About TMJ & Myofascial Pain Treatment
The temporomandibular joint (TMJ) is a remarkably complex joint and can be a source of pain for a number of individuals. TMJ disorders can manifest themselves in a variety of ways. Common symptoms include:
- Clicking/Popping of Jaw
- Jaw Locking Shut
- Headaches
- Ear Pain/Achiness
- Tinnitus
- Neck Pain
- Radiating Face Pain
- Tooth Pain
At our office, we can provide effective treatment for TMJ disorder, often with conservative therapy. Specializing in the physiological approach to head and neck pain, Drs. Brian and Rob have the extensive training and equipment to provide the most effective and unique services.
Our treatment primarily focuses on decompressing the joint space and finding a position for the jaw that is also comfortable for the surrounding muscles, which will permit healing to occur. It starts with taking a 3-D x-ray, called a CBCT image, in our office to visualize the relationship between the bones within the joint.
To learn more about our approach to treatment, visit our page on Physiologic Dentistry.
About TMJ & Myofascial Pain Treatment
The temporomandibular joint (TMJ) is a remarkably complex joint and can be a source of pain for a number of individuals. TMJ disorders can manifest themselves in a variety of ways. Common symptoms include:
- Clicking/Popping of Jaw
- Jaw Locking Shut
- Headaches
- Ear Pain/Achiness
- Tinnitus
- Neck Pain
- Radiating Face Pain
- Tooth Pain
At our office, we can provide effective treatment for TMJ disorder, often with conservative therapy. Specializing in the physiological approach to head and neck pain, Drs. Brian and Rob have the extensive training and equipment to provide the most effective and unique services.
Our treatment primarily focuses on decompressing the joint space and finding a position for the jaw that is also comfortable for the surrounding muscles, which will permit healing to occur. It starts with taking a 3-D x-ray, called a CBCT image, in our office to visualize the relationship between the bones within the joint.
To learn more about our approach to treatment, visit our page on Physiologic Dentistry.
The difference between TMJ & TMD…
The difference between TMJ & TMD…
The difference between TMJ & TMD…
WHAT IS TMJ?
TMJ is an abbreviation for the ‘temporomandibular joint.’ It refers to the joint itself –the actual bony relationship between the lower jaw and the skull. The lower jaw attaches to the base of the skull in two places, so everyone has two TMJ’s – one on the right side and one on the left side, directly in front of each ear.
In addition to the actual bones that are brought together at the joint, the TMJ also includes ligaments, nerves, blood vessels, neighboring muscles, and a disc that rests between the bones. The position of the disc has a very important role in proper function of the joint. It should remain centrally between the bones throughout the entire movement of opening and closing. The TMJ works like a sliding hinge, with the lower jaw rotating open on the disc like a hinge, while the disc itself slides forward and downward on the skull, all in one fluid motion.
WHAT IS TMD?
TMD, which stands for ‘temporomandibular joint dysfunction’, is the condition that results from improper development or a breakdown of one or both temporomandibular joints. This breakdown results in improper function and discomfort or pain.
People frequently refer to the condition of TMD by (incorrectly) calling it ‘TMJ.’ Due to the widespread adoption of this misnomer, it’s accepted within our profession to call it TMD or TMJ, when referring a problem with this joint.
A healthy TMJ has a few millimeters of space between the actual bones within the joint, which allows for healthy blood flow and lubrication of the complex. TMD arises from over-compression of this space within the TMJ. This loss of necessary space can result in compression of nerves and blood vessels, inflammation of the surrounding muscles, degeneration of the disc, or degeneration of the bone itself – all of which are responsible for creating the pain and symptoms listed above.
WHAT IS TMJ?
TMJ is an abbreviation for the ‘temporomandibular joint.’ It refers to the joint itself –the actual bony relationship between the lower jaw and the skull. The lower jaw attaches to the base of the skull in two places, so everyone has two TMJ’s – one on the right side and one on the left side, directly in front of each ear.
In addition to the actual bones that are brought together at the joint, the TMJ also includes ligaments, nerves, blood vessels, neighboring muscles, and a disc that rests between the bones. The position of the disc has a very important role in proper function of the joint. It should remain centrally between the bones throughout the entire movement of opening and closing. The TMJ works like a sliding hinge, with the lower jaw rotating open on the disc like a hinge, while the disc itself slides forward and downward on the skull, all in one fluid motion.
WHAT IS TMD?
TMD, which stands for ‘temporomandibular joint dysfunction’, is the condition that results from improper development or a breakdown of one or both temporomandibular joints. This breakdown results in improper function and discomfort or pain.
