What Is TMJ? | Buffalo NY
TMJ Dysfunction can be described as a family of problems related to the function of your lower jaw. If you have had symptoms like jaw pain, headaches, noises in your jaw joints when they move, locking of your jaw, difficulty chewing or swallowing, ringing in you ears, or even vertigo, you may be dealing with a TMJ problem. It might be a good idea to get that checked out.
There are many different theories and beliefs about what causes TMJ problems, and much controversy exists about what can be done to alleviate or resolve these conditions. I hope that the following information can give you a clearer idea about your particular condition. If you suffer from any of these symptoms, I hope that I can help you figure out what is wrong, and perhaps give you some guidance about how it might be corrected. Please understand, nothing on this website is intended to be individualized medical or dental advice, and a comprehensive examination is very important if you seek a specific diagnosis and/or treatment plan for your particular condition and/or circumstances.
Do You Have a TMJ Problem?
The following is a list of common symptoms related to TMJ problems…
- Pain in or around the ear, sometimes spreading to the face brought on by yawning, chewing or opening widely.
- Tenderness of the jaw muscles.
- An imbalanced or uncomfortable bite.
- Clicking or popping noises when you open or close your mouth, or when eating certain foods.
- Difficulty or pain when opening or closing your mouth.
- Recurring or persistent headaches or neck-aches.
- A jaw that gets stuck, locked, or “goes out”.
- Pressure, fullness, or ringing in your ears.
- Dizziness that can’t be explained.
Some of the Causes of TMJ Dysfunction:
- Parafunctional Habits: Stress, anxiety, and other intense, negative emotions can cause the jaw muscles to automatically tighten, squeezing the teeth together. This tightening can also squeeze the jaw joints slightly out of alignment, which can lead to adaptive remodeling of the joint structures. This remodeling can in turn lead to an increase in muscle tension, as some of the jaw muscles are recruited in an attempt to stabilize the joint. Parafunction (clenching or grinding the teeth) is thought to be the primary determinant of degenerative joint damage. Parafunction is one of the ways your body reacts to emotional stressors in your life. These can be past, present, or future. Most of us clench or grind our teeth on a regular basis, but few of us are aware of it. See the section labelled Why We Clench for more information on this.
- Airway Compromise: When the nervous system detects that the body is not getting enough air, the sympathetic response (fight or flight) is activated, and tooth clenching and grinding can occur. Mounting evidence suggests that these two conditions — bruxism and sleep apnea — are closely interconnected, and we cannot treat one without at least considering the other.
- Trauma or accident: Injuries to the jaw joints, the head, the neck, or any of the surrounding muscles, can initiate these types of conditions via injuries to the joint structures, and they can also cause a favorably adapted joint to transform into a painful or dysfunctional one. Whiplash-type injuries frequently result in damage to these joints.
- Musculoskeletal imbalances: A misalignment of the mandible (lower jaw bone) with the bones of the head can interfere with normal muscular function. When muscles pull on bones in an imbalances way, we can observe changes in those bones. Musculoskeletal imbalance related to the jaw can actually cause your face to become asymmetrical.
- Structural abnormalities: These include displaced discs, an uneven bite, missing teeth, asymmetrical growth of the upper or lower jaw, and size discrepancies between the upper and lower jaws. Any of these abnormalities can impede the function of the jaws, and lead to unfavorable adaptive changes.
- Chronic Inflammatory Disease: Inflammatory diseases such as Rheumatoid Arthritis or osteoarthritis may cause bone or disc degeneration (breakdown). If you have degenerative joint problems in other area of the body, it is possible that your jaw joints are compromised as well.
- Neurological Damage: Abnormalities within your nervous system can lead to many of these symptoms. In these cases, it is normally necessary to rule out more common structural or functional problems before exploring this as a cause. If neurological damage is suspected, you will be referred to a neurologist for evaluation.
- Infections: Rarely, infections with pathogenic organisms can cause TMJ-like symptoms. Shingles and Lyme Disease are two such conditions. Referral to your primary care physician, or an infectious disease specialist is necessary if this is suspected.
- Chronic Pain: There are times (rarely) when we cannot determine a physical cause of the symptoms. In these cases, management by a team experienced in pain management can be helpful, including specialists in cognitive therapy, neurofeedback, acupuncture, medical pain management, and alternative healing modalities such as Reiki and Quigong.
Contrary to what many people believe, there are many ways to successfully treat TMJ dysfunction. Finding the treatment protocol that will work the best for you can be a challenge, and may require some degree of trial and error. Here I will outline types of treatment modalities based on category.
Treatment of these sorts of problems is a journey, not a destination, and the path to wellness can be filled with obstacle. We will be there to guide you every step of the way.
Palliative or Supportive Therapy (reducing discomfort)
- Soft diet – slowly, and mindfully, eat foods that are very easy to chew
- Moist heat – soothes and softens tight muscles
- Anti-inflammatory medications – for temporary relief of pain from an acute injury
- Muscle relaxants – these medications help determine if the muscles are the cause
- Mindfulness training – learn how to better manage the stressors in your life
- Trigger Point Injections – immediately release tension in trigger points
- BOTOX – this can be helpful to relax and reshape muscles that are hyperactive
- Prolotherapy – a sugar solution is injected into the joint to help initiate a healing response
- Transcutaneous Electrical Nerve Stimulation (TENS) – used primarily for pain control
- Iontophoresis – for temporary reduction of inflammation
- Laser biostimulation – a wonderfully comfortable treatment that can have long-lasting anti-inflammatory, regenerative, and pain-relieving effects
Restorative & Corrective Treatments
- Regular range of motion stretches and exercises
- Correction of dysfunctional patterns of movement
- Physical Therapy
- Orthotic Therapy
- Occlusal Equilibration
- Orthodontic Treatment
- Occlusal Rehabilitation (Comprehensive Dental Restoration)
After orthotic therapy, you might find that your bite is uncomfortable, and this can be annoying. The orthotic, or bite splint, has made it obvious to you that there is a discrepancy between your jaw joints and the way your teeth fit together. In this case, your teeth can be adjusted by either selectively grinding them down, or adding to them, so that they fit together better. This grinding is done very selectively, and only after a “trial equilibration” has been done on stone models of your teeth to determine how much tooth structure needs to be removed in order to give you a more comfortable and balanced bite.
As you can see, occlusal equilibration not only helps the way the teeth fit and feel, but also frequently improves the way they look as well!