What Causes TMJ?

There are myths and unsubstantiated beliefs in the following philosophies on the causes of TMD that can lead to over-treatment and unsuccessful results for the patient. However, there is some truth in all of these popular viewpoints, which is why this complex problem oftentimes is treated by dentists, orthodontists, oral surgeons, physical therapists, massage therapists, psychologists, psychiatrists and various medical specialties.

1. Bad bites cause TMD… Fix the patient’s bite and you solve the problem. If only it were this simple! It is true that there are patients who have a filling or crown made by their dentist and they get severe, acute TMD problems. When the dentist adjusts the bite on his work, the pain goes away—a common situation that has fostered the belief that bad bites cause TMD.The truth is that 90% of the population has some type of bite problem but the prevalence of TMD is much lower (4-6% of the population). Statistically, 82% of all TMD cases are premenopausal females between the ages of 15 and 45 years, implicating hormonal causes. There are many factors related to TMD, and bad bites are an important consideration, but a doctor who only dwells on bite correction as TMD treatment may be missing a substantial part of the picture.
2. Stress causes TMD… Remove stress or manage the patient’s stress through difficult times, and the patient’s pain will be reduced. There is no question that personal stress is an important factor in TMD and stress management is an important part of each patient’s TMD treatment. People grind their teeth and muscles are tighter when we are under stress and this can certainly add to a patient’s pain. Stress management not only involves psychological treatment (cognitive-behavioral therapy, relaxation therapy and biofeedback), but also medication (muscle relaxants, tranquilizers and sleep aids).
3. Mechanical Problems… TMD problems are related to mechanical problems in the jaw joints that can be remedied by surgery. Many people have clicking and popping in the jaw joints and many people may have abnormal x-ray or MRI readings. Neither of these situations necessarily indicates that they need to be treated. In addition, oftentimes these people are not experiencing pain with these situations, which, again, indicates that treatment is not necessarily required.
4. Misalignment… TMD is related to poor posture or misalignment of the skull to the neck and jaw.
5. Diseases… Underlying medical diseases may cause or have TMD associated with them (e.g., rheumatoid arthritis, Lyme disease).
6. Neuromuscular Coordination…TMD is caused by poor neuromuscular coordination related to jaw misalignment and bad bites.

As you discuss your TMD problems with your health professional, it is important to be aware of these popular myths and beliefs so that a proper diagnosis can be made based upon your specific symptoms and medical history.