For most people, discomfort from TMJ disorders will eventually go away with little or no treatment. Some, however, develop significant, long-term problems. Simple steps that may help ease symptoms temporarily include eating soft foods, applying ice packs, and avoiding extreme jaw movements like wide yawning and gum chewing. Short term use of over-the-counter or prescription pain medicines and learning techniques to reduce stress may also provide relief. Even if symptoms become significant and persistent, most people still do not need aggressive types of treatment.

 

 

WHAT IS THE TEMPOROMANDIBULAR JOINT?

 

The temporomandibular joint (TMJ) is the area directly in front of the ear on either side of the head where the upper jaw (maxilla) and lower jaw (mandible) meet. Within the TMJ, there are moving parts that allow the upper jaw to close on the lower jaw. This joint is a typical sliding "ball and socket" that has a disc sandwiched between it. The TMJ is used throughout the day to move the jaw, especially in biting and chewing, talking, and yawning. It is one of the most frequently used joints of the body.

 

The temporomandibular joints are complex and are composed of muscles, tendons, and bones. Each component contributes to the smooth operation of the TMJ. When the muscles are relaxed and balanced and both jaw joints open and close comfortably, we are able to talk, chew, or yawn without pain.

 

WHAT ARE TMJ DISORDERS?

 

TMJ disorders are a group of complex problems of the jaw joint. TMJ disorders are also sometimes referred to as myofascial pain dysfunction and Costen's syndrome. Because muscles and joints work together, a problem with either one can lead to stiffness, headaches, ear pain, bite problems (malocclusion), clicking sounds, or locked jaws.

 

WHAT ARE THE CAUSES OF TMJ DISORDERS?

 

The following are behaviors or conditions that can lead to TMJ disorders:

 

  • Teeth grinding and teeth clenching (bruxism) increase the wear on the cartilage lining of the TMJ. Those who grind or clench their teeth may be unaware of this behavior unless they are told by someone observing this pattern while sleeping or by a dental professional noticing telltale signs of wear and tear on the teeth. Many patients awaken in the morning with jaw or ear pain.

 

  • Habitual gum chewing or fingernail biting.

 

  • Dental problems and misalignment of the teeth (malocclusion). Patients may complain that it is difficult to find a comfortable bite or that the way their teeth fit together has changed. Chewing on only one side of the jaw can lead to or be a result of TMJ problems.

 

  • Trauma to the jaws: Previous fractures in the jaw or facial bones can lead to TMJ disorders.

 

  • Stress frequently leads to unreleased nervous energy. It is very common for people under stress to release this nervous energy by either consciously or unconsciously grinding and clenching their teeth.

 

  • Occupational tasks or habits such as holding the telephone between the head and shoulder may contribute to TMJ .

 

 

WHAT ARE THE TREATMENTS FOR TMJ DISORDERS?

 

  • Jaw rest: It can be beneficial to keep the teeth apart as much as possible. It is also important to recognize when tooth grinding is occurring and devise methods to cease this activity. Patients are advised to avoid chewing gum or eating hard, chewy, or crunchy foods such as raw vegetables, candy, or nuts. Foods that require opening the mouth widely, such as a big hamburger, are also not recommended.

 

  • Heat and ice therapy: These assist in reducing muscle tension and spasm. However, immediately after an injury to the TMJ, treatment with cold applications is best. Cold packs can be helpful for relieving pain.

 

  • Medications: Anti-inflammatory medications such as aspirin, ibuprofen (Advil and others), naproxen (Aleve and others), or steroids can help control inflammation. Muscle relaxants, such as diazepam (Valium), aid in decreasing muscle spasms. In certain situations, local injection of cortisone preparations (methylprednisolone [Depo-Medrol], triamcinolone [Kenalog], Celestone) into the TMJ may be helpful.

 

  • Physical therapy: Passively opening and closing the jaw, massage, and electrical stimulation help to decrease pain and increase the range of motion and strength of the joint.

 

  • Stress management: Stress support groups, psychological counseling, and medications can also assist in reducing muscle tension. Biofeedback helps people recognize times of increased muscle activity and spasm and provides methods to help control them.

 

  • Occlusal therapy: A custom-made acrylic appliance (mouth guard) that fits over the teeth is commonly prescribed for night but may be required throughout the day. It acts to balance the bite and reduce or eliminate teeth grinding or clenching (bruxism).

 

  • Correction of bite abnormalities: Corrective dental therapy, such as orthodontics, may be required to correct an abnormal bite. Dental restorations assist in creating a more stable bite. Adjustments of bridges or crowns act to ensure proper alignment of the teeth.

 

  • Surgery: Surgery is indicated in those situations in which medical therapy has failed. It is done as a last resort. TMJ arthroscopy, ligament tightening, joint restructuring, and joint replacement are considered in the most severe cases of joint damage or deterioration.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

TMJ Treatment

Allure Dental Specialists

39 Fifth Ave.

New York, NY 10003

(P) 646.371.7125