In the Craniomandibular Dysfunction it is a malfunction of the jaw. These are noticeable through different symptoms.
What is Craniomandibular Dysfunction?
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The Craniomandibular Dysfunction is also known as Craniomandibular dysfunction, CMD or Functional pain syndrome designated. This generic term refers to functional, structural or psychological dysregulations of the temporomandibular joint. The malfunctions sometimes also cause pain. The complaints arise from disturbances in the interaction of joints, muscles and tendons.
About five to ten percent of all adults suffer from craniomandibular dysfunction. The jaw problems are particularly common in women who are of childbearing potential. During the menopause the symptoms usually improve. In younger children, however, craniomandibular dysfunction occurs only very rarely. The disease then increases up to puberty. There is a specific need for treatment with CMD in only around three percent of the population.
causes
Craniomandibular dysfunction is usually caused by a misalignment between the human lower jaw (mandible) and the skull (cranium). If the mandibular joint head is not in its correct position within the joint socket, there is even a risk of a dislocation of the jaw.
Common triggers of a craniomandibular dysfunction are the firm pressing of the jaws together and the grinding of the teeth (bruxism). In the temporomandibular joint, these problems often lead to disc displacements, osteoarthritis or myofascial pain. 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, and hormonal or sleep disorders. Psychological reasons are also included among the causes. This can be post-traumatic stress disorder or depression. Orthodontic therapies or the use of tooth crowns that are too high are sometimes the cause of craniomandibular dysfunction.
Symptoms, ailments & signs
Craniomandibular dysfunction leads to a wide variety of complaints. Primarily diffuse pain occurs, which can be seen both during movement and at rest. The pain is usually constant and dull. In addition, the symptoms can extend to the mouth, forehead, temples, eye socket, cheeks, neck, cervical spine, shoulders and back.
It is not uncommon for those affected to suffer from restricted jaw opening as well as rubbing and cracking noises when they open or close their jaws. A burning sensation in the mouth or tongue, tinnitus and ear pain are also possible. Some people also experience increased salivation, difficulty swallowing, visual disturbances, dizziness, tiredness and poor concentration. Movement restrictions sometimes occur in the cervical spine.
Diagnosis & Therapy
Since the symptoms of craniomandibular dysfunction are as numerous as they are varied, an exact diagnosis can be difficult in some patients. As a rule, the dentist is consulted first if there are complaints about the jaw. This can be used to determine whether the problems originate in the teeth or the temporomandibular joint. The dentist also checks possible sources of infection on the teeth.
A kinesiography can be used for a more precise examination that determines whether the jaw problems are caused by changes in jaw movements or by individual teeth. Electromyography is possible to determine muscle spasms. Other examination methods that can be considered are the taking of x-rays, radiological methods or an instrumental functional analysis (API / CPI).
However, psychological factors can also trigger craniomandibular dysfunction. For this reason, the patient is given some questionnaires to fill out. This must show a high degree of patience in the diagnosis, as it is considered to be time-consuming. Usually, craniomandibular dysfunction can be treated well. The disease usually takes a positive course. The symptoms improve after a few weeks.
Complications
With this disease, those affected primarily suffer from complaints of the jaw. These complaints have a very negative effect on the quality of life of the person affected and can significantly reduce it. Usually the patients suffer primarily from severe pain. The pain also occurs as resting pain and can lead to discomfort, especially at night, and thus to sleep problems.
It is not uncommon for patients to suffer from depression or appear irritable. The pain from the jaw can also spread to the eyes or head and lead to discomfort in these regions as well. The ingestion of food and liquids is also made more difficult by this complaint, so that deficiency symptoms or malnutrition may occur. Swallowing difficulties or visual disturbances can also occur.
It is not uncommon for patients to be unable to concentrate and to suffer from persistent fatigue. Treatment is carried out through various therapies. This can limit most complaints. There are usually no complications. However, it cannot be predicted whether the course of the disease will be completely positive. The life expectancy of the person affected is usually not restricted by this dysfunction.
When should you go to the doctor?
