TMJ is a popular term used to describe the symptoms that occur when the joints of the jaw and the chewing muscles (muscles of mastication) 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.
The muscles of mastication, also bilateral, work closely with your neck and shoulder muscles to enable chewing, swallowing, etc. When these joints or the muscles around them aren’t functioning properly, they can cause an assortment of problems.
How Does TMJ Develop?
Since your muscles and joints have to work together to ensure optimum jaw function, a problem with either one can lead to a TMJ disorder. For example, stress-induced teeth clenching or grinding, (bruxism), causes your muscles to tighten up putting undue strain on the TMJ joints. 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.
What Are the Signs of TMJ?
Common symptoms include: Clicking or popping of the jaw joints, stiffness, locking, or limited opening of your mouth, change in bite or feeling your bite is “off.” The clicking and popping represents disk/cartilage displacement and movements in and out of position.
Sometimes people suffer from symptoms they would not normally associate with bite problems such as sinus headaches, earaches, dizziness, or neck and shoulder pain. Frequently, these problems result from involuntary clenching or grinding (bruxism) at night.
How Is TMJ Treated?
There are various treatment options that Dr. Greenberg can utilize to improve the harmony and function of your jaw. Once an evaluation confirms a diagnosis of TMJ disorder, Dr. Greenberg will determine the proper course of treatment.
The initial goals are to relieve the muscle spasm and joint pain. This is usually accomplished with a pain reliever, anti-inflammatory 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
Sometimes stress management techniques such as biofeedback or physical therapy are 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. It may be worn 24 hours/day to help your jaw heal. An orthotic stabilization appliance is worn 24 hours or just at night to move your jaw into proper position. Appliances also help to protect from tooth wear.
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 restructuring are sometimes needed but are reserved for severe cases. Dr. Greenberg does not consider TMJ surgery unless the jaw can’t open, is dislocated and nonreducible, has severe degeneration, or the patient has undergone appliance treatment unsuccessfully.
For more information visit the TMJ Association atwww.TMJ.org
