Posts for tag: tmj disorders
After ruling out other causes for your jaw pain, your doctor or dentist has made a diagnosis: a temporomandibular joint disorder (TMD). With TMD, your pain symptoms and other dysfunctions are due to a problem associated with the temporomandibular joint (TMJ) that connects your lower jaw (mandible) to your upper skull (cranium).
There are a number of treatment options, but most can be classified as either aggressive or conservative. Aggressive treatments are more interventional and target problems with the teeth such as bite problems or jaw relationships as they relate to the bite, which are thought to be underlying causes for TMD. Such treatments include orthodontics to realign teeth, crown or bridgework, or surgical treatment to the jaw or joint itself. These treatments are controversial and irreversible — with no guarantee of symptom relief.
It’s thought by many to be appropriate, then, to start with more conservative treatments. Many of these are based on treating the TMJ — which is a joint, a moveable bony structure connected by muscles and tendons — with an orthopedic approach, using treatments similar to those used for other joint problems.
Here, then, are some of those conservative therapies that may relieve your TMD pain and other symptoms.
Physical Therapy. Commonly used to treat pain and dysfunction in other joints, physical therapies like manual manipulation, massage, alternating hot and cold packs or exercises can be used to relax, stretch or retrain the muscles that operate the TMJ while reducing pain and inflammation.
Medications. Medications may be incorporated into the treatment plan to relieve pain, reduce inflammation or relax tense muscles. Besides prescription drugs, over-the-counter anti-inflammatory drugs (such as ibuprofen or acetaminophen) are also commonly used.
Bite Appliances. If night-time teeth grinding or clenching habits are a primary cause for the TMD, you may benefit from wearing an occlusal bite guard while you sleep, designed to specifically fit your upper teeth. Because the lower teeth can’t grip the guard’s smooth plastic surface when biting down, they’ll more likely produce less force. This gives the jaw muscles a chance to relax during sleep.
Diet changes. Changing to softer foods, which don’t require strenuous chewing, and eliminating the chewing gum habit will further help reduce stress on the TMJs and also give your muscles a chance to relax and heal.
If you would like more information on TMD and treatment options, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “Seeking Relief from TMD.”
A blow to the face can result in a variety of injuries to your jaws and the temporomandibular joints (TMJs) that join the lower jaw to the skull. Only a thorough examination can determine the type and extent of the injury, and how to treat it.
The pain you feel in your jaw may indicate a direct injury, usually near the joint. This could mean the joint head (condyle) has dislocated, or moved out of the joint space. It could also mean you’ve fractured your lower jaw, most commonly just below the head of the joint.
Jaw pain can also indicate structures near the jaw and joint have been damaged and the jaw is indirectly affected. In some cases a damaged tooth may be radiating pain signals through the jaw (along similar nerve paths). More likely, trauma to soft tissue near the jaw joint has swelled with inflammation, putting pressure on the joint and temporarily stopping the condyle from seating fully in the joint space.
Any of these injuries can also cause painful muscle spasms, a defensive reaction from the body that causes muscles on either side of the jaw to limit movement preventing further damage (a natural splint, if you will). Thus, the pain may be compounded by a diminished range of motion when you try to chew or speak.
It’s important, therefore, to determine the exact cause of pain and limited movement before commencing treatment. Spasms and inflammation are usually treated with muscle relaxant drugs and anti-inflammatory pain relievers. In the case of a dislocation, gentle manipulation can ease the condyle back into the joint space. A fracture would require more extensive treatment, including repositioning broken bone and immobilizing the jaw from movement to allow healing. In the most severe cases, surgical treatment may be necessary to internally immobilize the joint.
If you sustain an injury that results in jaw swelling and pain, you should see us without delay. The sooner we can diagnose and begin the proper treatment for your injury, the less likely you’ll encounter long-term problems and the sooner you’ll be pain and swelling free.
If you would like more information on the causes and treatment of jaw pain, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “Jaw Pain.”
Chronic jaw pain can make eating, speaking or even smiling difficult. What's more, finding the right treatment approach can be just as difficult.
This is because TMD (Temporomandibular Disorder: named for the joints on either side of the lower jaw) actually describes a wide range of possible problems with the joints and connecting muscles. Any of them can result in impaired jaw function, radiating pain or even headaches.
We'll need to conduct a full dental and facial exam to accurately diagnose your jaw pain's cause. Even then, the way may still not be clear: there's considerable debate among dentists about the best treatment approach. Two basic schools of thought prevail, one conservative and non-invasive and the other more aggressive and interventional.
The conservative approach seeks to alleviate symptoms in a variety of ways, including recommending softer foods to give muscles and joints time to relax, applying cold and heat to ease soreness, massage of the jaw joint muscles, gentle stretching and jaw exercises. We may also prescribe medications like ibuprofen and other non-steroidal anti-inflammatory drugs for pain and swelling relief, and sometimes muscle relaxers to reduce spasms. If your pain stems from clenching or grinding habits, we could fit you with a custom bite guard you wear while you sleep to reduce the forces on your teeth.
The more aggressive approach is much more invasive. These methods include altering the bite or teeth position with orthodontics or dental work or surgically altering the joints themselves or the shape of the jaw. If you're recommended one of these more aggressive treatments, you should know they're not commonly used to treat TMD and they're irreversible. There's also no guarantee you'll gain relief from your symptoms, so by all means get a second opinion before undergoing any procedures.
For most people the best course of treatment is to start with the least invasive techniques, which are usually very successful. If they don't relieve your pain and limited function, we may then consider escalating treatment to more irreversible procedures to help you find relief from this unwelcome condition.
If you would like more information on jaw joint pain and how to treat it, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “Seeking Relief from TMD.”