If there is diffuse pain in the face and cervical spine, the cause may be craniomandibular dysfunction. A doctor's visit is indicated if the symptoms do not subside by themselves or if other symptoms appear. Symptoms such as burning in the mouth and on the tongue, ear pain 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 there is visual disturbance, dizziness or fatigue, for no specific cause.
If these symptoms increase rapidly 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 craniomandibular 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 orthopedic surgeon or internist. In less severe cases, the dysfunction does not need treatment.
Therapy & Treatment
Treatment of craniomandibular dysfunction depends on the underlying cause. In principle, a gentle and reversible treatment is used. The patient is given a special bite splint (occlusion splint) to relieve the jaw muscles and the temporomandibular joints and to coordinate the body and bite statics. Physiotherapy can also be undertaken to reduce tension in the muscles and to strengthen the muscles.
In addition, malpositions and functional disorders of the temporomandibular joint can be treated in this way. However, the actual benefit of an occlusal splint has not yet been clearly scientifically confirmed. There are several studies with different test results that are either for or against the effectiveness of the splint.
For chronic pain, the patient is usually given 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 sensible. This electrical stimulation current therapy is used to treat pain and to stimulate the muscles.
The alternating current used has a low frequency. The effect of trigger point infiltration, in which different active ingredients are administered into the muscles to alleviate the symptoms, is still under discussion. Self-treatment measures for the patient are also possible. They include the use of heat, cold, stretching exercises, stress management, relaxing exercises and the consumption of soft foods.
You can find your medication here
➔ Toothache medicationOutlook & forecast
If the patient with craniomandibular dysfunction makes use of the available medical options, there are good prospects for alleviation of the symptoms and long-term recovery. In collaboration with a doctor, a treatment plan is drawn up and various therapies are used. In many cases the therapies used have no other side effects. In addition, the patient receives instructions on how he can 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, contrary to expectations, 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 accordingly 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 worsens over a longer period of time and consequential damage or further illnesses occur. Spontaneous healing is not to be expected with this dysfunction. Although the consumption of soft foods results in short-term relief from symptoms, health deteriorates over the course of several months.
prevention
A prevention of craniomandibular dysfunction is possible by inserting an occlusal splint. In this way, the loss of substance in the teeth can be counteracted. The use of relaxation methods is also considered useful.
Aftercare
Craniomandibular Dysfunction, or CMD for short, requires consistent follow-up care due to the complexity of the clinical picture. 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. Active cooperation of the patient is also often a very decisive factor in aftercare with CMD.
The wrong bite, which led to the symptom complex of CMD, can be avoided as part of follow-up care by using special bite splints. Regular dental and orthodontic checks are also important. If psychological problems lead to teeth grinding at night, these should also be addressed in the best possible way in follow-up care. In this context, stress can be effectively reduced by relaxation methods such as progressive muscle relaxation according to Jacobsen, autogenic training or even going to a psychologist. Yoga is also often helpful here.
Physical complaints such as neck tension, back pain and headaches that are triggered by CMD can often only be improved in a long-term process. Therefore, in the follow-up care of craniomandibular dysfunction, it is important 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 the back school can be helpful.
You can do that yourself
Craniomandibular dysfunction can cause severe pain in the jaw area that extends into the back and abdomen. The everyday life of those affected by craniomandibular dysfunction is often severely restricted and the quality of life suffers.
In the area of self-help in everyday life, all measures that take the tension out of the jaw make sense. Wearing appropriate bite guards can be a first step towards relief. A physiotherapist who specializes in craniomandibular dysfunction can show sufferers exercises and massage movements that they can also use at home. A common cause is constant clenching of the teeth. Usually this happens unconsciously. Stress and constant tension in everyday life are the cause here. Sufferers therefore have to learn certain relaxation techniques and individual stress management in order to take pressure off themselves and the jaw. Exercises like yoga, which are regularly integrated into everyday life, bring relief to many patients.
The process that a temporomandibular joint starts to hurt is usually a long one. Accordingly, it can take a while before measures for self-help 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.
