Temporomandibular Joint Disorder (TMD)

Dibujo esquemático de la ATM o articulación temporomandibularThe temporomandibular joint (TMJ) is formed by the jawbone with the temporal bone of the skull. It is composed of a set of anatomical structures that, aided by specific muscle groups, allow the jaw to perform various movements (opening and closing, protrusion, retrusion, lateral movements) necessary for chewing function.

 

ATM 2

During diving, the TMJ can be affected by trauma, fractures, or dislocations, although these are very rare; the most common alteration is called temporomandibular joint dysfunction (TMJD), which occurs as a result of wearing and clenching the regulator mouthpiece during the duration of the dive or dives performed. The joint is neither structurally nor functionally prepared to maintain that position continuously, leading to an overload that results in the characteristic symptoms of TMJD:

  • Pain over the joint, worsening with movement or pressure, which may radiate to the ear or even cause headaches.
  • Joint noises, such as clicks or pops when opening or closing the mouth.
  • Limitation of joint movements.

 

Buceador utilizando regulador con boquilla personalizada

TMJD occurs more frequently in females, when diving in cold water, under stress, or with pre-existing inflammatory (arthritis) or degenerative (osteoarthritis) conditions of the TMJ, or dental occlusion abnormalities. The type of mouthpiece used also plays a role: soft silicone or acrylic resin mouthpieces that mold to fit the diver’s bite (customized mouthpieces) seem to be associated with a lower incidence of TMJD.

Treatment for TMJD involves pharmacological therapy with anti-inflammatories, analgesics, and muscle relaxants, rehabilitation with splints, and in severe cases, surgical treatment.