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TMJ Disorder

discomfTMJ disorders are problems related to your jaw joint. TMJ stands for Temporomandibular Joint, which is the name for each joint (right and left) that connects your jaw to your skull. Symptoms like pain or a “clicking” sound of the jaw joint are common with TMJ problems. Since some types of TMJ problems can lead to more serious conditions, early detection and treatment are important. Treatments vary depending on the symptoms and problems that are identified. Some problems require additional testing and imaging. MRI examination is common in cases when the joint health is in question. Sometimes treatment involves physical therapy or medications or both. A splint is often required when the teeth don’t fit well together, or clenching or grinding is suspected. Your dentist may be contacted to provide the splint if one is needed for your treatment. Unfortunately, some problems can only be corrected with surgery to the joint.
No one treatment can resolve TMJ disorders completely and treatment takes time to become effective. Drs. Gorab, Marsh and Scoggins can 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 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, 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


There are various treatment options that Drs. Gorab, Marsh and Scoggins can utilize to improve the harmony and function of your jaw. Once an evaluation confirms a diagnosis of TMJ disorder, the doctor 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 goals of treatment are to decrease symptoms and restore function. Usually this means relieving the muscle spasms and joint pain, which will allow normal function to return. Medications such anti-inflammatory medications or a muscle relaxant may be prescribed. Steroids can be injected directly into the joints to reduce pain and inflammation. Self-care treatments can often be effective as well and include:
1. Heat and massage to sore jaw and neck muscles to relieve stress and tenderness.
2. Avoiding clenching and grinding when you are awake.
3. Use of a night guard to avoid clenching and grinding when you are asleep (see below).
4. Soft non-chew diet.
5. Avoiding muscle stimulants such as caffeine and nicotine.
6. Taking over the counter medications that relieve inflammation, like Advil.
7. Exercising your jaw.
8. Practicing good posture.
Stress management techniques such as biofeedback or professional physical therapy may also be recommended, as well as a splint your dentist can make for you. 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. These appliances also help to protect your teeth from wear.

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. Gorab, Marsh and Scoggins do not consider TMJ surgery unless all other options have failed and jaw function cannot be restored without surgery.