TMD/TMJ
TMJ (temporomandibular joint) disorders are a family of problems related to your complex jaw joint. If you have had symptoms like pain or a “clicking” sound, you’ll be glad to know that these problems are more easily diagnosed and treated than they were in the past. These symptoms occur when the joints of the jaw and the chewing muscles (muscles of mastication) do not work together correctly. TMJ stands for Temporomandibular Joint, which is the name for each joint (right and left) that connects your jaw to your skull. Since some types of TMJ problems can lead to more serious conditions, early detection and treatment are important. Please tell us if you are experiencing symptoms. No one treatment can resolve TMJ disorders completely and treatment takes time to become effective.
Trouble with Your Jaw?
TMJ disorders develop for many reasons. You might clench or grind your teeth, tightening your jaw muscles and stressing your TM joint. You may have a damaged jaw joint due to injury or disease. Injuries and arthritis can damage the joint directly or stretch or tear the muscle ligaments. As a result, the disk, which is made of cartilage and functions as the “cushion” of the jaw joint, can slip out of position. Whatever the cause, the results may include a misaligned bite, pain, a clicking or grating noise when you open your mouth, or trouble opening your mouth wide.
Do You Have a TMJ Disorder?
- Are you aware of grinding or clenching your teeth?
- Do you wake up with sore, stiff muscles around your jaws?
- Do you have frequent headaches or neck aches?
- Does the pain get worse when you clench your teeth?
- Does stress make your clenching and pain worse?
- Does your jaw click, pop, grate, catch, or lock when you open your mouth?
- Is it difficult or painful to open your mouth, eat or yawn?
- Have you ever injured your neck, head or jaws?
- Have you had problems (such as arthritis) with other joints?
- Do you have teeth that no longer touch when you bite?
- Do your teeth meet differently from time to time?
- Is it hard to use your front teeth to bite or tear food?
- Are your teeth sensitive, loose, broken or worn?
The more times you answered “yes,” the more likely it is that you have a TMJ disorder. Understanding TMJ disorders will also help you understand how they are treated.
Treatment
If your TMJ disorder has caused problems with how your teeth fit together, you may need treatment such as bite adjustment (equilibration), orthodontics with or without jaw reconstruction, or restorative dental work. Surgical options such as arthroscopy and open joint repair restructuring are sometimes needed but are reserved for severe cases. Wendel Family Dental Centre will refer you to an oral and maxillofacial surgeon if more in depth treatment is necessary.
Diagnosis
Bruxism
Bruxism is the clenching or grinding of the teeth, which occurs primarily while you are sleeping. The symptoms of bruxism are:
- a sore, tired jaw
- difficulty opening and closing your mouth
- sensitive teeth
- earaches or pain in your jaw joint
The pressure on your teeth is many times greater during bruxism than during normal chewing. If left untreated you may experience:
- flattened or worn-down teeth
- chipped and broken teeth
- loose teeth
- damage to the bone around your teeth
- damage to your jaw joint, the TMJ
Though all the causes of grinding are not known, stress is often a factor. There are a variety of stress-reduction techniques that may be helpful, or medication might be recommended to temporarily reduce stress or to reduce pain and soreness.
Spaces, worn teeth, or teeth that are out of alignment may cause grinding and clenching. Crowns, bridges, or other dental restorations can restore your bite and eliminate the pattern of grinding and clenching. One of the most common and effective ways to stop the damage caused by grinding and clenching is the use of a NTI appliance or nightguard. Nightguards and NTI appliances are plastic devices that fit over your teeth and are worn at night to protect them from the damage caused by grinding. There are many types and styles of nightguards. Some are hard and some are soft; they may be worn on the top or the bottom teeth. Without treatment, the constant clenching and grinding of your teeth can cause widespread damage in your mouth. Dealing with the problem early on can restore harmony and prevent many future problems.
Treatment
There are various treatment options to improve the harmony and function of your jaw. Once an evaluation confirms a diagnosis of TMJ disorder, Wendel Family Dental Centre will determine the proper course of treatment. It is important to note that treatment always works best with a team approach of self-care joined with professional care.
The initial goals are to relieve the muscle spasm and joint pain. This is usually accomplished with a pain reliever, anti-inflammatory or muscle relaxant. Steroids can be injected directly into the joints to reduce pain and inflammation. Self-care treatments can often be effective as well and include:
- Resting your jaw
- Keeping your teeth apart when you are not swallowing or eating
- Eating soft foods
- Applying ice and heat
- Exercising your jaw
- Practicing good posture
Stress management techniques such as biofeedback or physical therapy may also be recommended, as well as a temporary, clear plastic appliance known as a splint. A splint or nightguard fits over your top or bottom teeth and helps keep your teeth apart, thereby relaxing the muscles and reducing pain. There are different types of appliances used for different purposes. A nightguard helps you stop clenching or grinding your teeth and reduces muscle tension at night and helps to protect the cartilage and joint surfaces. An anterior positioning appliance moves your jaw forward, relieves pressure on parts of your jaw and aids in disk repositioning. An orthotic stabilization appliance is worn all-day or just at night to move your jaw into proper position. Appliances also help to protect from tooth wear.
Bite Adjustment
A bite is considered to be healthy when all or most of the teeth are present and not destroyed by normal daily usage. It is destructive when teeth show wear, looseness or when TMJ (jaw joint) damage is seen. Bite therapy helps restore a bite that can function without damage and destruction.
The therapy may include:
- Reshaping the biting surfaces of the teeth and eliminating spots of excessive pressures where the teeth are brought into contact. This is done by carefully dividing bite pressures evenly across all of the teeth.
- Bite splint therapy using a custom fitted and adjusted plastic bite guard to keep the teeth apart, day, night or both.
- Braces, to reposition mal-aligned or drifted teeth.
- Replacement of old, worn out or damaged fillings.
- Reconstruction of badly worn and damaged teeth.
