TMJ Disorders

The lower jaw is attached to your head by the jaw joints or temporomandibular joints.  They are located in front of your ears.  When they work normally, your movement is smooth, soundless and painless.

Cause of symptoms

Pain, abnormal sounds, and abnormal movement are signs of joint dysfunction.  The most common cause of symptoms is muscle spasm and stress.  The most common sign of muscle spasm is jaw clenching and tooth grinding.

Stressful circumstances (good or bad) will cause an increase in muscle activity.  This muscle activity is directly related to jaw tension, clenching and grinding.  The more a patient clenches the more the muscles fatigue.  Muscle fatigue builds up lactic acid and will cause spasm and pain.  Many patients report headaches as a symptom – generally this is a muscle spasm.

There are many other conditions that will also affect your jaw joints.  Longstanding clenching/grinding and muscle tension can damage the internal structure of your joint.  Other systemic disease such rheumatoid arthritis, gout, and infections can also play a role in joint disease.

Abnormal growth of the joint and facial asymmetry will cause joint dysfunction as well as tooth loss and poor occlusion.

Treatment

Most patients should seek the care of their general dentist when symptoms first occur.  Night guards, bite appliances, anti-inflammatory medications and stress reduction are initial treatment options.  Also a soft diet and application of heat or cold to the area of muscle pain will help.

When symptoms do not respond appropriately, a referral to our office is made.  The initial consultation will be a radiographic and physical examination.  Muscle symptoms, range of motion, sounds, and facial skeleton are evaluated.  Stressful circumstances are explored.  Some patients may need other studies such as a CT scan, MRI, or blood tests.

Initial treatment is based on your specific diagnosis, however anti-inflammatory medications and muscle relaxants are usually utilized.  Physical therapy and counseling are also utilized.  Only occasionally are patients surgical candidates.

Surgical Options

Occasionally patients will need the joint space dilated and irrigated (arthrocentesis).  This is an office procedure, accomplished with intravenous sedation.  Other potential joint treatments involve arthroscopic surgery to repair a cartilage or attachment to the joint.  Open joint surgery is truly for the impaired patient with pain and limitation of motion who has not responded to more conservative treatment.  We are happy to evaluate your condition and make treatment recommendations.