|
Treatment of TMJ Disorders
Temporomandibular Joint Disorder (TMD) is a collective term referring to a number of clinical problems involving the Temporomandibular Joints (TMJ’s) and associated muscles and structures of the area.
TMD is thought to be fairly common as several researchers have found clicking and popping noises in the jaw joints to be present in 40-60% of the general population. Considering that normal healthy TMJ’s are completely silent at all times, the 40-60% figure is a rather staggering one to consider. The good news is that TMD symptoms are quite variable in nature, with most being a mild annoyance. However, a small percentage of patients with TMD have symptoms which degenerate into crippling chronic pain and limited jaw mobility. A recent National Institute of Health study indicates that over nine million Americans suffer from TMJ pain on a regular basis.
Common symptoms of TMD are:
• Pain about the face, head and neck regions
• Clicking, popping, and or grating noises in the jaw joints
• A limited ability to open the mouth wide or move it side-to-side
• Frequent headaches, often around the temple area
• Earaches, buzzing, or ringing noises in the ears
• Deep pain the jaw joint itself
• Soreness or pain in the cheek area
• "Sticking", "catching" or "locking up" of the jaw
• A sudden inability to find a comfortable bite position
Common causes of TMD symptoms are one or more of the following:
Long-term strain on the TMJ’s caused by a sleep pattern of chronic grinding and/or clenching of the teeth (bruxism). This may lead to permanent damage to the teeth and TMJ’s themselves.
Certain types of malocclusion (bad bites) can chronically overstress the TMJs and related structures every time the individual chews. This in turn can lead to TM joint damage.
Accidents involving direct or indirect trauma to the head, face, and / or neck may lead to partial or total TMJ disc dislocation, stretched or torn TMJ ligaments, and impaired joint function.
Extensive dental procedures which have overstressed the muscles, joints, ligaments, nerves, may also lead to TMJ ligament inflammation or damage. This in turn could lead to muscle spasms and / or TMJ disc dislocation.
General anesthesia intubations which strain weak TM joints or damage healthy TM joints by overextending the joint while the patient is asleep.
Arthritis of the TMJ’s particularly in patients which TM disc dislocations
Systemic diseases such as gout, lupus, scleroderma, and fibromyalgia may also contribute to TMJ - like symptoms or problems.
Growth and / or developmental disturbances of the structures of the face and TM joints may cause malformation of the TM joint structures than thus dysfunction.
Some other reasons for TMD are less identifiable and may result from a combination of small events such as lying against a partially strained or damaged (but previously asymptomatic) TMJ while sleeping.
Facial muscle irritability due to an inadequate diet. Research shows that substances such as caffeine, nicotine, and sugar can significantly increase muscle tension and impair their performance.
Emotional stress. Studies have also shown a link between stress and the frequency of teeth grinding at night. This chronic and prolonged nightly activity ultimately damages the TM joints or impair the body’s ability to heal a damaged joint.
How are TMJ Disorders Diagnosed?
The first step in the management of TMJ disorders is to determine that the concern is not another type of medical or dental problem behaving as if it were a TMJ problem. This determination is made following an initial TMJ Screening Visit. A TMJ screening visit includes the completion of a thorough TMJ history form, screening x-rays of the teeth and jaw joints, and a preliminary clinical examination of the jaw joints, muscle system, bite, and teeth. We also advise patients to seek a concurrent proper medical exam from a medical doctor (ideally an ENT) to rule out the presence of medical problems which are occurring in combination with or disguising themselves as TMJ problems.
Following the completion of a TMJ Screening Examination, a preliminary diagnosis can be rendered. If the preliminary diagnosis is TMJ disorder, then further studies and tests will be indicated to identify the exact nature of the disorder and to assist in developing an individualized treatment strategy.
How are TMJ Disorders Treated?
Initial treatment for TMJ disorder can range from resting the joints, switching to a soft diet and prescribed medication to stabilization of the joints through the use of a specially designed and custom adjusted hard acrylic orthotic appliance that fits on the top of the teeth. This appliance, when properly designed, redistributes the stresses on the TMJ’s, and muscle system while specifically guarding and guiding certain joint movements.
Does it work?
The vast majority of cases we treat are successfully managed through the use of orthotic appliances and / or a combination of orthotic appliance and physical therapy to reduce symptoms and accelerate healing.
Are all dentists similar in training and experience with treating TMJ.
No. It is advisable to research the training level and experience of your treating dentist to determine their success rate and skill level in the area of TMJ treatment. Dr. Henny has advanced training in the area of TMJ treatment through the Bethesda Naval Hospital, The Pankey Institute for Advanced Dental Study, and The Dawson Center for Advanced Dental Study in addition to over 12 years of successfully treating TMJ disorders.
Can I just buy a mouth guard at the store and treat this problem myself?
This is generally not advisable. Self care with these non-adjustable devices can put additional strain on already damaged jaw joints. They may also cause an individual to grind their teeth even more at night and thus worsen the symptoms.
What happens to the 5% of patients who are not successfully treated via professionally designed and managed orthotic appliances?
These patients are typically sent to one of the few highly trained and experienced TMJ surgical specialists in the world, Dr. Mark Piper in St. Petersburg, Florida. Dr. Piper evaluates each patient for the value of surgical intervention. To learn more about Dr. Piper and TMJ, you can visit his website at: www.piperclinic.com
Please do not hesitate to give our office a call at 540 774.1577 to learn more about TMJ disorder and how our conservative TMJ treatment strategies can assist you.
|
