TEMPOROMANDIBULAR JOINT SYNDROME

WHAT IS TMJ SYNDROME?

MASTICATORY STRUCTURES OF THE TEMPOROMANDIBULAR REGION
The masticatory structures of the temporomandibular region consist of the lower jaw bone (mandible) and temporal bone of the skull, which interface at the temporomandibular joints, via ligaments, on either side of the head. These combined hinge and gliding joints allow thejaw to move with the help of the appropriate muscle group. Each joint is separated into two compartments by an interarticular fibrocartil age, which acts as a shock absorber during chewing and provides stability during jaw motion. Within each compartment, there is a synovial membrane filled with fluid, which helps lubricate the joint. Pain and malfunction in the temporomandibular region may arise from problems in any or all of these structures.
SIGNS AND SYMPTOMS OF
TEMPOROMANDIBULAR JOINT (TMJ)
DYSFUNCTION
TMJ dysfunction is defined by the presence of various signs and symptoms in the temporomandibular region, which

maybe manifestations of abroad array of disturbances. There is no general consensus about the signs and symptoms that are required for a diagnosis of TMJ syndrome, and working definitions vary among practitioners. The most common complaints, popularly referred to as the ?TMJ triad,? include pain and/or muscle spasm in the temple and cheek, usually anterior to the ear; limited jaw motion; and clicking or popping of the joint. The pain can be complex and often radiates to other structures, such as the neck and shoulder muscles. Headache is also a frequently reported symptom.
CAUSES OF TMJ DYSFUNCTION
The proposed causes of TMJ syndrome are many and range from trauma to dietary deficiencies. Occasionally, a single underlying factor is diagnosed as the cause, but usually TMJ dysfunction is considered to be multifactorial in origin.

Source: T. Thompson, J. Dwyer. and C. Palmer, ?Nutritional Remedies for TMJ: Fact or Fiction,? Nutrition Today, Vol 26, No. 1, pp. 37-40, @ by Williams and
Wilkins, 1991.

7:74 QIIRoPRACrIC PATIENT RESOURCE MANUAL
Helpful Hints for TMJ Patients
? Avoid protruding your jaw (for example, when smoking, during conversation).
? Make every effort not to strain the ligaments of the jaw.
? Do not bite food with your front teeth.
? If you clench your teeth, remember to keep your lips together and your teeth slightly apart.
? Avoid chewing gum.
? Do not eat popcorn, crusts of bread, tough meat, or any food that will require prolonged chewing.
? Cut all foods into small pieces; avoid opening the mouth wide.
? Avoid pressure on your jaw during sleep. Sleep on your back if possible.
? Avoid the following habits:
?yawning widely, testing the joint, and ?playing with? the jaw
?chewing gum and tough, crunchy, or hard foods
?resting the chin and/or cheek in the palm of the hand when sitting or lying on one side
?eating, reading, or watching TV in bed
?clenching the teeth when tense, jogging, etc.
?licking the teeth with the tongue
?closing the lips to hide braces, splint, malocclusion, missing teeth, etc.
?nail biting
?lip biting or licking
-cheek biting or sucking
Source: Leonard G. Hudzinski and Gary Lawrence, ?Myofascial Pain and the Temporomandibular Joint,? in Clinical EMG for Surf ace Recordings: Volume 2, Jeffrey R. Cram, ed., Clinical Resources, @ 1990.