TMJ stands for temporomandibular joint; which is the name for each joint (right and left), that connects your jaw to your skull. TMJ disorders are a family of problems related to your complex jaw joint, and is an all encompassing term covering acute or chronic inflammation of the temporomandibular 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. The disorder and subsequent condition can result in significant pain, discomfort, dysfunction, and impairment.
Dysfunction refers to the limitation of jaw movement. This dysfunction can range from mild to severe. In milder cases, the only symptoms may be popping or clicking of the jaw. Common causes include: gum chewing, nail biting, teeth grinding or teeth clenching. Often times this dysfunction creates a misalignment of the teeth, causing them to be out of occlusion.
The temporomandibular joint is just as susceptible to many of the conditions that affect other joints in the body, including: arthritis, trauma, dislocations, and other developmental abnormalities. Since some types of TMJ problems can lead to more serious conditions, early detection and treatment are important. No one treatment can resolve TMJ disorders completely, and treatments take time to be effective.
Do you have trouble with your jaw?
TMJ disorders develop for a variety of reasons. You may clench or grind your teeth, or tighten your jaw muscles and therefore stress your TMJ joint. You may have a damaged jaw joint, due to injury or disease. Whatever the cause, the results may include a misaligned bite, pain, clicking or grating noises when you open your mouth, or may cause you to have trouble opening your mouth wide.
Important Questions to Ask Yourself
- Are you aware of grinding or clenching your teeth?
- Do you wake up with sore, stiff muscles around your jaw?
- 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 jaw?
- 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.
There are various treatment options that Dr. Ghobadi can utilize to improve the harmony and function of your jaw. Once an evaluation confirms a diagnosis of TMJ disorder, we will determine the proper course of treatment. It is important to note that treatment always works best with a team approach of self-care, as well as 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 injected directly into the joints 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 temporary, clear plastic appliance known as a splint. 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, 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 hours/day 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 restructuring are sometimes needed, but are reserved for severe cases. Dr. Ghobadi does not consider TMJ surgery unless the jaw can't open, is dislocated and nonreducible, has severe degeneration, or the patient has undergone appliance treatment unsuccessfully.