As of 2021, approximately 80 million adults and 8 million children/adolescents have Temporal Mandibular Joint Dysfunction (TMD) in the US. Symptoms of TMD may range from mild popping and clicking noises of the jaw to debilitating migraines. Some people even experience an inability to eat or talk. The Temporal Mandibular Joint (TMJ) is one of the primary body structures that allows for eating, talking, hygiene care, facial expressions, and even aids in intimate acts.
My personal story:
In April of 2022, I sadly was in a major car accident. Thankfully for the most part, I was ok and didn’t require any hospitalization time. However, the lasting effects of my car accident are something that I am still experiencing and working through today. I had never experienced any TMD previously. Now, due to the car accident and the whiplash that followed, I have experienced most if not all of the symptoms associated with TMD.
After the accident, I felt a strong continual discomfort in my bottom and top jaw. It felt like I had to break through glue to open my mouth, let alone chew food or talk. As my body started to heal from the initial shock, I assumed my mouth, head, and neck would too, but it still hasn’t completely. At its worst, I’ve experienced my jaw feeling stuck. I feared if I closed my mouth, I wouldn’t be able to open it again. There was a constant pain that radiated from my chest, up to my neck, into all of my teeth, and up into my head. This pain limits the foods I can eat and how I drink liquids.
Because I knew this wasn’t normal and a result of the accident, I visited my dentist. He educated me about TMD and informed me that I had multiple microfractures in the majority of my teeth as a result of the car accident and would require multiple dental procedures later on in life. But for now, he referred me to see a myofascial release trained OT or PT to help open up the connective tissues and fascia to help relieve my symptoms.
How Myofascial Release Helped my TMD
In just the few myofascial release treatments I have had since January, along with some added self-care in my routines, I have noticed a huge difference in my symptoms, my pain, and in my overall functioning. Over the last few months I have finally been able to have days between my pain cycle, not minutes. I have returned to the tough and crunchy foods I love without mashing or softening before consumption. I can now drink water from a normal water bottle, not one with only a straw. I have returned to having normal lengthy conversations with people. Engaging in public speaking events, I no longer experience pain, which could last for days.
Am I completely healed yet and “fixed”? Of course not. When the body experiences trauma, it can take quite a while to function at a more normal state again, if ever. Treating my symptoms conservatively and finding the root causes of my symptoms beyond the trauma is key to decreasing the severity of my symptoms and creating opportunities for my body to heal.
How do Occupational Therapists fit into the picture when treating TMD?
Currently, invasive and non-reversible treatments are being utilized (without strong evidence) to “fix” the issue in an attempt to gain patients their functionality back. The TMJ Association recognizes over 50 treatments. However, the evidence for most treatment is lacking. In 2019, it was reported that conservative treatment options including physical and psychosocial interventions are effective and should be started early in the care of TMD and be chosen over invasive, irreversible, and expensive interventions.
The occupation of eating, and other occupations TMD directly affects, are some of our most valued and repetitive activities of daily living. When limited from TMD, it can result in a decline in both physical and mental health for all ages. (Trust me, I know!) The cause is often considered multifactorial and includes biologic, behavioral, environmental, social, emotional, and cognitive components. Thus, making it imperative that occupational therapists become involved in treating those affected by TMD as occupational therapists have the most in-depth training within the biopsychosocial foundations of our practice. Occupational therapy practitioners must develop competence in the conservative treatments for the multifactorial components of TMD and education for patients to help them heal from pain and dysfunction to improve their quality of life.
Resources for Treating TMD
After reading this, if you think you have TMD or are unsure, make an appointment and let’s talk about it. We can educate you and give you tips on how to help yourself feel better.
We also offer a self-paced online course: Temporomandibular Joint Dysfunction: Eliminate Your Pain Naturally with a Fascia-Informed™ Approach.
Happy smiling,
Dr. Kaitlyn Rambo, OTD
Occupational Therapist at Mayer Fascia Wellness
References:
Aggarwal, V. R., Fu, Y., Main, C. J., & Wu, J. (2019). The effectiveness of self-management interventions in adults with chronic orofacial pain: A systematic review, meta-analysis and meta-regression. European journal of pain (London, England), 23(5), 849–865. https://doi.org/10.1002/ejp.1358
Empowering you with the truth. The TMJ Association. (2022, December 2). Retrieved February 16, 2023, from https://tmj.org/
Lee, Y. H., Auh, Q. S., An, J. S., & Kim, T. (2022). Poorer sleep quality in patients with chronic temporomandibular disorders compared to healthy controls. BMC musculoskeletal disorders, 23(1), 246. https://doi.org/10.1186/s12891-022-05195-y
Valesan, L. F., Da-Cas, C. D., Réus, J. C., Denardin, A. C. S., Garanhani, R. R., Bonotto, D., Januzzi, E., & de Souza, B. D. M. (2021). Prevalence of temporomandibular joint disorders: a systematic review and meta-analysis. Clinical oral investigations, 25(2), 441–453. https://doi.org/10.1007/s00784-020-03710-w
