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“TMD”, my jaw popped out

"TMD" is a curse word in Chinese that comes out with a strong attitude. Coincidentally, it is also one of the abbreviations for Temporomandibular Joint Disorder (TMD, TMJD). The term "TMD" refers to a collection of disorders with similar clinical symptoms whose etiology is still being investigated. It can be

classified as acute or chronic (lasting more than three months), depending on the duration. Some experts have suggested that the term "TMD" may be discarded in the future because some of the etiology has been fully identified and distinguished into different conditions.

Factors that may contribute to TMD include injury to the TMJ, such as wearing, tearing, or misalignment of the joint disks; structural abnormalities of the TMJ itself, or the presence of joint disease and inflammation, such as rheumatic diseases; false dental bites; dental health and oral hygiene problems; excessive tension or damage to the muscles surrounding the joint; genetic factors, with some individuals having a genetic predisposition to develop TMD more easily; emotional stress, anxiety, fatigue, and other social and psychological factors; personal lifestyle, such as chewing and sleeping on only one side, teeth grinding, and supporting one’s chin with hands, preference for overly hard foods, staying up all night, lack of sleep, and exposure to low temperature.

These factors may cause the joints to become overloaded, gradually beyond their

physical limits, therefore affecting their structure and function, which over time

may lead to the development of TMD. It is worth noticing that women are more likely to develop the disease than men, with a peak age in the 20s and 30s, and such a demographic profile may be related to lifestyle.

Possible symptoms of TMD include facial asymmetry; popping, dislocation, or locking of the joints, especially when opening, chewing, biting, or waking up in the morning, which may be noticeably uncomfortable or restricted, with many patients opening their mouths naturally to a width of only two fingers, with occlusal dysfunction; and persistent or intermittent localized pain or tenderness in the joints, frequent headaches, or neck pain, perhaps along with tinnitus. The examination involves a comprehensive clinical examination and imaging methods such as MRI, and should not be a "diagnosis of Google".

Possible treatments include changing daily habits, avoiding excessive mouth opening, sleeping on both sides, limiting chewing of hard objects, relaxing local muscles, etc. Medicine, such as anti-inflammatory and analgesic agents that nourish cartilage and relax muscles; injection therapy into the joint cavity and surrounding muscles, usually with sodium citrate injections to lubricate the joints; some of the new antidepressant medications have also proven effective. Physical therapy, like massage, stretching, and exercises specially designed to strengthen or relax muscles; and heating using infrared physical therapy devices. Orthodontic treatment to maintain oral hygiene, most commonly occlusal pads, and customized "plastic braces" to keep the upper and lower teeth in place, stabilizing the joints and muscles, and relieving tension.

It often takes a combination of several factors for a disease to occur. Since the exact cause of TMD is still unidentified, there are ongoing controversies regarding the best course of treatment. Conservative treatment and symptomatic relief using a variety of modalities is the main adoption; Some patients can recover on their own, while severe cases may undergo surgeries like joint replacement. In some cases, TMD may gradually develop into a long-term or chronic problem, and it is worth noticing that maintaining a good mood is crucial to recovery. When chewing, the temporomandibular joints (TMJs) are under great pressure and the joints need to move flexibly during speech, making it ironically challenging for patients to speak of their pain.

About one-third of adults suffer from TMD with varying degrees of severity, and many patients are not even aware that they have TMD. Due to the symptoms,  causes, and diverse treatments of the disease, there are many unsettled controversies. Many patients are at a loss,  not knowing how to seek medical assistance, complaining about their sufferings on the Internet, visiting various hospitals, yet receiving no assertive diagnosis or effective treatment.

TMD is more common and disturbing than it may seem. If you experience any

suspicious symptoms, please seek medical advice as soon as possible.


76, no. 10, Nov. 2007, pp. 1477–82.

Thomas, Davis C., et al. “Temporomandibular Joint Disorder Comorbidities.” Dental Clinics of North America, vol. 67, no. 2, Apr. 2023, pp. 379–92. PubMed,

Wadhokar, Om C., and Deepali S. Patil. “Current Trends in the Management of Temporomandibular Joint Dysfunction: A Review.” Cureus, vol. 14, no. 9, Sept. 2022, p. e29314. PubMed,

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