Craniomandibular dysfunction is a malfunction of the jaw. These are manifested by different symptoms.
What is craniomandibular dysfunction?
The cause of a craniomandibular dysfunction is usually a misalignment between the human lower jaw (mandible) and the skull (cranium). See AbbreviationFinder for abbreviations related to Craniomandibular Dysfunction.
Craniomandibular dysfunction is also known as craniomandibular dysfunction, TMD or functional pain syndrome. This generic term refers to functional, structural or psychological dysregulations of the temporomandibular joint. The malfunctions sometimes cause pain. The symptoms are caused by disturbances in the interaction of joints, muscles and tendons.
About five to ten percent of all adults suffer from temporomandibular dysfunction. Jaw problems are particularly common in women who are capable of bearing children. During the menopause, the symptoms usually improve. In smaller children, on the other hand, craniomandibular dysfunction occurs only very rarely. The disease then increases until puberty. Only around three percent of the population require specific treatment for CMD.
The cause of a craniomandibular dysfunction is usually a misalignment between the human lower jaw (mandible) and the skull (cranium). If the mandibular condyle is not in its correct position within the socket, there is even a risk of dislocating the jaw.
Clenching of the jaw and grinding the teeth (bruxism) are common triggers of craniomandibular dysfunction. These problems often lead to disc displacement, arthrosis or myofascial pain in the temporomandibular joint. In principle, doctors suspect a large number of different causes for the occurrence of craniomandibular dysfunction.
These include developmental disorders, genetic factors, misaligned teeth, the loss of one or more teeth as well as hormone or sleep disorders. Psychological reasons are also counted among the causes. It can be post-traumatic stress disorder or depression. Sometimes orthodontic therapies or the use of dental crowns that are too high are the cause of craniomandibular dysfunction.
Symptoms, Ailments & Signs
Craniomandibular dysfunction leads to numerous different symptoms. The main symptoms are diffuse pain, which manifests itself both during movement and at rest. The pain is usually constant and dull. In addition, the symptoms can radiate into the mouth, forehead, temples, eye sockets, cheeks, neck, cervical spine, shoulders and back.
It is not uncommon for those affected to also suffer from restricted jaw opening and grinding and cracking noises when they open or close their jaws. Furthermore, a burning sensation in the mouth or on the tongue, tinnitus and earache are all possible. Some of those affected also show increased salivation, difficulty swallowing, blurred vision, dizziness, tiredness and poor concentration. Occasionally, restricted movement occurs in the cervical spine.
Diagnosis & Therapy
Since the symptoms of TMD are as numerous as they are varied, an exact diagnosis can be difficult in some patients. As a rule, the dentist is consulted first when there are problems with the jaw. From this it can be determined whether the problems have their origin in the teeth or in the jaw joint. In addition, the dentist checks possible sources of infection on the teeth.
A kinesiography can provide a more accurate examination that will determine whether the jaw problems are caused by changes in jaw movement or by individual teeth. Electromyography can be used to detect muscle spasms. X-rays, radiological methods or an instrumental functional analysis (API/CPI) can be considered as further examination methods.
However, psychological factors can also trigger craniomandibular dysfunction. For this reason, the patient is given some questionnaires to fill out. The patient has to be very patient with the diagnosis, as it is considered to be time-consuming. Craniomandibular dysfunction can usually be treated well. The disease usually takes a positive course. The symptoms improve after a few weeks.
Patients with this disease primarily suffer from discomfort in the jaw. These complaints have a very negative effect on the quality of life of those affected and can significantly reduce it. As a rule, the patients primarily suffer from severe pain. The pain also occurs as rest pain and can lead to discomfort and thus to sleep problems, especially at night.
It is not uncommon for patients to suffer from depression or appear irritable. The pain can also spread from the jaw into the eyes or head and also lead to complaints in these regions. This complaint also makes it difficult to take in food and liquids, which can lead to deficiency symptoms or malnutrition. Difficulty swallowing or blurred vision can also occur.
Patients are often unable to concentrate and suffer from constant fatigue. Treatment is through various therapies. This can limit most complaints. Usually there are no complications. However, it cannot be predicted whether the course of the disease will be completely positive. The life expectancy of the affected person is usually not reduced by this dysfunction.
When should you go to the doctor?
If diffuse pain occurs in the face and cervical spine, there may be a craniomandibular dysfunction. A doctor’s visit is indicated if the symptoms do not go away on their own or if other signs of illness appear. Symptoms such as a burning sensation in the mouth and tongue, earache or difficulty swallowing require medical clarification. People who experience restricted mobility in the cervical spine or other problems with normal movements should contact their family doctor. The same applies if visual disturbances, dizziness or tiredness occur without any specific underlying cause.
