TMJ Disorders
TMJ (temporomandibular joint) disorders are a family of problems related to your 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 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. Fenton can help you have a healthier, more comfortable jaw.
Trouble With Your 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. 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.
TMJ/ TMD Questionnaire
Please fill this form out and bring it with you to your consultation if you are having your jaw joint evaluated.
TMD QUESTIONNAIRE
Education TMJ website
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?
- Are your teeth sensitive, loose, broken or worn?
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.
Treatment
There are various treatment options that Dr. Fenton can utilize to improve the harmony and function of your jaw. Once an evaluation confirms a diagnosis of TMJ disorder, Dr. Fenton will determine the proper course of treatment. It is important to note that treatment always works best with a team approach of self-care combined with professional care.
The initial goals are to relieve the muscle spasms 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
- Custom made dental bite guards
- Stress reduction
Stress management techniques such as biofeedback or physical therapy may also be recommended, as well as a custom 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. It also acts as a force distributor or “shock absorber” decreasing the pressure from clenching or grinding. There are different types of appliances used for different purposes. A nightguard helps protect your teeth and muscles from the effects of clenching or grinding your teeth and reduces muscle tension at night. It also helps to protect the cartilage and joint surfaces.
ARTHROCENTESIS
Arthrocentesis is a minimally invasive procedure that is often the first surgical procedure for a patient who has a displaced TMJ disc. It can be done as an in-office procedure under IV sedation. It involves the placement of two needles into the joint and fluid injected to break scar bands that are preventing freedom of movement of the TMJ disc. The procedure also removes tissue breakdown products and reduces inflammation.
When you get home (a few hours after the procedure), your joint and the surrounding area will be numb.You might have some swelling for a few days; however, most people are back at work after two to three days. There are generally no limits on physical activity or use of the jaw; usually the surgeon will recommend a jaw exercise program. You may be told to maintain a soft diet for a little while, but chances are you are already on one.
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. Fenton does not consider TMJ surgery unless the jaw can’t open, is dislocated and non-reducible, has severe degeneration, or the patient has undergone appliance treatment unsuccessfully.
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