The temporomandibular joints (TMJ) are the tiny joints connecting the jaw to the skull bone. When these small, triangular connecting tissues are damaged or strained, the result may be severe pain or limited jaw movement. At Smiley Dental in Lowell and Roslindale, MA, we offer a variety of treatment options to relieve pain and restore the full range of motion for patients suffering from TMD. If you need help with TMJ dysfunction or would like to find out more, contact our dedicated team today.
TMD, short for temperomandibular disorder, is estimated to affect as much as 40% of the population at some point in their lifetimes, and is especially prevalent in the young. Initial diagnosis is typically made through a visit to the dentist, and the eventual treatment multidisciplinary with various management techniques. One of the lesser known treatment techniques, but something that is gaining in popularity, is soft-tissue therapy of the masticatory muscles - the muscles used to move the jaw.
You notice some pain in your jaw when chewing, which progressively worsens over several weeks. Occasionally you feel a clicking or catching in your jaw when opening and closing your mouth. Eventually you are unable to fully open your mouth and experience pain even when you speak. If you have never experienced this, count yourself very lucky. If you have, you are already familiar with the relatively common condition known as TMD.
DIAGNOSIS & TREATMENT
The first step in the TMD therapy process is diagnosis. We encourage patients to let their dentist know right away if they experience any of the following warning signs of TMD:
- Throbbing pain even when the jaw is at rest
- Sharp pain when the jaw is in motion especially when biting or chewing
- Clicking and grinding sounds when moving the jaw
- Limited jaw movement
- Chronic headaches, neck pain, or earaches
- Ringing in the ear or loss of hearing
Dentists play a vital role in determining the warning signs of TMJ pain. Not only do they clean and repair your teeth, but they also track your dental and general health history. According to various studies, symptoms of TMD, or temporomandibular disorders, can start from mere tenderness and pain in the area to the locking of joints, resulting in difficulty closing and opening your mouth.
Physical examination is often done to patients who experience discomfort. This includes listening and feeling your jaw when you open and close it, pressing around the area to identify the painful sites and observing your jaw's scope of motion. To ensure proper diagnosis, dentists may also require panoramic X-rays, MRI or magnetic resonance imaging, or a CT scan to help them pinpoint the main cause of your discomfort.
There are various treatments for TMD and these include surgical procedures and therapies. Surgery is by far the most common TMJ treatment. This is done if other milder remedies didn't work and if the cause of the pain is a structural problem. The open-joint surgery is performed if tumors are found within the joint area or if severe scarring is present. While arthroscopy - another form of surgical procedure - creates only a small incision on the ear frontage, open-joint surgery requires the entire temporomandibular joint area to be opened.
Arthrocentesis is yet another procedure performed by licensed dentists, which involves the insertion of needles that help irrigate the joint area to remove detritus and treat inflammation. Injecting corticosteroid or botulinum toxin to jaw muscles can also help ease the pain.
There are also therapies which can treat TMJ disorders, one of which is the TENS therapy or transcutaneous electrical nerve stimulation therapy. Dentists will utilize low-level of electrical currents to relax your facial muscles and joints resulting to relieved pain. Ultrasound treatment and radio wave therapy are other therapeutic options you and your dentist have.
EQUILIBRATION & OCCLUSAL ADJUSTMENT
Once we determine patients are suffering from TMD, we may need to correct the alignment of the jaw in order to relieve pain and renew full, comfortable jaw movement. There are a number of options available to balance the bite, equilibration, and adjust occlusion, the way the bite fits together. Therapies to improve jaw movement and comfort will likely begin with jaw exercises and wearing a night guard to stabilize the jaw and allow it to rest in a comfortable position, during sleep. For more advanced cases, we may need to complete orthodontic adjustments, or recommend a local oral surgeon who can provide surgical adjustments.
Simple procedures and guidelines are often recommended for this disorder. To reduce muscle tension and spasm, ice packs can be used. Also, you may be advised to avoid chewy, crunchy, or tough types of food like candy, beef, raw vegetables, and the like.
One restorative and cosmetic dentistry treatment for this is occlusal equilibration. The dentist will reshape the teeth surfaces to take out any deflective interference, eventually helping the jaws to function properly and comfortably.
You may be prescribed to wear a mouth guard instead. It's usually a plastic or acrylic shield that will keep you from grinding and clenching your teeth. On the other hand, corrective dental therapy may be done to restore the stability of your bite. If wearing dental bridges or crowns, they may need to be adjusted to perfect the alignment of your teeth.
Lastly, severe TMJ cases may require arthroscopy, joint replacement and restructuring, or ligament tightening. These are rarely done - when all other cosmetic dentistry treatments just couldn't do.
At the first sign of a TMJ problem, make sure you consult a dentist. There are many treatment options available today. Letting the disorder go unchecked and untreated will only make the pain and other symptoms worse.