TMJ Disorders

TMJ (temporomandibular joint) disorders are a family of problems related to your jaw joint (in front of your ear.) If you have symptoms like pain or a “clicking” sound in or around your jaw joint, 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. TMJ stands for Temporomandibular Joint, which is the name for each joint (right and left) that connects your jaw to your skull. 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 treatment takes time to become effective. Dr. Orentlicher and Dr. Horowitz can help you have a healthier and more comfortable jaw.

Trouble with Your Jaw?

TMJ disorders develop for many reasons. You might clench or grind your teeth, tightening your jaw muscles and stressing your TM joint. You may have a damaged jaw joint due to injury or disease. Injuries and arthritis can damage the joint directly or stretch or tear the muscle ligaments. As a result, the disc, which is made of cartilage and functions as the “cushion” of the jaw joint, can slip out of position. Whatever the cause, the results may include a misaligned bite, pain, clicking or grating noise when you open your mouth, or trouble opening your mouth wide.

 

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Do You Have a TMJ Disorder?

  • Are you aware of grinding or clenching your teeth?
  • Do you wake up with sore, stiff muscles around your jaws?
  • 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 jaws?
  • 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.

Treatment

There are various treatment options that Drs. Orentlicher and Horowitz can utilize to improve the harmony and function of your jaw. Once an evaluation confirms a diagnosis of TMJ disorder, the doctors will determine the proper course of treatment. It is important to note that treatment always works best with a team approach of self-care joined with 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. 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 wearing a clear plastic appliance known as a splint. A splint fits over your top or bottom teeth and helps keep your teeth apart, thereby relaxing the muscles and reducing pain. Your dentist or orthodontist may have to adjust your appliance periodically until your bite has stabilized and you are comfortable while wearing the appliance. 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 orthotic stabilization appliance is worn 24 hours a day, or just at night, to relax your facial musculature and help your jaw heal. Bite appliances also help to protect your teeth 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 surgery, or restorative dental work. Surgical options such as arthrocentesis (a joint rinsing procedure), arthroscopy, and open joint repair are sometimes needed but are usually reserved for those cases that have evidence of disc displacements or internal joint problems that are not responsive to conservative/nonsurgical treatments. Drs. Orentlicher and Horowitz do not consider TMJ surgery unless the jaw opening is limited or restricted, the disc is dislocated and nonreducible, the joint has severe degeneration, or the patient has evidence of internal joint problems and has undergone conservative therapies unsuccessfully.