TMJ In-Depth

Your mouth is made up of several working components that allow it to perform some essential tasks every day. With your mouth, you can enjoy all of your favorite foods. Your mouth allows you to communicate effectively through speech. It also allows you to convey a wide array of emotions. When the different components of your mouth are healthy and working properly, you do not feel them. There is a good chance that you do not pay much if any, attention to your mouth at all. When any part of your mouth is not healthy, however, or has suffered an injury, it may not work properly. You may also be faced with irritation, inflammation, and a significant amount of pain. One of the components of your mouth essential for its functions that can be affected by significant issues is the temporomandibular joints. At Sunnyside Dentistry, we can diagnose issues with your temporomandibular joints and provide you with the treatment you need to restore the functioning and health of your mouth.

What are the Temporomandibular Joints?

Your mouth has two temporomandibular joints, commonly abbreviated as the TMJ. These joints are located one on each side of the face where your mandible, or lower jaw, meets your skull. These joints consist of a ball and socket, with a disc in the center. The TMJ is responsible for many of the movements of your mouth. They allow you to open and close your mouth, talk, and move your lower jaw from side to side. They work together with attached muscles, ligaments, and bones, enabling you to bite, chew, swallow, speak, and perform many other necessary daily functions.

What Causes Problems with the TMJ?

TMJ disorder is a term that encompasses some different issues that affect the comfort and functionality of your temporomandibular joints, as well as the attached muscles, ligaments, and bones. When any combination of these components is affected, the ability of your mouth to function properly is affected, making many things you once used to do with ease incredibly difficult. Common causes of TMJ disorder include:

•	Facial trauma. Any injuries to your face as a result of a car accident, a sports-related injury, a slip, and fall, or a physical fight can cause harm to the jaw and the joints.
•	Dislocation of the jaw. If your jaw becomes dislocated, even only temporarily, tiny tears can develop in the joints. These tears then lead to irritation and inflammation.
•	Bruxism. Grinding and clenching your teeth is an oral health condition known as bruxism. There are some different issues that can lead to this condition. Stress is one of the leading causes. When you are under stress, the muscles in your body, including those in your face and your mouth, become tense. When the muscles in your mouth become tense, it forces your teeth to clench together. During the day, you can stop your teeth from clenching and grinding if you notice it happening. However, stress can also affect you while you sleep. Your teeth can grind and clench uninterrupted during this time. Other issues that can lead to bruxism include certain types of medications, smoking, excessive alcohol consumption, and orthodontic issues.
•	Certain types of arthritis. There are two types of arthritis that can affect the health and functioning of your TMJ. Osteoarthritis is a condition in which the cartilage begins to deteriorate. Rheumatoid arthritis is a condition in which your immune system attacks your tissues. When this happens, your joints become inflamed, which can then cause a significant amount of pain.

Symptoms of TMJ Disorder

Because there are so many different causes of TMJ disorder, there are numerous different symptoms that you can experience. A majority of these symptoms do not occur right away. It may be a while before you even know that anything is wrong. The symptoms tend to come on gradually, worsening over time as the condition continues. Some symptoms that you might experience may seem completely unrelated to your mouth at all. This can lead you to mistakenly seek medical treatment rather than dental care and can result in a misdiagnosis. Symptoms of TMJ disorder include:

•	Significant pain in your jaw, your TMJ, and in your face.
•	Trouble, and pain, opening and closing your mouth.
•	Pain and difficulty while eating. You may find that you have a hard time eating many of your favorite foods.
•	Difficulty speaking.
•	Lockjaw. This is a condition in which your jaw temporarily locks, and you are unable to open or close your mouth.
•	Clicking, popping or grinding sensations.
•	Chronic headaches or earaches. Stress and pain in your TMJ can radiate up into your skull and your ears, leading to these seemingly unrelated symptoms.

Diagnosing TMJ Disorder

With so many different causes, it can be difficult to detect the cause of your discomfort difficult on your own. If you are experiencing any of these symptoms, it is important that you seek dental treatment. During your appointment, we perform a thorough oral exam to pinpoint the cause of your pain. In determining what is causing your TMJ disorder, we are then able to formulate an effective treatment plan to alleviate your pain and restore your quality of life.

During your oral exam, we first take a close look at the visible structures in your mouth. We look over your teeth, checking for alignment issues and wear patterns. We assess the jaw for alignment as well. In addition to a visual exam, we also take images of your mouth. These images may include x-rays, CT scans, or 3D images. These images enable us to see the structures of your mouth not visible to the naked eye. We can see the roots of your teeth, the condition of your jawbone, the muscles in your face and jaw, and your joints. With a complete picture of your oral health, we can make an accurate diagnosis as to the cause of your TMJ disorder and can formulate a treatment plan that will provide you with the relief that you need.

