TMJ Disorders

TMJ (temporomandibular joint) disorders are a family of problems related to the 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, of which there are two (one on the right and one on the left), serving to connect the jaw to the base of the skull. Since some types of TMJ problems can lead to more serious conditions, early detection and treatment are important.

It is unlikely that any single treatment can resolve TMJ disorders completely and treatment takes time to become effective.

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 Dr. Minkin can utilize to improve the harmony and function of your jaw. Once an evaluation confirms a diagnosis of TMJ disorder, your 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 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 can be used 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 clear plastic appliance known as a splint. A splint (also know as an orthosis 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, but generally they all help to deter clenching or grinding of your teeth and reduce muscle tension at night. It can also help to protect the cartilage, joint and tooth surfaces from abnormal stress and wear.

In many cases of TMJ disease and dysfunction, a minimally invasive technique known as TMJ arthrocentesis can be very effective. It is a simple office procedure, usually done with intravenous anesthesia. The main goal of arthrocentesis is to clear the joint of any possible adhesions and tissue debris which could be causing pain and inability to use the jaw properly. It can be very useful in cases where the joint is locked and the patient cannot open past a certain range, especially if the problem is treated early. Many patients are able to avoid other more involved treatments, such as bite adjustment (equilibration), orthodontics combined with jaw reconstruction, extensive restorative dental work, or surgery directly on the jaw. Although these procedures are sometimes needed even after arthrocentesis, they can sometimes be avoided with early intervention using arthrocentesis and splint therapy. They are usually reserved for severe cases and fortunately the vast majority of patients are not in this category.

In many cases of TMJ disease and dysfunction, a minimally invasive technique known as TMJ arthrocentesis can be very effective.