TMJ Disorders

TMJ (temporomandibular joint) 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 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.

Treatment

The initial goals  of treatment 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 treatments can often be effective as well and include:

1. Resting your jaw
2. Eating soft foods
3. Applying ice and heat
4. Practicing good posture.
5. Anti inflammatory medications

Stress management techniques such as biofeedback or physical therapy may also be helpful, as well as a temporary, clear plastic appliance known as a splint.  A splint or nightgaurd 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.  An anterior positioning appliance moves your jaw forward, relives pressure on parts of your jaw and aids in disk repositioning.  It may be worn 24 hours/day to help your jaw heal.  An orthotic stabilization appliance is worn 24 or just at night to move your jaw into proper position.  Appliances also help to protect from tooth 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. Our doctors do not consider TMJ surgery unless the jaw can’t open, is dislocated and nonreducible, has severe degeneration, and/or the patient has undergone appliance treatment unsuccessfully.