TMD and the lateral pterygoid muscle question

[kris191]

hi,

I have a few question i hope someone can answer about TMD and the lateral pterygoid muscle...

Does this happen mostly when there is a displaced disk? i.e. when the jaw moves to one side and kind of clicks out of place when opening or yawning?

If so will the lateral pterygoid muscle always be in spasm if there is a problem? or can the muscle move from a normal state to being in spasm intermittently?

When this muscle is in spasms, is this the muscle that has been identified as probably being responsibly for tinnitus and if the tinnitus varies in pitch and intensity could be linked to when the lateral pterygoid muscle muscle is in spasm or when is more stressed that normal because of TMD problems?

Can TMD cause Eustation tube dysfunction when no infections or any other signs of problems are present? is common in people with TMD?

and finally....

What is the best permanent, but conservative treatment for a displaced disk?

thanks in advance.

kris

[terri1234]

I read your question and answers with interest since I have been suffering from facial pain and some of the other things you mentioned like tinnitus and eustachian tube drainage.  I have been thinking it is all neck and spine related, and even had a spinal fusion which only made it worse.  But since the surgery I have located the Pterygoid muscles as being one of my BIG problems, altho not the only problem.  So my question to you is: how does one know if the disc is displaced?  Also, do you have any trouble talking and forming words?  My face get pulled down by those muscles and I feel like I can't even talk.  Any, any help is appreciated.  Thanks.

[scottma]

Some tmj sufferers may have disc pathology beyond repairment at the time of diagnosis and treatemnt, as long as ideal occlusion is established, non-painful function of neuromuscular system is still achievable. If you are highly interested and motivated, Please review the textbook written by peter dawson, tilted" functional occlusion,from tmj to smile design." This book may not be accepted universally by all tmj specialists, but it does offer some good clinical observations and experiences for practitioners.

[kris191]

thanks for your replay scottma....

if occlusal therapy doesn't always always fix the displaced disk, how can this help harmonize the function of the mastication muscles?

[scottma]

It is believed that hypercontraction or spasm of superior lateral pterygoid muscle is the main culprit of disc displacement. Myofascial trigger point pathology of superior lateral pterygoid muscle is documented to be associated with tinnitus and referred pain of tmj. Harmonious function of  masticatory muscles requires optimized occlusion.Occlusal therapy ,either through occlusal appliance or occlusal equilibration, generally is highly effective for temporomandibular disorder. Displaced disc is not always reduced after occlusal therapy. However, non-reduced disc  can still function well without causing problem.