Temporomandibular dysfunction (TMD) is a disorder that consists of a cluster of symptoms and impaired tolerance for routine daily activities including but not limited to oral function (chewing, talking, oral hygiene).

What causes TMD?
There are a variety of factors that may contribute to TMD.  Trauma, such as a blow to the face or injuries sustained during forceful chewing, are some of the more common examples.  Other times TMD might present itself without a known cause.  In such cases, it is thought that repetitive loading of the joint (ex. fingernail biting) over a long period of time, poor postures, and stress, are the main sources of the dysfunction.

How do I know if I have TMD?
TMD can present itself in a variety of ways including:

• Pain located in the TMJ or adjacent structures (ear, teeth, jaw, etc.)
• Difficulty opening the mouth
• Difficulty closing the mouth
• Pain with chewing
• Sudden changes in occlusion of the teeth (how the teeth come together)
• Catching or locking during opening or closing the mouth
• Asymmetrical opening or closing of the mouth
• Joint noises (popping, grinding, rubbing)
• Dizziness and/or stuffiness in the ear

I suffer from TMD... How can Physical Therapy help?
Physical Therapy (PT) is one of many options for the treatment of TMD and in some cases your DMD or DDS may prescribe PT while you are still under their care.

Physical Therapy can help to reduce the pain associated with TMD, as well as improve your ability to perform normal activities like chewing food, talking, even yawning.

What should I expect on my first visit with a Physical Therapist?
When you arrive for your initial visit with the physical therapist, you will need to first answer some questions regarding your current condition.  Following a thorough history, the Physical Therapist will examine you to determine if you are appropriate for PT treatment.  A typical initial visit consists of some of the following tests and measures: 

• Postural exam
• Visual inspection of TMJ range of motion (ROM) and Cervical Spine ROM
• Measurements of TMJ ROM and Cervical Spine ROM
• Palpation of involved structures and adjacent structures

If all goes well on the first visit and your condition is appropriate for PT treatment the Physical Therapist might proceed with some initial treatments depending on the amount of time remaining.

Subsequent visits will be required to address your condition more fully and will always be scheduled at your convenience.

Depending on the duration of your symptoms and nature of your condition, successful treatment might take upwards of a couple months.  In the event you do not appear to be responding to treatment your referring DMD, DDS, or physician will be contacted to ensure that the proper treatment is prescribed.

What treatments will I receive at Physical Therapy?
If you have been to Physical Therapy for another problem in the past, then you might be a little familiar with what goes on during a typical session.  However, TMD is unique and requires a little more attention than just exercises.  Some of the treatments offered:

• Soft tissue mobilization/myofascial release
• Joint mobilization/manipulation
• Passive/Active range of motion activities
• Stretching
• Postural Correction
• Neuromuscular re-education exercises
• Strengthening exercises
• Moist heat, Ice

Successful treatment of TMD also requires an individual home exercise program that should be tailored to fit your needs.