Temporomandibular Joint Disorder (TMJ/TMD)
You may not give it a second of thought, but the hinge that connects your jaw to the temporal bones of your skull is critical to eating, talking, even breathing heavily. This is the temporomandibular joint. When problems develop with this joint, the condition is known as temporomandibular joint disorder (TMJ or TMD) and it can create chronic pain. We treat TMJ at Sindledecker Dentistry.
What Is Temporomandibular Joint Disorder (TMJ/TMD)?
For your bite to function and fit, three components must work together: your teeth, the masseter muscles, and your temporomandibular joint. When all is well, you have no pain in the jaw or face area, and there isn’t any clicking or popping when you chew. But if one of the three components creates alignment problems with the jaw, this leads to problems with the bite that can lead to jaw pain that can also radiate down into the neck and shoulders. You are suffering from temporomandibular joint disorder (TMJ).
What are the symptoms of TMJ?
TMJ is most common in people between the ages of 20 and 40; women have the condition more often than men. These are the typical symptoms:
- Pain or tenderness in your face, jaw joint area, neck and shoulders, or in and around the ears when you chew or otherwise open your mouth
- Clicking, popping, or grating sounds in the jaw joint when you chew or simply open or close your mouth
- Jaws that get “stuck” or “lock” either open or closed
- Consistent headaches
- Regular jaw stiffness
- Ear ringing
- Unintentional teeth grinding
- A tired feeling in your face
- Upper shoulder pain
Types of TMJ Disorders
Temporomandibular joint disorders are placed into three categories:
- Muscle Disorders. This is the most common form of TMJ. These disorders cause discomfort and pain in the muscles that surround the jaw and also in the muscles of the neck and shoulder.
- Joint-Derangement Disorders. These disorders are structural, as opposed to muscular, conditions. These disorders are often times caused by injury to the lower jaw. This can be due to trauma, bruxism, dislocation, excessive jaw movements, or displacement of the articular disc.
- Degenerative/Inflammatory Disorders. The overuse or aging of the joint can cause inflammation or degeneration of the jaw. This may be cause by osteoarthritis, a perforated TMJ disc, or rheumatoid arthritis.
A patient may experience on or more of these disorders at the same time.
Causes of TMD
Diagnosing TMJ can be tricky, as symptoms such as an earache or shoulder pain can be attributed to other causes. But the experience of Dr. Sindledecker with the condition is an advantage for our patients. Causes often can be traced back to problems with the patient’s bite, but other subtler issues such as stress and nightly teeth clenching during sleep can also contribute. Traumatic injury to the jaw or joints can lead to TMJ, plus research points to a possible genetic predisposition.
Here are some of the causes of TMJ:
- Grinding teeth during sleep
- Clenching the teeth
- Movement of the soft cushion or disc between the ball and socket of the joint
- Arthritis in the joint
- Stress, which can cause a person to tighten facial and jaw muscles
- Traumatic injury to the jaw
How do we diagnose TMJ?
At Sindledecker Dentistry, we have extensive experience with TMJ. When searching for a reason behind a patient’s jaw and neck pain, we first eliminate other conditions that can create the same symptoms: tooth decay, gum disease, arthritis, even sinus infections. When we suspect TMJ, we check for areas of tenderness around the jaw joints. This is a sign that the muscles are being overworked. We’ll have you open and close your jaw, listening for the clicking, popping, and grating sounds typical with TMJ.
We also use these tests to identify TMJ:
- Full-face x-rays, MRIs, or CT scans — These may be used to view the position of the jaw and temporomandibular joints.
- Sonography – Sound waves are used to determine whether there are any problems with jaw alignment. Dr. Sindledecker also listens for any abnormal sounds emanating from the jaw.
- Electromyography (EMG) – This method uses the electricity generated by jaw muscles to measure both muscle and nerve function. It can help to see when there is a reaction (such as pain) to movement.
- Computerized test equipment — This is used to measure the correct resting position of the jaw, identifying misalignment problems.
TMJ Treatment Options
When addressing a patient’s chronic TMJ pain, we have a variety of approaches. These can range from corrective dentistry to creating a night guard to wear during sleep. Botox injections may even be used to calm overactive muscles.
Here are the treatments we use to correct TMJ:
- Splints or night guards — Night grinding and clenching is a main factor in TMJ. To combat this, it’s important to put the jaw in the correct position at night. To do this, we fabricate plastic mouthpieces that fit over the upper and lower teeth. These are usually worn at night.
- Cosmetic dentistry — To correct alignment, we can replace missing teeth with dental implants or bridges, crown overly worn teeth, or move the teeth with orthodontics. This can involve widening constricted arches.
- Botox injections — While Botox is known for its ability to erase wrinkles on the upper third of the face, it can also be used for TMJ patients. It is very effective for relaxing the overused muscles that lead to TMJ pain.
- Lifestyle changes — Stress and anxiety are often root causes of TMJ; stress reduction techniques are important.
- Exercises — Tightening the jaw muscles and clenching the teeth is a common cause of TMJ problems. We have various jaw exercises that stimulate and relax the jaw muscles.
- Transcutaneous electrical nerve stimulation (TENS) — Small electrical pulses are delivered to the jaw muscles through a small wand. These pulses stimulate the nerves, encouraging the muscles to relax and the jaw to fall into alignment.
Will TMJ correct itself?
This is a yes and no answer. If your TMJ is related to personal stress that is making you clench and grind your teeth, removing the source of the stress can alleviate your symptoms. However, if your TMJ is due to alignment problems with your jaw and bite, your TMJ will continue until these problems are corrected.
Schedule a Consultation
To learn more about Temporomandibular Joint Disorder or to schedule a consultation, please call (561) 368-2928