TMJ (temporomandibular joint) disorders are a family of problems related to your complex jaw joint. If you have had symptoms like pain or a “clicking” sound, you will 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) are damaged or 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. Rabe can help you have a healthier and more comfortable jaw. Patient cooperation and follow through is essential for the best short and long-term results.
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 disk, which is made of cartilage and functions as a “cushion” for the bones of the jaw joint, can slip out of position. Whatever the cause, the results may include a misaligned bite, pain, clicking, difficulty opening your mouth or a grating noise when you open your mouth.
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 Dr. Rabe and your dentist can utilize to improve the harmony and function of your jaws. Once an evaluation confirms a diagnosis of TMJ disorder, Dr. Rabe will determine the proper course of treatment. It is important to note that treatment always works best when a team approach of self-care is 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 medication 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, physical therapy or counseling 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 and reduces muscle tension at night and helps to protect the cartilage and joint surfaces. An anterior positioning appliance moves your jaw forward, relieves pressure on parts of your jaw and aids in disk repositioning. An orthotic stabilization appliance is worn to move your jaw into proper position. Appliances also help to protect from excessive tooth wear.
On occasion, arthrocentesis, an office procedure that allows Dr. Rabe to insert medications directly into the joint, to free adhesions or to irrigate the inflamed joint will be recommended as an early intervention.
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 are sometimes needed but are reserved for severe cases.
Dr. Rabe does not consider TMJ surgery unless the jaw cannot open, is dislocated or unreducible, has severe degeneration, or is causing the patient pain and symptoms that have not responded to non-surgical therapy. Joint repair or reconstruction surgery is performed in the hospital and is followed by a period of 4-6 weeks of physical therapy.
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