TMJ Disorders – Carmel Valley | Del Mar | San Diego
TMJ disorders are a family of problems related to the complex jaw joints. If you have symptoms such as pain or a “clicking” sound, you’ll be glad to know that these problems are now more easily diagnosed and treated than they were in the past. 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. For those TMJ disorders requiring treatment, no one treatment can be used to resolve all TMJ disorders completely. Treatment takes time to become effective. Dr. Sidal can help diagnose your condition and help you have a healthier and more comfortable jaw.
Trouble with Your Jaw
TMJ disorders develop for many reasons. You might clench or grind your teeth, tightening your jaw muscles and stressing your TM joints. You may have a damaged jaw joint due to injury or disease. 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. Locking of the jaw can also occur.
Do You Have a TMJ Disorder?
- Are you aware of grinding or clenching your teeth?
- Do you wake up with sore, stiff muscles around your jaws?
- Do you have frequent headaches or neck aches?
- Does the pain get worse when you clench your teeth?
- Does stress make your clenching and pain worse?
- Is it difficult or painful to open your mouth, eat or yawn?
- Have you ever injured your neck, head or jaws?
- Have you had problems (such as arthritis) with other joints?
- Do you have teeth that no longer touch when you bite?
- Do your teeth meet differently from time to time?
- Is it hard to use your front teeth to bite or tear food?
- Are your teeth sensitive, loose, broken or worn?
The more times you answered “yes” to the above questions, the more likely it is that you may have a TMJ disorder. Understanding TMJ disorders will also help you understand how they are treated.
There are various treatment options that Dr. Sidal can utilize to improve the harmony and function of your jaws. Once an evaluation confirms a diagnosis of TMJ disorder, your doctor 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 goals are to relieve muscle spasm and joint pain. This is usually accomplished with at-home self physiotherapy, together with a pain reliever, anti-inflammatory, and/or muscle relaxant medication. Occasionally steroids can be injected directly into the joints to reduce pain and inflammation. Self-care treatments can often 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
Stress management techniques such as biofeedback or physical therapy may also be recommended, as well as a temporary, clear plastic appliance known as a splint. A splint or nightguard fits over your top or bottom teeth and helps keep your teeth apart, thereby relaxing the muscles and reducing pain. There are different types of appliances used for different purposes. A nightguard helps you stop clenching or grinding your teeth and reduces muscle tension at night and helps to protect the cartilage and joint surfaces. An anterior positioning appliance moves your jaw forward, relieves pressure on parts of your jaw and aids in disk position. It may be worn 24 hours/day to help your jaw heal. Appliances also help to protect from tooth wear.
Arthrocentesis is a minimally-invasive procedure that may be advised to reduce a dislocated joint, to improve mouth opening, or to relieve joint pain when other, non-invasive treatments have not succeeded. Arthrocentesis involves filling the joint cavity with sterile fluid under pressure and “washing out” the joint. Simultaneous manipulation of the joint will often relieve adhesions and reduce dislocations.
What about bite correction or surgery?
If your TMJ disorder is caused by problems with how your teeth fit together, you may need treatment such as bite adjustment (equilibration), orthodontics with or without jaw surgery and/or restorative dental rehabilitation. Surgical options such as arthroscopy and open joint surgery are sometimes needed, but are reserved for severe cases. Dr. Sidal does not consider TMJ surgery unless the jaw cannot open, is dislocated and nonreducible, has severe degeneration, or the patient has undergone non-surgical treatment unsuccessfully.