TMJ dysfunction with various complaints
The diagnosis of cranio mandibular dysfunction (CMD) is generally far less known than gnashing of teeth (bruxism), although both are often closely related. It is not uncommon for sufferers to suffer from the unrecognized illness with its diverse symptoms for a long time. There can be very different causes of pain in the temporomandibular joint, which radiate from there to other parts of the body. Once the CMD has been diagnosed, simple therapy methods often help.
CMD - short overview
- What is CMD? CMD stands for Cranio Mandibular Dysfunction, a collective term for functional disorders of the temporomandibular joint. The disorders often occur together or as a result of teeth grinding.
- What are the symptoms of CMD? A variety of symptoms can be related to CMD. In addition to pain and restricted movement of the chewing organ and in the jaw, there may also be ear complaints, headaches, shoulder and back pain and other symptoms.
- How is CMD treated? Conservative therapy measures are usually very effective, depending on the causes. In many cases, occlusal splints, manual therapies and methods for reducing stress lead to successful treatment.
Definition - What is Cranio Mandibular Dysfunction?
In the professional world, the term cranio mandibular dysfunction is used as an umbrella term for existing malpositions and associated functional disorders of the temporomandibular joints. The term is derived from the skull (cranium) and lower jaw (mandible), where the jaw joints are located. Dysfunction generally describes a malfunction.
CMD also summarizes a variety of symptoms in the area of the chewing muscles, the temporomandibular joint and the adjacent structures in the mouth area or in the head area. But complaints can also occur in almost all other areas of the body.
According to a CMD statistic from the Society for Dental Health, Function and Aesthetics, around 20 percent of the population is affected by a CMD and needs treatment. This corresponds to the generally accepted frequency of gnashing of teeth (bruxism) - a symptom that, according to the German Dental Association, can lead to cranio mandibular dysfunction. Teeth grinding occurs especially at the age of thirty-five to forty-five and affects women more than men.
The particular complexity of the possible symptoms that can occur with cranio mandibular dysfunction often complicates the diagnosis and appropriate treatment. Symptoms can occur not only on the temporomandibular joint and in the entire area of the chewing apparatus, but also in distant parts of the body.
Pain and functional limitations of the chewing organ are the main general symptoms. This can cause pain in the masticatory muscles, in the temporomandibular joint and in the area of the ears (ringing in the ears or tinnitus, pressure in the ears, ear crack).
Due to the changed, asymmetrical movements of the upper and lower jaw and the incorrect bite position, functional disorders develop, which can lead to jaw cracking and tooth problems, but also to facial pain and headache. The cause is usually certain chewing muscle overloads, which lead to radiating pain in the head. Even neck pain and tension, shoulder pain, back pain and other ailments can be related to CMD.
CMD: causes and risk factors
The development of cranio mandibular dysfunction is essentially based on two main factors: misaligned teeth and stress. But other triggers can also lead to problems with the jaw.
Stress and mental stress
The chewing system performs the most complex joint movements in the body. It owes this to its three-dimensionally movable jaw joints. In addition, the chewing muscles are able to mobilize the greatest punctual force. During periods of stress, some people tend to clench their teeth or grind their teeth (especially during sleep). After a while, this becomes visible on a worn bit (abrasion) and a changed bite height. The disturbed interplay of skull and lower jaw then develops.
However, disturbances in the bite caused by misaligned teeth or anomalies in the bite position can also cause a CMD. Possible gaps here include tooth gaps and unsuitable dentures.
With CMD, it is also important to always consider other possible causes. These can be very different and range from the consequences of an accident or treatment and incorrect posture (cervical spine) to excessive chewing on chewing gum, fingernails and others.
Signs of gnashing of teeth and cranio mandibular dysfunction can be noticed during a dental check-up. Losses of the hard tooth substance and other damage to the teeth can usually be clearly recognized. If pain occurs when palpating the chewing muscles, or if you experience pain and restrictions in the jaw area - when opening and closing the mouth - a suspicion of CDM is already obvious.
An accurate diagnosis can only be made using a special functional analysis, a method that is not standard in every dental practice and requires further training and interdisciplinary collaboration. Magnetic resonance therapy has proven to be suitable as a supplementary imaging method, as it can also represent soft tissue in addition to the bony structures and thus covers all structures on the temporomandibular joint.
There are also simple questionnaires for a CMD self-check. This CMD test is intended to enable people without or prior to special examination procedures to determine possible symptoms of cranio-mandibular dysfunction themselves.
Treatment of a CMD: interdisciplinary and holistic
If the diagnosis is CMD, this requires an interdisciplinary therapy tailored to the individual causes. This is the only way to effectively treat the various symptoms. The first and mostly successful therapies are conservative. Invasive measures such as oral and maxillofacial surgery should only be used if the other forms of treatment fail and serious symptoms persist.
Dental functional therapy using a bite splint (occlusal splint) is one of the most common forms of treatment. In any case, this therapy should have been preceded by a clinical and instrumental function test. An individually adjusted splint helps to prevent further wear of the teeth and the resulting consequences. The chewing muscles are also relaxed. Regular inspection appointments are necessary to continuously adapt the rail. control success and determine the duration of treatment.
In the end, the therapy goal is a healthy bite with a physiologically correct position of the temporomandibular joints.
Especially at the beginning of a CMD treatment, methods from physiotherapy and osteopathy can help to remedy the painful functional disorders in the area of the masticatory muscles and the temporomandibular joint. The diagnosis and treatment of possible incorrect posture also play an important role.
If excessive stress is a cause of the disease, this stressful situation must be resolved as quickly as possible. Various measures are suitable for this, such as psychological procedures or relaxation methods and other home remedies for stress relief.
Cold or warm applications can also help to relax the jaw muscles and alleviate the symptoms. (cs)
Author and source information
This text corresponds to the requirements of the medical literature, medical guidelines and current studies and has been checked by medical doctors.
Dr. rer. nat. Corinna Schultheis
- Society for Dental Health, Function and Aesthetics (ed.): Information and recommendation portal www.gzfa.de, diagnostics and therapy - CMD craniomandibular dysfunction, call: 11.09.2019, gzfa.de
- German Society for Dental, Oral and Maxillofacial Surgery e. V. (ed.): Website of the functional society www.gdfdt.de, patient - clinical pictures, access: 11.09.2019, dgfdt.de
- Bundeszahnärztekammer (ed.): Position paper "Bruxism as a risk factor for craniomandibular dysfunction (CMD)", January 2018, bzaek.de
- CMD-Dachverband e.V. (ed.): Information portal craniomandibular dysfunction www.cmd-dachverband.de, for patients, access: 11.09.2019, cmd-dachverband.de
- Health information center (publisher): Information portal CMD - Craniomandibular Dysfunction www.cmd-arztsuche.de, All about CMD, Access: 11.09.2019, cmd-arztsuche.de
ICD codes for this disease: K07.6ICD codes are internationally valid encodings for medical diagnoses. You can find e.g. in doctor's letters or on disability certificates.