Treatment of TMD
The temporomandibular joint is the hinge that connects your jaw to the temporal bones of your skull — your temporomandibular joint (TMJ). This joint comes into play throughout our daily lives, allowing us to chew, talk, even breathe heavily. When problems arise with the TMJ and the corresponding muscles and teeth, this is known as temporomandibular joint disorder (TMD). Dr. Nancy E. Gill and Dr. Dallas Kenson are both trained and have significant practical experience treating TMD with neuromuscular dentistry.
What is temporomandibular joint disorder?
You think of your bite as your teeth, but a balanced bite actually requires the temporomandibular joint, the teeth, and the masseter muscles to all work together in harmony. When all is properly aligned, chewing is quiet and you don’t have pain in the jaw or lower face. But if one or more of the three components of your bite force the jaw into misalignment, you now have problems with every movement of the jaw. This can lead to pain across the jaw and face, and it can radiate down into the neck and shoulders. You are suffering from temporomandibular joint disorder (TMD).
What are the symptoms of TMD?
TMD can lead to chronic pain. It’s most common in younger people, between the ages of 20 and 40, occurring more in women than men. These are the typical symptoms associated with TMD:
- Pain or tenderness in your face, jaw joint area, neck and shoulders, or in and around the ears when you chew or otherwise open your mouth
- Jaws that get “stuck” or “lock” either open or closed
- Clicking, popping, or grating sounds in the jaw joint when you chew or simply open or close your mouth
- Consistent headaches
- Regular jaw stiffness
- Ear ringing
- Unintentional teeth grinding
- A tired feeling in your face
- Upper shoulder pain
What causes TMD?
Diagnosing TMD can be difficult unless the dentist has experience with neuromuscular dentistry, as Dr. Gill and Dr. Kenson do. Symptoms such as earaches, headaches, and facial pain can be incorrectly attributed to sinus infections, tooth decay, even gum disease. Causes can be related to problems with the bite, but also from subtler issues such as stress and nightly teeth clenching during sleep. Traumatic injury to the jaw joints or related muscles can also lead to TMD. Some causes of TMD are still unknown, although research points to a possible genetic predisposition. Here are some causes of TMD:
- Grinding or clenching the teeth
- Movement of the soft cushion or disc between the ball and socket of the joint
- Arthritis in the joint
- Stress, which can cause a person to tighten facial and jaw muscles or clench the teeth
Can Bruxism Lead to TMD?
When a person clenches and grinds their teeth, usually during sleep, this is called bruxism. Stress and anxiety are often thought to cause bruxism, but it can also be the result of a misaligned bite and other reasons. Left untreated bruxism can lead to TMD.
How Is TMD Diagnosed?
TMD is often misdiagnosed because it exhibits symptoms similar to other conditions. But when Dr. Gill and Dr. Kenson suspect TMD, they look for areas of tenderness around the jaw joints. This is a sign that the muscles are being overworked due to jaw misalignment. You’ll be asked to open and close your jaw, and they listen for clicking, popping, and grating — these are telltale signs of TMD.
Other tests are also employed, if necessary:
- Full-face x-rays, MRIs, or CT scans — These may be used to view the position of the jaw and temporomandibular joints.
- Sonography – Sound waves are used to determine whether there are any problems with jaw alignment. Dr. Gill and Dr. Kenson also listen for any abnormal sounds emanating from the jaw.
- Electromyography (EMG) – This method uses the electricity generated by jaw muscles to measure both muscle and nerve function. It can help to see when there is a reaction (such as pain) to movement.
- Computerized test equipment — This is used to measure the correct resting position of the jaw, identifying misalignment problems.
A variety of approaches are used to treat TMD. These can run from relaxation exercises at home to anti-inflammatory medications, from traditional dental work to creating a splint for nighttime use. Sometimes, it’s a process of trial and error; we’ll try a certain approach and if it doesn’t have the desired effect, we’ll move to the next option.
These are some of the methods we use to help our patients overcome TMD:
- Cosmetic dentistry — To correct alignment, we can replace missing teeth with dental implants or bridges, crown overly worn teeth, or move the teeth with orthodontics. This can involve widening constricted arches.
- Splints or night guards — Night grinding and clenching is often a main factor in TMD. To combat this, it’s important to put the jaw in the correct position at night. To do this, we fabricate plastic mouthpieces that fit over the upper and lower teeth. These are usually worn at night.
- Exercises — Tightening the jaw muscles and clenching the teeth is a common cause of TMD problems. We have various jaw exercises that stimulate and relax the jaw muscles.
- Medication — Muscle relaxants and anti-inflammatory medication can be effective.
- Lifestyle changes — Stress and anxiety are often root causes; stress reduction techniques are important.
- Transcutaneous electrical nerve stimulation (TENS) — Small electrical pulses are delivered to the jaw muscles through a small wand. These pulses stimulate the nerves, encouraging the muscles to relax and the jaw to fall into alignment.
- Botox injections — While Botox is known for its ability to erase wrinkles on the upper third of the face, it can also be used for TMD patients. It is very effective for relaxing the overused muscles that lead to TMD pain.
Can TMD Resolve On Its Own?
People sometimes believe their TMD is simply the result of a phase in life, such as a stressful situation at work. If the stressors are removed, a person’s TMD may resolve itself. But if the jaw is out of alignment, the condition needs treatment. Correction may be as simple as creating a custom night guard to wear while sleeping to stop teeth grinding and clenching, or treatment may be much more involved. Every case is unique. In extreme cases, surgery could be necessary.
Request a Consultation
To schedule a TMJ disorder consultation with Dr. Gill and Dr. Kenson, call (303) 277-9600 today!