To many doctors and patients alike, TMJ is a dreaded voodoo-like problem that causes much discomfort for patients and stress for practitioners. However, advances in dental education and training have now given dentists proper tools for treating and eliminating much of the pain associated with TMJ symptoms. Let’s start with the basics… TMJ stands for Temporal Mandibular Joint. The painful disorder involving the TMJ is known as TMD (Temporomandibular Disorder). Every person has two TMJ’s, one on each side of the skull. It is one of the most complicated joints in the body allowing for both rotation (like a ball-socket joint) and translation (controlled and deliberate dislocation of the joint). This joint endures a tremendous amount of stress from the time we are born and throughout our lifetime. When we talk, chew, grind or clench we are utilizing the joint and all of the associated muscles and ligaments. Pain from the TMJ can be caused by numerous problems, the three most common being muscles, inflammation and joint pain. The most common of all is muscle pain. The muscles can become irritated, over-worked, inflamed and painful from grinding and/or clenching, or from problems with how the teeth function together (aka your bite). This frequently can cause stiffness of the face, chronic headaches, pain when chewing or even a noisy joint.
A proper examination with a history from a patient can help discover the cause of the problem, and allow us to determine how to properly treat the problem. Many times the pain and problems can be treated with a custom made bite splint (night guard), which is designed with a specific problem in mind. For some people this will be adequate and reduce the pain associated with TMJ. For others, once the pain is controlled with the bite splint, more detailed examination into the bite is necessary. Many times the way the teeth hit and glide across each other when chewing, closing, etc., can cause interferences that negatively impact both the joint and the muscles. Sometimes this can be corrected with minor adjustments to individual teeth to make them work in harmony with the joint and supporting structures. Other times it is more complex requiring orthodontics or restorative treatment such as multiple crowns.
Grinding and Clenching are very common problems for many people. This destructive habit is usually caused by life stress and taken out on our teeth subconsciously. A recent long term study has also shown a link between chronic stomach acid reflux (GERD) and sleep apnea and grinding. Even if someone has no TMJ pain associated with grinding and clenching, there may be a silent force causing slow wear and destruction of the teeth. Grinding and clenching is a major cause of fracturing teeth and restorations. The chronic nature of grinding slowly cracks the teeth, especially molars, and leads to the need for treatment such as crowns, root canals and extraction. Chronic grinding can also slowly wear down teeth, making the teeth sensitive to cold, shorter in height and less attractive. It is difficult to stop one from grinding, however, with a custom bite splint (usually worn at bedtime), we can prevent further damage to the teeth from these uncontrollable habits. It is far more cost effective to fabricate a bite splint, than to correct the damage from fractured and worn teeth down the road.
After hundreds of hours of continuing education in managing and treating the TMJ, we provide exceptional treatment to our patients that need it. If you have pain or questions please feel free to ask us, or visit our website at http://www.vanguarddentalgroup.com/nh-dental-services/general-dentistry.php to learn more about TMD.