Home Remedies for TMJ Disorder

For patients who do not suffer from a severe TMJ disorder, it may be possible to treat the condition at home. There are a few different techniques that you can use to help alleviate your pain. These include:

•	Over the counter pain relievers. NSAID pain relievers such as ibuprofen and naproxen can help to relieve inflammation.
•	Ice and heat. Ice packs and heat packs can help to manage pain and alleviate swelling in your jaw.
•	A TMJ diet. When you have TMJ disorder, certain types of foods can be difficult to eat. Not only that, but they can cause pain while you chew as well. Foods that are hard, crunchy, sticky, or large. Eating these foods when your TMJ is already irritated and inflamed can exacerbate your discomfort and prevent the jaw and joints from healing. Instead, we recommend sticking to a diet of softer, easier to chew foods. You can also make larger foods easier to manage by cutting them into smaller pieces.
•	Practicing relaxation techniques. If your TMJ discomfort is caused by stress, practicing relaxation techniques may be able to help provide you with relief. There are a few different tactics that you can try including deep breathing, practicing meditation, and yoga. Many can achieve stress relief simply by participating in a hobby that they enjoy.

Night Guards

A night guard also called an oral or occlusal splint, is a device that is worn over your teeth much like a sports mouth guard. However, unlike a mouth guard, your night guard is only worn while you sleep. The night guard achieves two purposes. One of these jobs is to hold your jaw in proper alignment while you sleep, preventing your lower jaw from sliding backward. It also works as a cushion, acting as a buffer and absorbing the impact of forces your muscles exert on your teeth, your jaws, and your TMJ.

You may have seen night guards for sale at your local pharmacy. While these types of night guards provide an affordable option, they are not always the most effective. These night guards do not often fit properly. If your night guard does not fit, it can fall out. It is also possible for night guards to interfere with your breathing. These issues can prevent you from getting relief.

If we recommend a night guard for your TMJ disorder, we can custom create one for you based on digital impressions of your mouth. With these impressions, we are also able to take your bite into consideration, which helps to provide you with the best possible results. Custom night guards may cost more than the ones you will find at the pharmacy, at least at first, but you can be assured that your night guard will work. Instead of going back to the pharmacy and trying multiple different night guards, you can be assured that your custom night guard will fit. Additionally, custom night guards are made from high-quality materials and will last longer than ones you will find over the counter.

Botox Injections

When you think of Botox, what comes to mind? Botox injections are commonly associated with cosmetic surgery procedures. This particular treatment is often used to reduce, and even eliminate, the appearance of fine lines and wrinkles, providing a younger, smoother looking appearance. It can also be used to treat TMJ disorder, namely TMJ disorder caused by bruxism. Botox for TMJ involves a series of targeted injections. The Botox works to block the signals sent by nerves, preventing the muscles that cause grinding and clenching from contracting. Tension in the jaw is alleviated, lessening the pressures placed upon your teeth, your jaw, and your TMJ.

Orthodontics

Orthodontic treatment can be effective for providing those with alignment issues relief from TMJ disorder. One of the most common orthodontic treatments is with traditional metal braces. In addition to correcting the alignment of your teeth, they are also effective for adjusting how your teeth are aligned in respect to one another across your upper and lower arches.

Braces rely on brackets and wires to adjust the alignment of your teeth and your jaws. Brackets are bonded to the front surfaces of your teeth, and the wires are attached to each bracket using an elastic O-ring or ligature. The wires are responsible for the movement and stabilization of your teeth. If your jaws need realigning, braces can be outfitted with springs or rubber bands. With your teeth and jaws in proper alignment, your TMJ symptoms dissipate.

Today, you have options when it comes to orthodontic treatment. There are effective ways to correct the alignment of your teeth in more discreet manners. These include such treatments as clear or ceramic braces, lingual braces, and clear aligners.

Treating TMJ Disorder with Surgery

If no other treatments have provided you with relief from TMJ disorder, or if your TMJ disorder is severe, you may be recommended for surgery. There are a few different types of surgical procedures that might be performed.

•	Arthrocentesis. Arthrocentesis is a minor surgical procedure performed to alleviate your pain. With this treatment, small needles are inserted into the joints to wash them out. In some cases, small, specialized tools are used to remove damaged tissue found within the joint, dislodge the disc, or dislodge the jaw.
•	Arthroscopy. With this treatment an arthroscope, a tool equipped with a light and a camera on the end of it. The arthroscope is inserted into the jaw through small incisions and allows us to examine the joints and surrounding areas. During this procedure, we can also eliminate inflammation and realign joints and discs if necessary.
•	Open jaw surgery. Open jaw surgery is the most invasive surgical treatment for TMJ disorder. This particular course of action may be recommended if bony structures have been worn down, there are tumors in the jaw, or excessive scar tissue or bone fragments found in the jaw. During open jaw surgery, the entire area is opened up so that the structures can be more closely examined and provides the access needed to perform necessary treatment. Due to the invasive nature of open jaw surgery, this particular course of action is only recommended if necessary.

When you are suffering from TMJ disorder, the most basic tasks can become difficult and excruciatingly painful. With an accurate diagnosis of the cause of your TMJ issues and an effective treatment plan, we can help to restore the health of your mouth, alleviate your pain, and improve your quality of life. Call Sunnyside Dentistry at (503) 451-5104 today to learn more and schedule your consultation.