If these symptoms rapidly increase in intensity, it is best to consult a doctor immediately. People who suffer from a misalignment between the lower jaw and the skull, grind their teeth or suffer from osteoarthritis are particularly prone to developing TMJ dysfunction. Anyone who is part of these risk groups must speak to the responsible doctor immediately if the symptoms mentioned occur. The condition is usually treated by an orthopedist or an internist. In less severe cases, the dysfunction does not require treatment.
Treatment & Therapy
The therapy of the craniomandibular dysfunction depends on the triggering cause. In principle, a gentle and reversible treatment is used. In order to relieve the chewing muscles and the jaw joints and to coordinate body and bite statics, the patient is given a special bite splint (occlusal splint). In addition, physiotherapy can be carried out to relieve muscle tension and strengthen the muscles.
In addition, malpositions and functional disorders of the jaw joint can be treated in this way. However, the actual benefit of an occlusion splint has not yet been scientifically confirmed. There are several studies with different test results that either speak for or against the effectiveness of the splint.
In the case of chronic pain, the patient usually receives medication that has a pain-relieving, anti-inflammatory, sleep-promoting or muscle-relaxing effect, which leads to an improvement in the quality of life. The use of transcutaneous electrical nerve stimulation (TENS) is also considered useful. This electrical stimulation current therapy is used to treat pain and stimulate muscles.
The alternating current used has a low frequency. The effect of trigger point infiltrations, in which different active ingredients are administered into the muscles to relieve the symptoms, is still under discussion. Self-treatment measures by the patient are also possible. They include the use of heat, cold, stretching, stress management, relaxation exercises, and eating soft foods.
Outlook & Forecast
If the person affected by craniomandibular dysfunction uses the available medical options, there are good prospects for alleviating the symptoms that have occurred and for long-term recovery. In cooperation with a doctor, a treatment plan is drawn up and various therapies are used. In many cases, the therapies used are without any side effects. In addition, the patient receives instructions on how to carry out a symptom-free chewing process in the future. If the doctor’s specifications are met, those affected usually report an alleviation of the symptoms after a short time.
If unexpected side effects occur, this can contribute to delays in the healing process. An optimization of the treatment plan is necessary. Clarifying the cause is essential for a good prognosis. This can be difficult to recognize due to the symptoms and can take some time.
If the person concerned decides that he does not want to use medical treatment for himself, an increase in impairments can be expected. Existing pain can become more intense and spread further. The chewing process deteriorates over a longer period of time and consequential damage or other diseases occur. Spontaneous healing is not to be expected with this dysfunction. Although eating soft foods provides short-term relief from symptoms, health deteriorates over the course of several months.
It is possible to prevent craniomandibular dysfunction by inserting an occlusion splint. In this way, the loss of substance in the teeth can be counteracted. The use of relaxation methods is also considered useful.
Due to the complexity of the clinical picture, craniomandibular dysfunction or CMD for short requires consistent follow-up care. Here, the orthodontist and physicians from the relevant disciplines, such as orthopedists or neurologists, are often involved in interdisciplinary collaboration. Physiotherapists also often accompany this process after the acute treatment. The patient’s active cooperation is also often a very decisive factor in follow-up care with CMD.
The malocclusion that led to the CMD symptom complex can be avoided during follow-up care by using special bite splints. Regular dental and orthodontic check-ups are also important. If psychological problems lead to nocturnal teeth grinding, these should also be addressed as best as possible during aftercare. In this context, stress can be reduced by relaxation methods such as progressive muscle relaxation according to Jacobsen, autogenic training or even going to the psychologist. Yoga is also often helpful here.
Physical complaints such as neck tension, back pain and headaches caused by CMD can often only be improved over a long period of time. It is therefore also important in the aftercare of craniomandibular dysfunction to build up weak muscles, stretch shortened muscles and do something good for tense muscles with massages. For the upright posture of the spine, which is particularly important in CMD, targeted gymnastics for the back or attending back school can be helpful.
You can do that yourself
In the case of craniomandibular dysfunction, severe pain can occur in the jaw area, which extends to the back and abdomen. The everyday life of those affected by craniomandibular dysfunction is often severely restricted and their quality of life suffers.
In the area of self-help in everyday life, all measures that take the tension out of the jaw are therefore useful. Wearing appropriate bite splints can be a first step towards relief. A physiotherapist who specializes in TMJ can show people exercises and massage techniques they can use at home. A common cause is the constant clenching of the teeth. Most of the time this happens unconsciously. Stress and permanent tension in everyday life are the causes here. Those affected must therefore learn certain techniques for relaxation and individual stress management in order to take pressure off themselves and their jaws. exercises like yoga, which are regularly integrated into everyday life, bring relief to many patients.
The process by which a temporomandibular joint starts to hurt is usually a lengthy one. Accordingly, it can also take a while before self-help measures in everyday life such as stress reduction, relaxation exercises and wearing splints show a lasting effect. It is therefore important that these measures are implemented consistently.