What is TMJ?
Many patients come to a neuromuscular dental practice, having been told they have TMJ. They do. As a matter of fact, they have two of them! TMJ refers to the temporomandibular joint, commonly called the jaw joint. The term TMJ is commonly used to describe a disorder known in the neuromuscular dental community as temporomandibular joint disorder or TMD. TMD is associated with a number of chronic problems including headaches, facial, jaw, neck and shoulder pain, ringing in the ears, and tingling of the arms and fingertips. In addition, many TMD patients also suffer from chipped, worn and broken teeth. Others report snoring, night grinding of the teeth, frequent ear infections, and airway constriction.
Who gets TMD (TMJ)?
Unfortunately the majority of the population is stricken with TMD to some degree. Female patients tend to report higher levels of pain and discomfort, however the male patient is more likely to damage the teeth, gums, joints, and bone. Children seem to be particularly susceptible to TMD, however early detection, as always, is beneficial. Common early warning signs of TMD include chronic ear infections, constant biting, chewing, or sucking of the fingers, lips, or gum, snoring or grinding of the teeth while sleeping, and constant leaning of the head on the arms.
What causes TMD (TMJ)?
For many patients the source of their pain can be traced to a condition referred to as malocclusion, more commonly known as “bad bite”. This is the condition in which the upper and lower teeth do not fit together as they should. Instead the teeth are misaligned, causing a lack of support to facial muscles and joints used to swallow and chew. Because these muscles are straining to hold a misaligned position, TMD patients often suffer from pain throughout the face, head, neck, arms, and shoulders. Underbites and overbites are examples of such misalignments. Even though a patient may have aesthetically beautiful teeth or received orthodontic treatments to straighten teeth, that patient may still have a TMD problem causing discomfort in the teeth, muscles, and joints that is not readily recognizable outside of the neuromuscular dental community.
How is TMD (TMJ) diagnosed?
The patient is tested using computerized jaw tracking devices in order to measure the position of the jaw at rest, the movement of the TMJ (jaw) joints and muscles, and the path the jaw takes to close. In order to establish the functions of the muscles both in the stressed and resting position, as well as, the relationship of the jaw to the skull, electromyography is employed. Electromyography is a term describing a device that allows musculoskeletal electrical activity to be recorded in a visual or audio format. Patients are then tested for abnormal jaw joint sounds using a sonographic device that records the results. X-rays may be taken in order to further assess the TMJ (jaw) joints and the position of the teeth. The combination of these cutting edge technologies and techniques allow the doctor confirm the TMD symptoms are, in fact, the result of malocclusion.
How is TMD (TMJ) treated?
In most situations TMD (TMJ) patients seeking treatment will undergo three phases of treatment listed as follows:
Phase One: Eliminate Muscle Pain & Spasms
The patient’s comfort is of the utmost importance, thus commanding that the first step is to relieve the patient of the TMD symptoms. This is done using Ultra Low Frequency Transcutaneous Electrical Stimulation Unit otherwise known as the ULF-TENS Unit.
This is a gentle way to relax the muscles by causing a higher level of blood flow and the wasted products to be flushed away. The patient finds relief as the body is prompted to produce endorphins, providing a natural anesthetic.
Phase Two: Stabilization of the Bite
In order to correct the “bad bite”, the patient will be fitted for a custom-made removable orthotic to be worn over the bottom teeth. The orthotic is constructed of clear plastic and can be easily adjusted by the doctor. This allows the bite to rest in proper alignment without altering the actual teeth. Once the proper bite has been achieved and the patient has been relieved of all symptoms, permanent treatment options can be considered to maintain the proper position.
Phase 3: Long-term Options
There are a number of options for long-term bite management. The following are the most common neuromuscular treatments:
This simple procedure is used to smooth and reshape tooth enamel to achieve a permanent stable bite position. Anesthesia is not needed for this procedure, however this treatment is not suitable for the many more extreme case.
This option involves the construction of a permanent orthotic that is worn over the back teeth in order to achieve the correct alignment.
This procedure employs crowns as a way to alter the height and occlusal surfaces of the individually teeth, also providing a permanent solution to the patient’s TMD (TMJ) problem.
Braces can also be used to correct the position of healthy teeth.
Common symptoms
- Headaches/Migraines
- Facial Pain
- Neck & Shoulder Pain
- Tinnitus (Ringing in the Ears)
- Vertigo
- Unexplained Loose Teeth
- Jaw Pain
- Limited Jaw Movement
- Locking Jaw
- Numbness or Tingling in the Arms & Fingers
- Worn, Cracked or Broken Teeth
- Depression
- Clicking or Popping of the Jaw Joints
- Sensitive & Sore Teeth
