TMJ / Bruxism Seeking Medical Help

TMJ disorder treatment

Proper diagnosis is critical to make sure you receive treatment for your particular condition. At The Smiles Dr we will only recommend treatment after conducting a thorough health history, clinical exam, taking appropriate X-rays, and perhaps confirming the condition through other diagnostic tests.

At The Smiles Dr we may prescribe a multiple-phase treatment plan. Simple and painless techniques are available to decrease discomfort. Here are a few of the treatments we offer:

- Taking a non-aspirin pain reliever or prescription medications such as muscle relaxants, analgesics, or anti-inflammatory drugs
- Eating soft foods
- Avoiding chewing gum
- Applying moist heat or ice
- Physical therapy
- Teaching relaxation techniques to control muscle tension
- Stress management training techniques
- Posture training
- Wearing bite plates to eliminate the harmful effects of clenching or grinding the teeth, and a better positioning of the jaws
- Adjusting the bite, known as "occlusal equilibration" involving removing interferences when the teeth touch
- Replacement of defective restorations that prevent the jaws from meeting properly
- Orthodontics, to put the teeth in proper position
- Surgery
- TENS- Transcutaneous Electrical neural Stimulation
- Trigger Point Injections
- Physical Exercises for the Jaw
- Appliance Therapy (An acrylic, retainer type of device)

In most cases we treat the symptoms related to TMJ disorders can be successfully treated to reduce or eliminate your discomfort. Postponement of treatment usually results in more damage to the joint, muscles, or teeth.

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EXAMS & TESTS

• Medical history: In diagnosing your jaw problem, the dentist will ask the following questions:

o What kind of pain do you have?
o Is it an ache or a throbbing pain or a sharp stabbing pain?
o Is the pain continuous or intermittent?
o Can you outline the area of pain on your face with your finger?
o What helps to alleviate the pain? What aggravates the pain?
o Do you grind or clench your teeth? Do you bite your nails or chew on any objects, such as pens or pencils?
o Do you hold the telephone with your shoulder against your ear for a long time?
o Do you chew gum often? For how long?
o Do you have any oral habits that you have not mentioned?

• Physical examination: During the physical examination, your doctor will examine your head, neck, face, and temporomandibular joints, noting any of the following:

o Tenderness (pain) and its location
o Sounds, such as clicking, popping, grating
o The mandible (lower jaw) range of motion and whether it is easy to open and close and can move from side to side and forward-backward without any pain
o Your assessment of pain on a scale from 0 (no pain) to 10
o Wear on buccal cusps of the mandibular teeth, especially the canine
o The rigidity and or tenderness of the chewing muscles
o How your teeth fit together: normal, open bite, crossbite, overbite, dental restorations, or skeletal deformity

• Imaging: X-rays may be taken of the mouth and jaw. CT or MRI may also be used. The MRI was designed for soft tissue and, therefore, will show the location of the TMJ disc in relationship to the jaw and skull bones. That will give the doctor a better idea as to the proper treatment approach.

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TMJ disorder and headaches

One out of every 15 Australians suffers from chronic headaches, and they spend over millions of dollars every year for over-the-counter medications to relieve their pain. They never imagine that their headaches may be caused by TMJ, and that their pain is the result of a bad bite.

At The Smiles Dr we know a bad bite can put your jaw-to-skull relationship out of alignment.

When this happens, TMJ symptoms occur. This cluster of symptoms can include: headaches, earaches, ear ringing, loud jaw clicking, even stiffness and pain in the jaw, neck, shoulders and back. This cluster has puzzled doctors in the past. Now we can put a name to it: TMJ.

The two most common forms of headaches are Tension type (TTHA) and Migraine. The tension type is commonly a symptom of TMJ, but both tension and migraine types of headaches overlap when patients have had pain for long periods of time.

Many TMJ sufferers have been involved in a motor vehicle accident resulting in neck and back pain. Tension of the muscles of the face and head also contributes to the occurrence of facial and head pain, as does clenching and grinding of the teeth. Another common symptom involves the ears since the temporomandibular joint is very close to the ear. An evaluation of the TMJ, facial, and cervical muscles can help these patients.

Dentists are often the first to diagnose TMJ. They are familiar with conservative treatments. Specially trained facial pain experts can be helpful in diagnosing and treating TMJ.

|Prevention|

If you tend to have occasional bouts with jaw pain, avoid chewing gum or biting on objects, such as pens or fingernails. Avoid eating hard or chewy food. When you yawn, support your lower jaw with your hand.
See your dentist if you grind your teeth at night or find yourself clenching your jaw. The dentist can make a splint for you.

|Outlook|

Most people do well with conservative therapy, such as resting the jaw or using a mouth splint. The success of treatment depends on how severe the symptoms are and how well you comply with treatment.

Only about 1% of patients require joint replacement.

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