TMJ Disorders

TMJ (temporomandibular joint) disorders are a family of problems related to your complex jaw joint. If you have had symptoms like pain or a “clicking” sound, you’ll be glad to know that these problems are more easily diagnosed and treated than they were in the past. These symptoms occur when the joints of the jaw and the chewing muscles (muscles of mastication) do not work together correctly. TMJ stands for temporomandibular joint, which is the name for each joint (right and left) that connects your jaw to your skull. Since some types of TMJ problems can lead to more serious conditions, early detection and treatment are important.

Often no one treatment can resolve TMJ disorders completely and treatment takes time to become effective. Wayne can help you have a healthier and more comfortable jaw.

Trouble With Your Jaw?

TMJ disorders develop for many reasons. If you are told you clench or grind your teeth then this is true, Everyone does. Clenching, grinding, bruxism and”stress” have little to do with the cause of TMJ problems. If you are told they are, then think again.”Treating” your clenching or stress will have no effect on your TMJ disorder. Many many studies have shown this, including using Botox to treat facial muscle pain or “tension”. It doesn’t usually work and costs a lot of money.

Let me give an example; if you have arthritis in your hip then walking up a mountain will make it sore. To say the normal use of walking causes your problem isn’t totally correct, yes you could reduce the amount you walk and improve your symptoms, just as you could avoid chewing hard foods. If you fix the actual problem which is arthritis in your hip then you can walk and use your legs normally with no pain or limitation. Similarly fixing the underlying cause of your TMJ pain can allow you to use your Jaws normally and without pain.

You may have a damaged jaw joint due to injury or disease although the most common is an instability in the joint cartilage and displacement of the joint meniscus which then creates clicking and crackling sounds. Injuries and arthritis can damage the joint directly or stretch or tear the muscle ligaments. As a result, the disk, which is made of cartilage and functions as the cushion of the jaw joint, can slip out of position. Whatever the cause, the results may include a misaligned bite, pain, clicking, or grating noise when you open your mouth or trouble opening your mouth wide.

Do You Have A TMJ Disorder?

  • If you are pain free and can open your jaw freely chew hard foods without pain or locking then you are fine.
  • If you are reading this page and have face pain, jaw joint pain or limited movement which has gone on for more than 8 weeks then you probably have a TMJ disorder.

Other conditions such as headache syndromes and head and neck pathology can give similar symtpoms. It is essential to have a thorough examination and establish a definite diagnosis before undergoing any treatment. 

Treatment

There are various treatment options that Wayne can utilize to improve the harmony and function of your jaw. Once an evaluation confirms a diagnosis and the type of TMJ disorder, Wayne will determine the proper course of treatment. It is important to note that treatment always works best with a team approach of self-care joined with professional care.

The initial goal is to determine if the problem is a headache syndrome, internal joint derangement or a mixture of both. Treatments can range from reassurance, exercises, medicines, oral appliances and surgery. Steroids can be injected directly into the joints to reduce pain and inflammation or more recently injection of your own growth factors taken from your own blood serum are showing more promise, Wayne can provide this treatment.

Some recommend self-care treatments over the first 8 weeks can be effective and include:

  • Resting your jaw
  • Keeping your teeth apart when you are not swallowing or eating
  • Eating soft foods
  • Applying ice and heat
  • Exercising your jaw
  • Practicing good posture

Studies tend to show that if you got better after doing this, then you would have got better anyway even if you did nothing. There are some self care techniques that are effective in certain conditions but you need a diagnosis and Wayne can explain what will help.

Physical therapy may also be recommended, as well as a temporary, clear plastic appliance known as a splint or “Bite Raising Appliance”. A splint fits over your top or bottom teeth and helps keep your teeth apart, no one really knows how they work, but in specific situations they help. They don’t help for the most common TMJ condition of a clicking painless jaw. Appliances also help to protect from tooth wear.

What About Bite Correction Or Surgery?

If your TMJ disorder has caused problems with how your teeth fit together, you may need orthodontics with or without jaw joint surgery, or restorative dental work. Surgical options such as arthroscopy and open joint repair or Total Joint Replacement are sometimes needed, but are reserved for severe cases. Wayne does not consider TMJ surgery unless the jaw can’t open, is dislocated and nonreducible, has severe degeneration, or the patient has not responded to non-surgical treatment.  Chronic pain is another reason for surgery after other options have been tried.

 

The Most Important thing about TMJ problems

The most important step is to make a diagnosis; bruxism, clenching or stress is not a diagnosis. There is an internationally agreed list of diagnoses for TMD / TMJ problems which you can view here: IADR Diagnostic Criteria outline

Wayne can offer the full range of management from physiotherapy, orthotic, medical and surgical treatment. For TMJ problems the saying is very true “When the only tool you have is a hammer, every problem looks like a nail”. If all your healthcare provider can do is prescribe medicines, tell you not to stress, just do physical therapy or only ever make bite appliances then that is all you will get from them every time, regardless of your diagnosis. See someone with the full toolkit.  Get a clear diagnosis and get appropriate treatment.