Patient Services

TMJ Analysis and Treatment

Temporomandibular joint (TMJ) disorders can involve several problems that affect your jaw joint and ability to chew.
TMJ disorders often involve some facial pain with or without apparent destructive changes in the joint, which can be seen on dental films.  TMJ is a commonly seen condition in primary care and dentistry practice, and the incidence is increasing, often due to increases in stress of individuals. More than 10 million people in the United States may have TMJ problems

Treatment
Often TMJ problems are related to sore muscles that spasm periodically. This type of problem usually responds to conservative treatment, which can include any or a combination of the following:

• Soft diet — Avoid hard or crunchy foods. Cut food into small pieces and chew with your back teeth rather than biting into large items, such as a thick sandwich, with your front teeth.
• Physical therapy, which can include heat, massage and ultrasound
• Intraoral plastic splints, to control teeth clenching and grinding
• Stress reduction therapy, including biofeedback
• Over-the-counter pain relievers
• Prescription anti-inflammatory medications
• Prescription muscle-relaxing medications
• Bite adjustment, which might include reshaping teeth slightly so that they meet properly
• Replacement of missing teeth
• Orthodontic therapy

Some Facts About TMJ Disorders

• TMJ primarily affects women, especially women 20-40. The male-to-female ratio is 1:4. The reason isn't clear, but one theory is that the collagen that holds the disk in position between the ball and socket is structurally different in women. This may cause more women to have dislocated disks, which can lead to TMJ problems. In addition, some studies have suggested that hormones like estrogen may affect the way women perceive pain
• The condition is multi-factorial and includes malocclusion, jaw clenching, bruxism, personality disorders, increased pain sensitivity, and stress and anxiety; in most patients more than one factor is present.
• Significance of psychological factors has been recognized during the past few years.
• Studies estimate that between 20% and 30% of people experience the symptoms of TMJ problems.

The causes of TMJ are not understood completely but can include:

• Trauma to the jaw, either a direct blow to the joint or prolonged clenching or grinding of the teeth (bruxism)
• Tension or stress, which triggers muscle spasms
• Poor alignment of the teeth (malocclusion)
• Arthritis of the temporomandibular joint
• Tumors of the temporomandibular joint
• Certain medical problems, such as rheumatoid arthritis or osteoarthritis can affect the temporomandibular joint.

Symptoms:

• Pain or tenderness in the area in front of your ear, especially when you chew, speak or open your mouth wide
• An occasional feeling of the jaw being stuck open or closed
• Facial-muscle spasms that make it difficult to open your mouth or that make it feel as though your teeth don't meet normally
• Clicking, popping or cracking sounds or a grating sensation in the jaw when you open or close your mouth
• Headaches that tend to start in the front of the ear and spread to the rest of the head or neck

TMJ problems may last only a few short weeks when they are caused by trauma to the jaw, for example. Other types of TMJ disorders, such as a problem caused by arthritis or bruxism, can last months or even years, depending on how they respond to treatment.

Prevention of TMJ Disorders

A TMJ problem caused by bruxism, or clenching or grinding, can be prevented utilizing a mouthguard or nightguard, which is a molded piece of plastic used to reduce the pressure on the jaw.