TMJ is a dental or orthodontic problem, which can result in medical symptoms, such as headache, pain in the face, jaw, ears, shoulders and neck. If not properly diagnosed and treated, the pain can range from mild to excruciating. The tendency is for the condition to worsen over time, if left untreated, as the facial and jaw muscles spasm and become more strained through injury or overuse.
This pattern can be dramatically improved if professional treatment is sought and you work to change the ways you deal with stress in your daily life. This can be achieved by eliminating habits that damage the jaw system, such as gum chewing, ice chomping, lip biting, teeth or jaw clenching, night-time grinding and other jaw-destructive behaviors.
The goal of TMJ treatment includes:
- Helping you achieve alignment of the jaw muscles, joints and bones
- Reducing the strain, inflammation, and overwork of the jaw muscles and joints
- Eliminating or reducing pain in the face, jaw, shoulders, and neck
- Teaching you to handle stress in healthier ways
Many relaxation techniques, such as biofeedback, may provide healthy alternatives.
What Are Some Treatments My Orthodontist Might Recommend?
There are many treatments available for TMJ, however, the treatment recommended to you may differ with ones recommended to another TMJ sufferer, depending upon the severity of your condition, as well as the part of the jaw assembly that is damaged. A person with severe scarring or degeneration of the jaw bone itself, or of the Temporomandibular Joint, may require a surgical option, such as arthroscopy, whereas a person with minor strain in the surrounding facial muscle tissue may only require a change in jaw use habits, along with the prescription of an anti-inflammatory drug to relieve swelling.
When comparing your symptoms and treatment with that of others, just keep in mind that like many other medical conditions, TMJ requires the diagnostic expertise of a professional, and the treatments they recommend may vary, depending on your symptoms. Also, because TMJ is such a complex syndrome, a period of "trial and error" may be required to find the most effective treatment.
The initial goal of treatment is always to give the patient pain relief and muscle relaxation. Once the immediate pain is relieved, there are sometimes additional treatments that may be required to permanently solve the disorder, especially if there is degeneration of the jaw bone itself, or of the Temporomandibular Joint.
Treatments most often used include:
Splint Therapy
Personal Habits/Behaviors
Biofeedback
Non-Steroidal Anti-Inflammatory Drugs
T.E.N.S. ("Transcontaneous Nerve Stimulation")
Braces
Equilibration
Arthroscopic Surgery
Splint Therapy: (an apparatus which your orthodontist may call "occlusal orthotic devices" or "occlusal guards" or "night guard"). It is used to relieve jaw strain, which is often a result of two things:
- Malocclusion - misalignment of your bite pattern. In other words, if your teeth are out of alignment, or if you've had extensive dental work done, such as crowns and bridges, your jaw may not be able to fit together properly, which causes undue stress, pressure, and strain on the jaw area as a whole.
- Bruxism - the severe wearing of the teeth by gritting and grinding, often in sleep, but sometimes also during the day. Bruxism results in damage to the teeth, the jaw, and the strain on jaw muscles and other facial tissue, which can trigger pain. It has been estimated that up to 75% of us have a habit of grinding or clenching our teeth when we experience emotional stress or tension. A splint is designed to prevent the unconscious nervous habits that often put strain on our jaw region.
A splint is generally made of hard or soft plastic, and is designed to fit over the upper or lower teeth, or sometimes both. It looks like a retainer, but without the wire. It is specially made for the bite pattern of your particular mouth, and is molded to fit your teeth. Almost all TMJ patients are treated with splints at some point in their therapy. The splint is usually worn both day and night for several months, but is eventually tapered off to only nighttime wear.
Many patients find significant relief after 3-4 weeks of splint treatment. However, it is important to wear the splint consistently to obtain best results. The pain may reoccur if the splint is not worn according to your orthodontist's instructions, or if other injury occurs in the jaw region.
Back to List
Personal Habits/Behaviors: A change in personal habits and behaviors are often required, such as no gum chewing, ice biting, pen or pencil chewing, lip biting, jaw clenching and teeth grinding. Other changes may be recommended, such as a change to a softer diet, at least temporarily, to relieve jaw strain. [See TMJ: Recovery for a more complete list of recommended lifestyle changes].
Back to List
Biofeedback: It may be recommended that you learn to use biofeedback, or other relaxation techniques to identify when emotional stress is causing you to clench or grind your teeth. A psychologist or other mental health care professional may provide biofeedback. Your doctor, dentist, or orthodontist will be able to recommend someone.
Back to List
Non-Steroidal Anti-Inflammatory Drugs (such as Ibuprofen): may be recommended to reduce swelling and muscle tension so that the jaw muscles can relax.
Back to List
T.E.N.S. ("Transcontaneous nerve stimulation"): This is a small battery-operated unit, about the size of a cassette tape player that is worn inconspicuously at your waist. A radio signal is sent from the device to a small receiver implanted just under the skin of your abdomen, another wire makes contact with the brain. T.E.N.S. reduces pain by emitting electrical waves that interfere with pain signals normally received by the brain. It is a good solution for those in acute pain, as it can provide relief with no adverse side effects.
Back to List
Braces: If there is evidence of teeth or jaw misalignment that cannot be corrected by a splint, then braces are sometimes recommended.
Back to List
Equilibration: After the initial muscle swelling is down, after a couple of months of wearing a splint, the orthodontist is able to examine the jaw and teeth alignment in a "relaxed" position. If he/she decides that uneven teeth height, or dental fixtures, such as crowns or bridges that stick up too far cause the TMJ, then "equilibration" may be recommended. It is a drilling away of the tooth surface to correct the bite position and allow the jaw muscles and ligaments to work together without strain.
Back to List
Arthroscopic Surgery: This is a one-hour surgery performed by an oral surgeon, but only after your orthodontist or dentist has determined that you have an actual Temporomandibular Joint problem, and not a soft tissue problem. Only about 10% of TMJ patients require arthroscopic intervention, after all other treatment methods have failed.
Arthroscopic surgery is recommended only after the application of mouth splints, anti-inflammatory drugs, and other conservative methods of treatment have failed. A tomogram (x-ray) or MRI would determine the necessity for arthroscopic surgery. If arthritis is present in the joint, or if it is out of position, or scar tissue is present, then arthroscopy may be used to eliminate scar tissue or bone spurs to help create better functioning of the jaw. Your orthodontist or dentist will refer you to an oral surgeon and provide more detailed information should this procedure become necessary. The surgery may or may not be covered by your medical or dental insurance plan. [See TMJ: Cost/Insurance]
Back to List
|
