TMJ Disorders

TMJ disorders are a family of problems related to your complex jaw joint.

What is TMJ?

TMJ stands for Temporomandibular Joint, which is the name for each joint (right and left) that connects your jaw to your skull.

Clicking or popping sounds from your TMJ area are found in 40% of the normal population at one time or another without any dysfunctional problems (pain or limited motion) associated with it. In the cases where symptoms like pain with limited motion with a “clicking” or “popping” sounds occur, we now call this TMD or Temporomandibular Dysfunction.

Treatment of TMD or TMJ disorders

You’ll be glad to know that these problems are more easily diagnosed and often treated non surgically or with minimally invasive surgery 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. Since some types of TMJ problems can lead to more serious conditions, early detection and treatment are important.

No one treatment can resolve TMD disorders completely and treatment often takes time to become effective.

What causes TMJ disorders?

TMJ disorders develop for many reasons. Some of the most common causes of TMJ disorders are:

  • Clenching
  • Grinding
  • Tightening jaw muscles
  • Stress
  • Injury
  • Arthritis

Any of the causes listed above 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 result may include a misaligned bite, pain, clicking, or grating noise when you open your mouth or trouble opening your mouth wide.

How do you know if you have a TMJ disorder?

As we mentioned earlier, just because you are experiencing popping of your jaw does not mean that you have a TMJ disorder. The following questions are a good resource to help you determine whether or not you should call our office for a consultation.

  • 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?
  • Is stress making 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 TMD disorder. Understanding TMD disorders will also help you understand how they are treated.

Treatment of TMJ disorders

There are various treatment options that we can utilize to improve the function of your jaw. However, the first step in treatment is always an evaluation. This allows us to confirm a diagnosis of TMJ disorder, and then proceed with the proper course of treatment. Regardless of the specific treatment plan, outcomes are always 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, or muscle relaxant. Steroids can be injected directly into the joints to reduce pain and inflammation.

Self-care treatment

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 intermittently to the affected joint and muscles
  • Exercising your jaw for regaining normal range of motion when the pain subsides
  • Practicing good posture

Professional treatment

Most often, you will likely be referred to a TMD Oral-Facial Pain specialist first for evaluation and treatment. This specialist will usually recommend non-surgical type of treatment prior to being considered for any surgical intervention. Some non-surgical treatments include:

  • Stress management techniques such as biofeedback
  • Physical therapy
  • Splints – temporary plastic appliance or night guard.

Different types of appliances or splints

Splints are temporary, clear plastic appliances (sometimes referred to as night guards. Appliances also help to protect from tooth wear. There are different types of appliances used for different purposes.

  1. Night Guard – A night guard helps you reduce clenching or grinding forces on your teeth and reduces muscle tension at night and therefore helps to protect the cartilage and joint surfaces.
  2. Anterior Positioning – An anterior positioning appliance moves your jaw forward, relieves pressure on parts of your jaw and aids in disk repositioning. It may be worn 24 hours/day to help your jaw heal.
  3. Orthotic Stabilization – An orthotic stabilization appliance is worn 24 hours/day or just at night to move your jaw into proper position.

 

What about Bite Correction or Surgery?

If your TMD disorder has caused problems with or was the result of 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. Dr. Chun does not consider or recommend TMJ surgery unless the jaw can’t open chronically more than 25mm, is dislocated and nonreducible, has severe degeneration with significant pain, or the patient has undergone appliance and physical therapy treatment unsuccessfully and is recommended by the Oral Facial Pain / TMD specialist for surgical treatment.