TMJ (temporomandibular joint) disorders are a family of problems related to your complex jaw joint. If you have had symptoms like pain or a "clicking" sound, you'll be glad to know that these problems are more easily diagnosed and treated than they were in the past. These symptoms 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. Since some types of TMJ problems can lead to more serious conditions, early detection and treatment are important.
No one treatment can resolve TMJ disorders completely and treatment takes time to become effective. Dr. Tye can help you have a healthier and more comfortable jaw.
TMJ disorders develop for many reasons. You might clench or grind your teeth, tightening your jaw muscles and stressing your TM joint. You may have a damaged jaw joint due to injury or disease. 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. Cardinal signs of TMJ Disorder are Facial Pain, Limited Oral Opening, Popping and Clicking in front of the ear, and Headaches. The TMJ disk may be inflamed (Synovitis) or out of place (dislocated). Many patients suffer from this chronic disease process. A thorough medical and dental exam is important in evaluating TMJ Disorder. Contributing factors to the disease process include stress, trauma, bite problems, and systemic conditions such as arthritis.
Whatever the cause, the results may include a misaligned bite, pain, clicking or grating noise when you open your mouth or trouble opening your mouth wide.
The more times you answered "yes," the more likely it is that you have a TMJ disorder. Understanding TMJ disorders will also help you understand how they are treated.
There are various treatment options that Dr. Tye can utilize to improve the harmony and function of your jaw. Once an evaluation confirms a diagnosis of TMJ disorder, Dr. Tye will determine the proper course of treatment. It is important to note that treatment always works best with a team approach of self-care joined with professional care.
Medical management includes non-steroidal anti-inflammatory agents and muscle relaxers. Conservative therapy includes physiotherapy or exercises, a soft diet, TENS, and biofeedback. Dental management includes braces for bad bites, occlusal splint therapy, and occlusal rehabilitation.
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:
Stress management techniques such as biofeedback or physical therapy may also be recommended, as well as a temporary, clear plastic appliance known as a splint. A splint or night guard 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, relives 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 or just at night to move your jaw into proper position. Appliances also help to protect from tooth wear.
To provide you with a better understanding of tmj surgery, we have provided the following multimedia presentation. Many common questions pertaining to tmj surgery are discussed.
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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. This may include TMJ Arthroscopy or TMJ Arthroplasty. TMJ Arthroscopy, similar to knee arthroscopy, allows Dr.Tye to inspect the joint, free adhesions, and manipulate the disk. It is both diagnostic, allowing Dr. Tye to inspect and document the condition, and therapeutic, often improving symptoms of oral opening and pain. With open TMJ Arthroplasty, Dr.Tye may reposition or replace the TMJ disk and/or remove bone spurs of the jaw bone. Surgery may be warranted for those who suffer from TMJ Disorder who have failed conservative treatment and whose symptoms are severe enough to interfere with daily life.
Dr. Tye does not consider TMJ surgery unless the jaw can't open, is dislocated and nonreducible, has severe degeneration, or the patient has undergone conservative treatment including appliance treatment unsuccessfully.