TMJ Disorders

TMJ disorders are a family of problems related to your complex jaw joint. TMJ stands for temporomandibular joint, which is the name for each joint (right and left) that connects your jaw to your skull. If you have had symptoms like pain or a clicking sound in your jaw, you’ll be glad to know 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 do not work together correctly. Since some types of TMJ problems can lead to more serious conditions, early detection and treatment are important.

Causes

• Clenching or grinding 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 of the above, the disk which is made of cartilage and functions as the “cushion” of the jaw joint can slip out of position.

Regardless of the cause, the results may include a misaligned bite, pain, clicking or grating noise when you open your mouth, or you may have 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 may have a TMJ disorder. Understanding TMJ disorders will also help you understand how they are treated.

Treatment

Once an evaluation confirms a TMJ diagnosis, our doctors will determine the proper course of treatment. It is important to note that the treatment typically works better 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 agent or muscle relaxant. Steroids can be injected directly into the joints to reduce pain and inflammation.

• Self-care treatments often work 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 and 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. The splint (or night guard) fits over your top and bottom teeth and helps keep your teeth apart, thereby relaxing the muscle and reducing pain.

• Different types of appliances serve different purposes. A night guard helps you stop clenching or grinding your teeth and reduces muscle tension at night, helping 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 24 hours/day or just at night to move your jaw into proper position.

• If your TMJ disorder has caused problems with how your teeth fit together, you may need treatment such as bite adjustment, 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. TMJ surgery is generally only considered when the jaw can’t open, is dislocated and nonreducible, has severe degeneration, or if the patient has undergone appliance therapy treatment unsuccessfully.