TMJ Disorders

TMJ Disorders, commonly referred to as just “lockjaw”, include a family of disorders directly and indirectly related to the temporomandibular joint, or the jaw joint. This is one of the most frequently used joint in your body as it is responsible for speaking and chewing.  The muscles that control this joint are also some of the most frequently used muscles. Most TMJ disorders result from dysfunction of either the joint itself or the muscles that control the joint. Since some TMJ disorders can become chronic and even debilitating conditions, early and accurate diagnosis and treatment is important.

What are the Symptoms?

Temporomandibular joint disorders are often associated with the following symptoms:

• Pain when talking, yawning, or chewing
• Neck, shoulder, back pain
• Headaches
• Ear pain
• Clicking or popping noises when opening the jaw
• Unable to fully open or close the jaw
• Frequently clenching or grinding the teeth
• Recent changes to your bite
• Recent trauma or injury to the head or neck
• Increased stress in your life

What Causes TMJ Pain?

There are two broad families of TMJ disorders that are each managed differently. TMJ pain is usually either caused by the muscles controlling the joint, myofascial pain, or by internal derangement of the joint itself. Myofascial pain is often associated with clenching and grinding the teeth and can worsen during times of emotional or psychological stress. Internal derangement of the joint can be caused by inflammation, trauma, bite misalignment, arthritis, and damage to the bone, cartilage, or ligaments of the joint.

What Can I Do To Manage My TMJ Disorder?

The first step to manage any TMJ disorder is proper diagnosis.  This can be done after a thorough history, exam, and any necessary imaging.  During your exam, Dr. Loveless will check for pain, tension, tenderness and trigger points. He will also evaluate your range of motion and determine what the best treatment is for the specific condition.

Medical Treatment

Muscle pain can be treated both medically and with physical therapy. Common medicines include:

• Anti-inflammatories: NSAIDS reduce swelling , heat, redness, and pain, they relieve inflammation as well
• Analgesics can be used in the short term until the symptoms are manageable
• Muscle Relaxants help ease muscle tension. These are helpful short term in patients with acute muscle spasm
• Antidepressants can be used to reduce pain and bruxism. Using doses much lower than would be used for depression, these medicine can improve lockjaw symptoms.

Non-Medical Therapeutic Treatment

People with TMJ Disorders often go through periods or remission and sometimes have acute flare ups.  During flare ups patients often receive therapy including:

• Massage
• Heat and cold therapy
• Local anesthetics or trigger point injections
• Jaw stretching exercises
• Ultrasound
• Softened Diet

Dental Treatment

If your TMJ disorder is due to chronic clenching, grinding, or a malocclusion, you will likely benefit from dental treatment for TMJ. These include:

• Splint: A splint is an appliance that fits over your upper or lower teeth. It is usually worn at night and will help prevent strain on the muscles and the joint if you are clenching. A splint is one of the only TMJ therapies that are scientifically proven to reduce lockjaw symptoms.
• Orthodontics: If the upper and lower teeth are out of alignment causing a malocclusion this may contribute to TMJ problems. An orthodontist can align the teeth to an optimal position to reduce symptoms.
• Bite adjustment/Restorative Treatment: If your bite doesn’t fit together properly or if you have multiple missing teeth, restoring the missing teeth or adjusting the bite may be beneficial to decrease TMJ symptoms.

Surgical Treatment

Surgical treatment for TMJ disorders include arthrocentesis, arthroscopy, open joint arthroplasty and total joint replacement. These procedures are sometimes needed, but are reserved for severe cases that have failed other more conservative measures. Surgery is usually not considered unless the jaw can’t open, is dislocated and nonreducible, has severe degeneration or the patient has tried splint therapy unsuccessfully.