First of all, 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 United States. Symptoms of TMD may range from mild popping and clicking noises of the jaw to debilitating migraines or some even experience an inability to eat or talk. The Temporal Mandibular Joint (TMJ) serves as one of the primary body structures that allows for eating, talking, hygiene care, making facial expressions, and even aides 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 even today. I had never experienced any TMD previously in life but, due to the impact of the car accident and the whiplash that followed, I have experienced most if not all of the symptoms associated with TMD and more.
After the accident, I felt a strong continual discomfort in my bottom and top jaw, feeling like I had to break through glue to open my mouth, let alone chew food or talk. As my body started to heal from some of 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 and if I closed my mouth, I wouldn’t be able to open it again. Or a constant pain that radiates from my chest, up to my neck, into all of my teeth, and up into my head limiting the foods I can eat and how I drink liquids. Because I knew this wasn’t normal and probably a result of the accident, I visited my dentist where 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 some of my symptoms.
In just a 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 been able to return to eating carrots, apples, meats and other foods that I love that I don’t have to mash or soften before consumption. I can now drink water from a normal water bottle and not one with only a straw. I have been able to return to having normal lengthy conversations with people or engage in public speaking events and not feeling pain immediately when I get done talking that can last for days after.
Am I completely healed yet and “fixed”? Of course not, trauma the body experiences 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 my tissues experienced is key to decrease the severity of my symptoms and to create opportunities for my body to heal optimally.
How do Occupational Therapists fit into the picture when treating TMD?
Currently, invasive and non-reversible treatments are being utilized without strong evidence to actually to “fix” the issue in 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 effects, are some of our most valued and repetitive activities of daily living and when limited from TMD, can result in a decline in both physical and mental health for all ages. (Trust me, I know!) The cause is often considered multifactorial including 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.
After reading this, if you think you have TMD or are unsure, make an appointment and let’s talk about it. We can give you some education and tips on how you can help yourself feel better.
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