People frequently refer to the condition of TMD by (incorrectly) calling it ‘TMJ.’ Due to the widespread adoption of this misnomer, it’s accepted within our profession to call it TMD or TMJ, when referring a problem with this joint.
A healthy TMJ has a few millimeters of space between the actual bones within the joint, which allows for healthy blood flow and lubrication of the complex. TMD arises from over-compression of this space within the TMJ. This loss of necessary space can result in compression of nerves and blood vessels, inflammation of the surrounding muscles, degeneration of the disc, or degeneration of the bone itself – all of which are responsible for creating the pain and symptoms listed above.
Still have questions?
We can help…
If you suffer from any of the symptoms listed above, this could be the case. Please contact our office to set up a consultation to have a personal discussion about what symptoms are affecting you and how we can help. In order to examine your joints radiographically, we recommend using a 3-D image, called a Cone Beam CT, that can be taken during your visit. Pairing this information with a full evaluation of your jaw relationship and symptoms will help us to accurately diagnose your condition.
There’s a wide range of treatment options that we offer, and subsequently, a wide range of fees. It all depends on what symptoms we’re aiming to help you with, the severity of damage to the bony structures, and how comprehensive our treatment needs to be to get the results you’re looking for.
There are some instances where an underlying joint issue can be aggravated by staying open too long or too wide during a dental visit. These conditions often self-resolve with limited treatment (see above How do you calm a TMJ flare up?). Less frequent but also possible, patients can sometimes experience a change in their bite after dental work or orthodontic movement that contributes to further compression of the joint space, resulting in TMD symptoms. In our office, we take extra attention with all restorative and orthodontic procedures to preserve the bite relationship and prevent this from happening.
Sometimes it feels good to ice sore muscles, but in this case – heat wins. Warm compress is preferred over cold compress because the heat dilates the blood vessels, increasing blood flow to the area. This brings in more oxygen and nutrients and removes waste materials and lactic acid, creating an environment more conducive to healing.
Use a warm compress 20 minutes at a time as needed and limit your food intake to a soft diet. Taking Ibuprofen (Advil or Motrin) can help to decrease inflammation and pain in and around the joint. If you already have a bite splint or night guard, you may find it helpful to wear during the daytime. Reach out to our office or follow up with an LVI-trained dentist near you for comprehensive treatment options.
The inability to open your mouth fully is often accompanied by pain when you get to the widest you’re able to open. This condition occurs when the disc of the TMJ slides out of position and then becomes an obstacle to normal joint function. Use warm compress for 20 minutes at a time, try to allow your muscles to relax, and wiggle in whatever way you’re able to move. Doing this should help to unlock this position. If you are unable to reach success on your own, please contact our office and we’d be happy to help you resolve this issue and offer treatment options to stabilize the joint to prevent future complications.
This is called a ‘closed lock’ and happens when the disc of the TMJ slides out of position in a way that prevents your jaw from opening. Use a warm compress for 20 minutes at a time, try to allow your muscles to relax, and wiggle in whatever way you’re able to move. Doing this should help to unlock this position. If you are unable to reach success on your own, please contact our office and we’d be happy to help you resolve this issue and offer treatment options to stabilize the joint to prevent future complications.
Treating the TMJ should primarily focus on decompressing the joint and satisfying the functional needs of the associated muscles and other surrounding tissues. We can accomplish this by finding the optimal jaw position, using TENS relaxation and electrodes that measure the activity of key muscles involved. Once recorded, we can make a removable bite splint called an orthotic, that directs the patient into this jaw position when biting. We create both a daytime orthotic and a nighttime appliance to maintain this position. For many patients, this will provide adequate relief and, after a few months of therapy, they continue onward wearing only the nighttime appliance. More definitive treatments can involve physiologic orthodontics or bite correction using porcelain veneers and crowns.
Our bodies are amazingly capable of adapting to function in situations that aren’t ideal. Sometimes this adaptability can help prevent more noticeable symptoms from ever developing. Unfortunately, however, it’s more common that symptoms will worsen as the disc and bones of the joint degenerate further from trying to function within the over-compressed joint space.
Clicking, or “popping,” occurs when the lower jawbone slides on or off the disc. Ideally, this bone should stay centrally located on the disc as the whole complex slides down and forward on the skull to permit wider opening. One out of four people experience clicking in the TMJ. We become particularly concerned when pain or discomfort accompanies the clicking, but clicking in and of itself can be an early warning sign that symptoms are more likely to develop in the future.
