TMJ Disorders

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.

No one treatment can resolve TMJ disorders completely and treatment takes time to become effective. Dr. Werner, Dr. Rubel, Dr. Strange or Dr. Madson might be able to help you have a healthier and more comfortable jaw.

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 and 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, clicking or grating noises when you open your mouth and cause 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

Generally TMJ disorders are initially managed with conservative, or non-surgical, treatment modalities before any surgical interventions are considered.

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 protect your teeth during clenching or grinding of your teeth and can help reduce muscle tension at night to protect the cartilage and joint surfaces. An anterior positioning appliance moves your jaw forward to relieve pressure on parts of your jaw and aid in disk repositioning. It may need to be worn 24 hours/day to help your jaw heal. An orthotic stabilization appliance is worn 24 hours/day or just at night to move your jaw into proper position. These should not be worn for too long after treatment as it can cause your teeth to shift positions. Appliances also can help to protect from tooth wear.

There are various treatment options that Drs. Werner, Rubel, Strange or Madson can utilize to improve the harmony and function of your jaw. Once an evaluation confirms a diagnosis of a TMJ disorder, Drs. Werner, Rubel, Strange or Madson will determine the proper course of treatment. The treatment of TMJ disorders often involves multiple doctors, including oral medicine specialists and your dentist. 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 possible muscle spasms and joint pain. This is usually accomplished with an anti-inflammatory or muscle relaxant. Steroids can be injected directly into the joints to reduce pain and inflammation at times. 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

What About Bite Correction Or Surgery?

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 are sometimes needed, but are reserved for severe cases. Drs. Werner, Rubel, Strange or Madson do not consider TMJ surgery unless the jaw has significant dysfunction, is dislocated and non-reducible, has severe degeneration or the patient has undergone non-surgical treatment unsuccessfully by their dentist.