Understanding Temporomandibular Joint (TMJ) Disorders
The temporomandibular joint (TMJ) is the hinge joint that connects the lower jaw (mandible) to the temporal bone of the skull. Temporomandibular disorders (TMD) occur as a result of problems with this jaw joint and surrounding chewing muscles. This joint is immediately in front of the ear on each side of your head. The joints are flexible, allowing the jaw to move smoothly up and down and side to side and enabling you to talk, chew, and yawn.
The stability of healthy and comfortable jaw function begins in the temporomandibular joints (TMJ). There must be a harmony of function between the TMJ, chewing muscles, and ligaments and the teeth (bite). The degree of harmony needed for any person to be comfortable is affected by the patient’s dental condition and their stress management profile.
What Causes TMJ Disorder (TMD)?
Most dentists believe that symptoms arise from problems with the muscles of the jaw or with the parts of the joint itself. Injury to the jaw, the TMJ, or the muscles of the head and neck such as from a heavy blow or whiplash can cause TMD. Other possible causes include:
- Grinding or clenching the teeth, which puts a lot of pressure on the TMJ.
- Dislocation of the soft cushion or disc between the ball and socket.
- Presence of osteoarthritis or rheumatoid arthritis in the TMJ.
- Stress, which can cause a person to tighten facial and jaw muscles or clench the teeth.
An intuitive and caring practitioner is required to diagnose and manage these difficult problems. It’s generally agreed that before restorative care can be provided, the chewing muscles should be in their most relaxed and unstrained positions (comfortable).
Do You Have Any of These Symptoms of TMD?
People with TMD can experience severe pain and discomfort that can be temporary or last for many years. Occluso-muscle problems can manifest themselves as headaches, neck aches, discomfort and/or mobility in teeth, worn or fractured teeth. More women than men experience TMD and it’s seen most commonly in people between the ages of 20 and 40.
TMD Treatment – Relief From Migraines, Jaw Pain, and Other Symptoms
With a careful advanced bite analysis, some common treatments may be recommended:
- Nightguard/Bite Plane/NTI Appliances
- Reshaping or Restoring the tooth surfaces
- Orthodontic treatment with Invisalign
- Replacement of missing teeth with implants, fixed bridges, or dentures
- Remodeling impaired mouth
Dr. McCoy has had thorough training in bite related problems and TMJ disorders. He has helped relieve jaw pain for many of his patients. Some patients come to him specifically for this jaw problem and the pain associated with migraine headaches.
- Jaw Clicking
- Positive Pinky Test
- Worn down teeth
What Can I Do If I Have TMD?
Dr. McCoy has been diagnosing and treating bite-related, jaw joint problems for many years with success. At times the remedy is just a simple one-tooth bite adjustment. Each problem has unique needs to be managed. Ways to treat or relieve TMD symptoms include:
- Apply moist heat or cold packs. Apply an ice pack to the side of your face and temple area for about 10 minutes. Do a few simple stretching exercises for your jaw (as instructed by your dentist or physical therapist). After exercising, apply a warm towel or washcloth to the side of your face for about 5 minutes. Perform this routine a few times each day.
- Eat soft foods. Eat soft foods such as yogurt, mashed potatoes, cottage cheese, soup, scrambled eggs, fish, cooked fruits and vegetables, beans, and grains. In addition, cut foods into small pieces to decrease the amount of chewing required. Avoid hard and crunchy foods (like hard rolls, pretzels, raw carrots), chewy foods (like caramels and taffy) and thick and large foods that require your mouth to open wide to fit.
- Take medications. To relieve muscle pain and swelling, try non-steroidal anti-inflammatory drugs (NSAIDs), such as aspirin or ibuprofen (Advil, Motrin), which can be bought over-the-counter. We can prescribe higher doses of these or other NSAIDs or drugs for pain such as narcotic analgesics. Muscle relaxants, especially for people who grind or clench their teeth, can help relax tight jaw muscles. Anti-anxiety medications can help relieve stress that is sometimes thought to aggravate TMD. Antidepressants, when used in low doses, can also help reduce or control pain. Muscle relaxants, anti-anxiety drugs, and antidepressants are available by prescription only.
- Wear a night guard or NTI appliance. Nightguards are plastic mouthpieces that fit over the upper teeth. NTI’s are smaller appliances that fit over your two front top teeth. Both appliances prevent the upper and lower teeth from coming together, lessening the effects of clenching or grinding the teeth. We’ll discuss with you what type of mouth guard appliance you may need.
- Undergo corrective dental treatments. Replace missing teeth; use crowns, bridges, or braces to balance the biting surfaces of your teeth or to correct a bite problem.
- Avoid extreme jaw movements. Keep yawning and chewing (especially gum or ice) to a minimum and avoid extreme jaw movements such as yelling or singing.
- Don’t rest your chin on your hand or hold the telephone between your shoulder and ear. Practice good posture to reduce neck and facial pain.
- Keep your teeth slightly apart as often as you can to relieve pressure on the jaw. To control clenching or grinding during the day, place your tongue between your teeth.
- Learn relaxation techniques to help control muscle tension in the jaw. Ask your dentist about the need for physical therapy or massage. Consider stress reduction therapy, including biofeedback.