TMJ (temporomandibular joint) disorders are a family of problems related to your jaw joint and/or the surrounding muscles. If you have had symptoms like pain or a “clicking” sound, 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 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.
Trouble with your jaw?
TMJ disorders develop for many reasons. You might clench or grind your teeth, fatiguing your jaw muscles or you may have a structurally damaged jaw joint due to injury or erosive 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 the “cushion” of the jaw joint, can slip out of position. Whatever the cause, the results may include a misaligned/changing bite, pain, clicking, or grating noise when you open your mouth, or trouble opening.
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?
- Does your jaw ever get “locked open” or “locked closed”
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.
There are various treatment options for TMJ that Drs. Baker and Weber can utilize to improve the function of your jaw. Once an evaluation confirms a diagnosis of TMJ disorder, Drs. Baker or Weber will determine the proper course of treatment. It is important to note that treatment always works best with a team approach of self-care combined with professional care.
Many times the goal is to relieve the muscular tension surrounding the joint. This is usually accomplished by multiple different modalities all with the end goal of decreasing muscular tension. Initially, medicines that are often prescribed are a non-steroidal anti-inflammatory drug (NSAID) along with a muscle relaxant. Steroids can be injected directly into the joints to reduce pain and inflammation. Along with medications, it is imperative that self-care treatments are followed to obtain the best possible outcome. These include:
- Resting your jaw with a non-chew diet
- Keeping your teeth apart when you are not swallowing or eating
- warm heat compresses
- mental stress-reducing exercises
- active awareness to avoid muscular jaw clenching
- wearing an oral appliance
Stress management techniques such as biofeedback or physical therapy 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 many different types of appliances made for different purposes. A nightguard helps you stop clenching or grinding your teeth and reduces muscle tension at night. Appliances also help protect tooth wear. Many time muscular tension can still persist after following all of the modalities above. Some patients find relief with neurotoxin injections (botox) into the painful/hyperactive muscles surrounding the joint.
What about surgery?
If your TMJ disorder has significant structural TMJ damage and is causing significant problems with how you function in your daily life then surgical intervention may be an option for you. For most TMJ disorders surgery is not the first-line treatment of choice, but certain severe disease processes tend to push towards surgery. These scenarios tend to be limited jaw function (opening/closing) and/or pain that is severely limiting your daily quality of life after non-surgical measures have failed. Surgical treatment can range from a simple “wash out” of the joint (arthrocentesis), or Botox treatment in the hyperactive muscles, or open joint repair/restructuring (arthroplasty), or jaw reconstruction with a total joint replacement. Surgical options are sometimes indicated but are reserved for severe cases. Drs. Baker and Weber do not consider TMJ surgery unless the jaw can’t open, is dislocated and non-reducible, has severe degeneration, or the patient has undergone conservative treatment unsuccessfully.