What are the causes of TMJ Disorder?

The causes of "TMJD" are numerous and varied. Most of the causes have created changes in the orthopedic relationship in the joint(s). These imbalances and misalignments cause stresses on the joint apparatus, leading to breakdown and pain. It is important to realize that there could be damage to the joint system, long before pain appears. The pain mechanism is not always from the acute situation. Repetitive damage will ultimately lead to pain, in most cases, but not all.

  1. Whiplash from a traumatic event, such as an auto accident or fall
  2. Osteoarthritis, rheumatoid arthritis, infectious arthritis
  3. Chronic long term tooth clenching or grinding
  4. Females are three to four times more at risk than males.
  5. Structural discrepancies in the skeleton leading to postural difficulties
  6. Missing posterior teeth
  7. Tooth problems, such as a "bad bite" or what is sometimes called a trapped mandible. This is where you see a large "overbite".
  8. Chronic stress
  9. Biting on paper clips, fingernails, pencils, pens, etc. This is referred to as chronic "micro trauma."
  10. Head posture, such as sitting in front of a computer screen for long periods
  11. Back pain- sometimes it is hard to determine if the pain from the TMJ is from the back or referred from the back.
  12. Osteochondritis
  13. Heredity

This is not an exclusive list, nor is it meant to be. Certainly factors, such as the possibility of tumors, nutritional deficiency, and allergy should be considered. Some TMJ authorities implicate the orthodontic practice of the removal of four (bicuspid) premolar teeth as causing TMJD. This is a controversial issue. The orthodontic dentists say that this is not so. Both the TMJ doctors and the orthodontic communities have presented their "proof." I believe that usually a multitude of factors causes TMJD. The astute diagnostician will analyze all possibilities carefully before creating a cause and effect scenario. Then and only then can treatment begin.

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E-mail: drg@tmjheadache.com