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TMJ Disorders

What Is TMJ?

The TMJ, Temporomandibular Joint or jaw joint is often associated with several painful areas of the jaw, neck, sinuses, teeth, etc… Whenever there is pain in one of these areas, it is sometimes called TMD or Temporomandibular Disorder. These joint located on each side of the head in front of the ears are probably the most used and sophisticated joints of the body while talking, chewing, singing, and swallowing.

Muscles attachments of the jaw, head, and neck will often become stiff or painful with a TM Disorder. Each TMJ has a small disc which allows smooth movement of the jaw when functioning and protection during compression. Disc disorders can be a cause of bite changes, annoying noises, or locking jaws. When the chewing muscles and jaw joints do not function properly together, it sometimes leads to moderate or severe pain and headaches.

Many or possibly most headaches and even migraines can be a result of a temporomandibular disorder. If you suffer with headaches, dizziness, jaw fatigue, earaches, facial pain, difficulty in closing the teeth together, pain when chewing or neck and shoulder stiffness, it may be TMJ disorder.

Could I Have TMD?

MRI of a normal TMJ

It is estimated as many as one in every four Americans suffers from one or more symptoms of a TMD. While the majority of sufferers are women; men and adolescents also suffer with symptoms.

Common symptoms are: headaches, migraine, jaw pain, jaw joint noises, neck pain, neck stiffness, ear pain, and ear stuffiness, and decreased jaw or neck range of motion.

Mandibular disk displacement

Many people are aware of having jaw joint noises which are often misunderstood. They are caused from the disc being out of position (a disc displacement). This can be a situation that doesn’t have to be addressed, but for most, they should address it and seek treatment when they experience pain or headaches and joint noises.

Most individuals having headaches don’t think to consider a TMD causing it but should. It is very important that TM disorder or joint noises be evaluated at the earliest time of onset, which often allows the most opportunity for correction of the problem.

Many dentist and doctors will make a notation of a joint noise in the record and make a comment to the effect to let them know, if it bothers them. This can result in missing a special window of opportunity for treatment.

What Causes TMJ?

There are many causes like trauma (blow to the head, whiplash), malocclusion (bad bite or missing teeth), poor posture, bruxism (teeth grinding) or skeletal malformation, arthritis in the joint or clenching brought on by stress. Anything that keeps these muscles, bones and joints from working together harmoniously is called TMJ disorder.

Symptoms of TMJ

Symptoms associated with TMJ disorder could include, but are not limited to, pain located in the eyes, mouth, throat, ears, jaw and neck. It is imperative that you be screened by a dentist trained and experienced in these disorders. Treatment is usually indicated when you suffer with any of these symptoms listed:

Decreased posterior joint space

  • Headaches
  • Teeth that do not meet properly
  • Dizziness
  • Difficulty chewing or swallowing
  • Ringing or stuffiness in the ears
  • Pain or pressure behind eyes
  • Shoulder stiffness
  • Facial Pain
  • Limited opening of the jaw
  • Jaw clicking or pain
  • Jaw goes to one side when opening
  • Neck pain
  • Tingling or numbness in arms
  • Teeth sensitive to cold

Condyle,Fossa descrepancies

Diagnosing TMJ Disorders

Severe TMJ arthritis

Temporomandibular Joint Disorders (TMD/TMJ) can be difficult to diagnose because the problem often crosses over into several different specialties in medicine and dentistry.

People who suffer from this disorder have typically visited many different health care professionals -- all of whom may have a piece of the puzzle, yet they continue to have problems with their TM joints.

Along with a health history, we perform a thorough exam, appropriate x-rays, range of motion testing, joint vibration analysis, jaw tracking, and other diagnostics on an as-needed basis. This helps us to arrive at an accurate diagnosis.

ADVANCED STATE-OF-THE-ART EQUIPMENT:

A wide range of diagnostic methods are available to identify head, neck, facial and TMJ problems. Each method is used only as needed in each individual case. These tests might include:

  • JVA – Joint Vibration Analysis
  • Jaw tracking computerized equipment
  • EMG – Electromyography
  • Cone Beam CT scanning

Treating TMJ

Our office provides the latest in techniques for diagnosis and treatment of a temporomandibular disorder.

If you suffer with headaches, dizziness, jaw fatigue, earaches, facial pain, difficulty in closing the teeth together, pain when chewing or neck and shoulder stiffness, it may be TMJ disorder.

Pain complaints may involve the chewing muscles, the jaw joints, the jaws or even the teeth

Medication, physical modality therapy and other therapies available in our office include:

  • Splints
  • High Voltage Stimulation
  • Ultrasound
  • Iontophoresis
  • Spray & Stretch
  • Trigger Point Injections
  • Prolotherapy
  • TENS
  • Medication
  • Cold Laser
  • Surgical referral options

A custom fitted orthotic, also known as a splint - is the most suggested form of treatment. The splint helps eliminate muscle spasm and pain which occur with bite imbalance. It also stabilizes the TM joints. The purpose of the splint is to balance the bite so the teeth, muscles and joints all work in harmony -- without strain or pain.

Once the proper jaw position is established, patients may need orthodontics or reconstruction. We have knowledge of both orthodontics and reconstruction, if needed, and will direct the completion of this jaw position with your orthodontist or dentist. We can also offer referrals. Photo below depicts a normal TMJ morphology.

Graphic copyright TMJ diagnostics

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