The temporomandibular joint (TMJ), more commonly referred to as the “jaw joint, assists in the opening, closing, and functional movement of the jaw. Drs. Mogelof are trained in the diagnosis of TMD (Temporomandibular Disorders). This category includes many problems that can mimic joint related pain but actually have separate medical diagnoses, many of which could be muscular. That is why the correct diagnosis is very important so that patients are treated as efficiently and as non-invasively as possible. In addition, correct diagnosis will often prevent a patient from being treated by more aggressive methods, thereby saving cost and time.
WHAT TO LOOK FOR:
-Jaw locking, painful jaw clicking
-Burning mouth syndrome
-Ear pain/ear stuffiness
WAYS TO MANAGE:
-Oral appliance therapy
-Trigger point injection
-Botulinum toxin injections
-Self care strategies
If you have had symptoms like pain or a “clicking” sound, when you eat or speak, these problems can be diagnosed and treated to a better result 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. Drs. Andrew and Scott Mogelof can help you have a healthier and more comfortable jaw.
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. 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.
Do You Have a TMJ Disorder?
- Are you aware of grinding or clenching your teeth?
- Do you wake up with sore, stiff muscles around your jaws?
- Do you have frequent headaches or neck aches?
- Does the pain get worse when you clench your teeth?
- Does stress make your clenching and pain worse?
- Does your jaw click, pop, grate, catch, or lock when you open your mouth?
- Is it difficult or painful to open your mouth, eat, or yawn?
- Have you ever injured your neck, head, or jaws?
- Have you had problems (such as arthritis) with other joints?
- Do you have teeth that no longer touch when you bite?
- Do your teeth meet differently from time to time?
- Is it hard to use your front teeth to bite or tear food?
The more times you answered “yes”, the more likely it is that you have a bite problem or TMJ disorder.
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
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 nightguard) fits over your top or bottom teeth and helps keep your bite in a position that will relax the muscles and reduce 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/day 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 been caused by problems with how your teeth fit together, you may need bite adjustment (equilibration), orthodontics (teeth moved) with or without jaw reconstruction, or restorative dentistry to build up your bite. Surgical options such as arthroscopy and open joint repair restructuring are sometimes needed, but are reserved for severe cases. Drs. Mogelof consider TMJ surgery as a last resort unless the jaw can’t open, is dislocated and nonreducible (can’t be put back in position), has severe degeneration, or the patient has undergone appliance treatment unsuccessfully. We have a network of excellent Surgeons with whom to consult if necessary.