TMJ


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The temporomandibular joint, or TMJ, connects out lower jaw to our skull, allowing us to chew and speak.

The National Institutes of Health (NIH) estimates that about 10 million Americans are affected by TMJ, aka TMJ disorder or TMJ syndrome. (TMJ stands for Temporomandibular Joint Syndrome -- now that's a mouthful!) If you have chronic jaw pain, hear a clicking or popping sound when you open and close your mouth or consistently wake up with headaches, you could be one of them. The good news? Discomfort doesn't always last long. The not-so-good? Severe pain that persists for weeks generally means it's not going to get better without the help of a TMJ dentist or TMJ specialist.

Common Treatments for TMJ Disorder

TMJ syndrome is a complex disorder affecting -- in different ways and to different degrees -- the jaw joints, facial muscles, facial nerves and surrounding tissues. Scientists are uncertain about the causes of TMJ disorder, although stress, hormonal fluctuations in women, misaligned bites (malocclusions) and teeth grinding are considerations.

Symptoms of TMJ disorder are also expansive. You might experience chronic jaw pain while others have persistent neck pain or earaches. Thus, there is no one-size-fits-all treatment for TMJ. And though treatment of TMJ syndrome is not recognized by the ADA as a dental specialty, many dentists do have experience and expertise treating patients with TMJ. These professionals often go by the name "TMJ dentist" or "TMJ specialist."

A TMJ dentist or TMJ specialist can customize a treatment plan that addresses your specific problems and eases your particular ailments. According to the TMJ Association (TMJA), there are approximately 50 types of treatments for TMJ disorder.

Following are the most common treatments recommended by a TMJ dentist or TMJ specialist:

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Take prescription meds. Over-the-counter pain relievers can temporarily alleviate the jaw discomfort associated with TMJ syndrome. However, it may be necessary to get a prescription for a stronger pain reliever or muscle relaxant from a TMJ dentist. In some cases, anti-depressants or anti-anxietals can also help reduce stress and, consequently, prevent teeth grinding.

Replace missing teeth. Gaps in your smile can cause teeth to shift and may eventually lead to an irregular bite. This asymmetry can, in turn, overtax the TMJ jaw joints and cause pain. It is believed that replacing a missing tooth (with a dental implant, dental bridge or partial denture) can also be effective in reducing TMJ disorder pain.

Try physical therapy. A TMJ dentist or TMJ specialist can devise exercises designed specifically to keep your jaw joints relaxed, loose and pain-free. Consistency is imperative, though. Doing a little bit every day is integral to easing TMJ syndrome.

Wear orthodontic braces. Bite problems like overbites, underbites and crossbites aren't merely cosmetic flaws. These problems also inhibit your jaw from moving properly - a problem that can cause TMJ jaw pain. Dental braces are typically recommended to correct misaligned bites and have the added benefit of mitigating TMJ disorder. However, some TMJ specialists say that braces only work for mild to moderate cases of TMJ

Use a dental splint or mouthguard. There are different types of splints and mouthguards available to help prevent teeth grinding, a habit believed to provoke TMJ pain. Some splints prevent the upper and lower teeth from touching (and thus grinding or clenching); others move the lower jaw forward or backward. These are custom-made by a TMJ dentist or TMJ specialist.

Consider cortisone injections. Cortisone is a steroid that's been used for over 50 years to relieve the inflammation and pain associated with arthritis. It can also be highly effective in relieving TMJ pain. A single injection of cortisone may bring instant - though temporary -- relief to TMJ sufferers.

Flush out the joints. This is a lesser-known, invasive treatment that could relieve TMJ syndrome. Two needles are inserted into the TMJ jaw joints: One is attached to a syringe filled with a rinsing solution that flushes out the joints, and the fluid exits out the other needle. This procedure can be performed with local anesthesia in a TMJ dentist's office.

Get oral surgery. Oral surgery for TMJ disorder is considered a last-resort solution and recommended for people whose face or jaw has become misshapen due to a number of factors. For example, a patient with arthritis and severe TMJ syndrome may eventually experience loose bone fragments in the jaw. This can be corrected through oral surgery.

Oftentimes, a TMJ dentist or TMJ specialist will also recommend a self-care program to augment one of the above treatments. Recommendations might include:

- Eating soft foods to avoid taxing the jaw
- Using ice packs to ease pain
- Avoiding chewing gum

While this self-care routine might seem simple, it's effective enough to act as a standalone treatment for mild cases of TMJ disorder.

What to Ask a TMJ Dentist

The success of professional TMJ treatment will depend, in part, on you. Your involvement is necessary every step of the way - from talking openly about your health and habits to asking the right questions to following the advice of your TMJ specialist. Preparing for dental visits is often overlooked, but it plays a vital role in the treatment of TMJ syndrome.

Be an active participant in your treatment by asking a TMJ specialist the following questions:

- Why is this treatment essential for me?
- What are the benefits? The risks?
- Is it reversible or permanent?
- Will it reduce my pain?
- What are my alternatives?
- What are the advantages & disadvantages of other options?
- Is there a follow-up program? What's involved?
- How much is treatment?
- Does dental insurance cover it?

Now that you know some of your treatment options and how to prepare for a TMJ consultation, it's time to get help.


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