Overview of the TMJ and TMJ Dysfunction
The temporomandibular joint (TMJ) is a hinge joint where the lower jaw (mandible) adjoins the base of the skull (temporal bone), just in the front of the ears. A disc of cartilage cushions the area where the bones meet and aids in jaw movement. Muscles attached to the jaw and skull control jaw position and movement. One of the most complicated and used joints in the body, the TMJ experiences more forces from different directions than any other joint.
Studies have shown as many as two-thirds of the adult U.S. population has some degree of change in the TMJ’s. Of these cases one-third are mild, one-third moderate, and one-third severe. It tends to afflict women aged 15-45 more often than others. Changes in the TMJ’s may or may not be accompanied by pain or other signs and symptoms. Because of this, the dysfunction is often overlooked or thought to be something else.
Some possible causes of TMJ Dysfunction:
- A poor, misaligned bite
- Stress
- Clenching and grinding of teeth
- Arthritis
- Trauma
Signs and Symptoms of TMJ Dysfunction
Although by no means a complete list, these are some of the more common signs and symptoms of TMJ dysfunction.
Signs:
- Common activities such as smiling, talking and eating become more challenging and sometimes painful
- Difficulty opening your mouth
- An embarrassing popping of the joint
- The joint may also click, grate or lock
- Worn, cracked or broken teeth
- Failure of previous dental work
- Disruption of normal sleep patterns
Symptoms:
- Headaches
- Tired, overworked or painful muscles of the head, neck, face and shoulders, often in the morning
- Pain in the joint
- Toothache
- Earache; ringing in the ear (tinnitus)
- Dizziness
- Unexplained pain
Even though the patient may not notice any of these signs and symptoms, destruction of the system (joints, muscles and teeth) can still be taking place.
Diagnosis of TMJ Dysfunction
A normal, healthy TMJ glides quietly, gently, and without pain as it functions. If the joints are healthy but signs and symptoms are present, we need to seek other causes for these problems.
If the joints are dysfunctional, we must determine why, and we encourage a comprehensive evaluation of the history and present condition.
The evaluation of the joints requires obtaining a thorough history to compare and contrast with the present condition. The evaluation of the joints for diagnosis involves listening with a stethoscope (auscultation), and feeling and sensing (palpation) jaw movements during function. Additionally, we may conduct other tests to determine the health of the joints, muscles, and teeth.
We will analyze radiographic (x-ray) images of the joints. We will study models of the teeth on an instrument that simulates three dimensional movements of the lower jaw. Then, using this information, we will make a diagnosis and formulate a customized plan of treatment.
Treatment of TMJ Dysfunction
When we evaluate your joints as they function, we find the causes that produce pain. Once the causes of pain have been discovered, we begin by treating them conservatively. Because the disease often progresses, greater success in treatment occurs with application of early and individualized therapies. We aim to restore the system of the teeth, muscles, and joints to a state of harmonious function.
In order to locate the proper joint position and achieve harmonious function, we utilize a removable acrylic bite (or occlusal) splint. The therapeutic phase of treatment involves adjustment of the splint to put TMJ’s in their correct position, to the extent that is physiologically possible. This leads to properly aligned jaws and muscles that are comfortable and relaxed.
The conservative nature of splint therapy becomes apparent as the bite and muscles are relieved of stress and the joints adapt to a more stable position. And all this occurs while having done nothing surgically to the teeth, muscles, and joints. We are able to maintain this stability with a very high percentage of our patients.
The joints must stabilize and function properly before we begin any definitive treatment. After the new position stabilizes over time, we can implement other treatment to maintain the stability. We may also consider continuing to use the splint for maintenance. Other choices for the long term include reshaping the teeth to adjust the bite, positioning the teeth differently, or using restorations to change the shape of and strengthen the teeth.
Why Treat Your TMJ Dysfunction?
Overwhelmingly, our patients notice and appreciate the significant decrease or total loss of pain as a result of their treatment. The dramatic recovery experienced with relaxed muscles and a comfortable bite produce remarkable enhancements in your health, comfort, function, and natural beauty.
