The Importance of TMJ Treatment

The jaw joint, also known as the temporomandibular joint, is one of the most flexible joints in the body. It serves an important role in connecting the lower jaw (mandible) to the skull (temporal bone).

However, when the jaw is misaligned, a host of painful and limiting symptoms may occur. From headaches to neck and facial pain, it can be debilitating. Not to mention the future oral health problems that arise from untreated TMJ. That’s why it’s vital to seek help sooner rather than later when suffering from temporomandibular joint disorder (TMJ).

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What is TMJ?

Temporomandibular joint disorder (TMJ) is not a single condition, but rather a number of conditions that are caused by jaw misalignment. This neuromuscular disorder often results in migraine-like headaches and other painful symptoms, yet remains one of the most commonly overlooked causes of chronic facial neck and shoulder pain.

When left untreated, TMJ can lead to progressively worsening pain and can also contribute to oral health problems including premature wear of your teeth and periodontal disease. It’s important to know that TMJ is a degenerative disease and does not get better without treatment.

Symptoms of TMJ include:

  • Clicking or popping noises when chewing
  • Grinding noises when moving the jaw
  • Pain and/or swelling around the jaw joint
  • Limited jaw movement
  • Complete lockjaw
  • Sleep Apnea

Furthermore, the trigeminal nerve runs through the jaw. It is the largest of the cranial nerves. Jaw misalignment can put pressure on this nerve and cause many of the symptoms of TMJ that occur outside of the immediate jaw area.

Risk Factors When TMJ is Not Properly Treated

A “risk factor” is a condition that increases your chances of developing a disease or disorder. It is possible to have TMJ without having any of the risk factors discussed below, but the more risk factors you have, the more likely it is you will develop this disorder.

Some of the most common risk factors for TMJ include:

Misaligned bite
If your teeth are not in proper alignment, your jaw muscles will experience constant stress trying to shift your bite back into a manageable position, leading to TMJ.

Bruxism
Stress causes many people to habitually grind or clench their teeth at night, and sometimes even during the day. This constant wear can change the shape of your teeth and bite, eventually causing TMJ.

Jaw deformities
Some people are born with facial bone deformities that affect how their jaw functions and/or how their bite comes together.

Bad posture
If you suffer from bad posture due to a spinal misalignment or other issues with body mechanics and stability, TMJ is a common result.

Arthritis
Certain arthritic conditions can damage the cartilage that lines your joints, changing and degrading bone, resulting in TMJ.

Synovitis

This condition involves inflammation of your synovial membrane, which lines the temporomandibular joint.

Jaw or facial injuries
TMJ can result any time one of your facial bones suffers a traumatic injury, such as a fracture or dislocation.

Gender
Women are three times more likely to develop TMJ than men.

TMJ Treatment

Your TMJ treatment options depend on the circumstances of your condition. In some cases, the uncomfortable symptoms of TMJ can be relieved by creating a nighttime grinding appliance to help protect the muscles, teeth and jaw joints from the forces of nighttime grinding.

Patients whose TMJ is caused by bite conditions or significant jaw alignment problems that are not alleviated by use of a nighttime grinding appliance may benefit from the use of an oral appliance worn during the day.

Other long-term solutions include:

Coronoplasty/Equilibration

This is the simplest course of treatment and is used when your bite is only slightly misaligned. Our dentists will re-shape and smooth the enamel of your teeth, thus correcting your teeth and bite, alleviating your headaches without needing an anesthetic.

Permanent Orthotic

If needed, our dentists can bond an orthotic designed to maintain a relaxed, natural bite to your teeth or a removable long-term orthotic.

Reconstruction

Used if your teeth are severely damaged or if the misalignment is significant, full smile reconstruction involves layering porcelain onto your teeth to maintain your bite.

Braces

If your TMJ symptoms are caused by a misaligned bite but your teeth are healthy, our dentists might recommend fixing the problem with braces or Invisalign®.

In all cases, TMJ treatment will occur in phases, allowing for long-term results and a lasting relief from pain.

Frequently Asked Questions

How can I fix my TMJ at home?

TMJ disorder can stem from things like overuse of the joint, bruxism (clenching and grinding), stress, a sleeping disorder such as snoring and sleep apnea, or something as complex as tooth misalignment. In some cases, professional treatment is the only option for fixing TMJ problems. But in other situations, there are steps you can take at home to alleviate joint soreness and overuse.

If you’re experiencing TMJ pain, you can take an anti-inflammatory pain reliever such as ibuprofen to minimize soreness and inflammation of your muscles. Next, take care to avoid hard, crunchy, or chewy foods (including gum) that require heavy biting pressure. You may want to stick to a soft diet for a few days until symptoms subside.

During flare ups, apply a warm compress to the side of your TMJ for up to 20 minutes at a time. Pay attention to circumstances related to your jaw pain, to find triggers such as stress or bruxism.
If your symptoms don’t improve or keep coming back, be sure to speak to our Calgary dentist about a possible bite splint or mouthguard.

How do you diagnose TMJ?

Everyone has a TMJ (temporomandibular joint) but not everyone has TMJ disorder (TMD/TMJD). Your TMJ can be felt just in front of and below your ears when you open and close your mouth. But when your TMJ isn’t functioning properly and you suspect TMD, some of your symptoms might include:
• Headaches
• Popping and clicking when you open and close your mouth
• Ear pain
• Prominent jaw muscles
• Flattened or worn-down teeth
• Teeth grinding
• Broken dental work

However, there are other structural issues that need to be considered when diagnosing TMJ disorder. Our Calgary dentist will perform a thorough oral exam as well as palpate your TMJ and surrounding muscles to pinpoint any irregular findings. From there, we’ll order a full-mouth image – be it a panoramic X-ray or a CT scan – to further evaluate the actual joint and surrounding structures. For instance, if there is bone resorption (shrinkage) or damage to the disc and ligaments inside of your TMJ, the treatment plan will be affected. Being able to see inside of your mouth with an X-ray or 3D scan will insure an accurate diagnosis.

Is TMJ a medical or dental condition?

That’s a great question! There’s a bit of “overlap” so to speak when it comes to insurance coverage for TMJ disorder. For example, if your TMJ pain is because of tooth misalignment and requires orthodontic therapy, it would revert back to underlying dental conditions. However, other conditions like sleep apnea or stress can also cause TMJ pain, making it more of a medical issue.

Since TMJ treatments fall within both medical and dental categories, it’s sometimes possible to file your insurance claims to one policy or the other. It all depends on the type of therapy that you and our Calgary TMJ dentist decide on.

Take bite splints for example. If you clench your teeth during the day because of a stressful job, a custom bruxism (grinding) appliance can alleviate muscle tension and pain. But it’s considered a dental appliance so the insurance claim would be applied to your oral health benefits.
If your TMJ disorder is so severe that it requires surgical intervention due to joint damage, your treatment would fall under the medical category.

What kind of doctor do I see for TMJ pain?

The best place to go for TMJ treatment in Calgary is usually your family dentist. From here, we can evaluate your jaw joint and muscles to determine the primary factors that are contributing to your TMD. In most cases, a dentist is the best professional to see for TMJ treatment. However, there are always exceptions. For example, if you have degenerative bone or a disc inside of your TMJ, or your pain is because of an automobile accident, we would possibly refer you to a specialist like an oral surgeon for further evaluation.

A medical doctor can help with TMJ symptoms of pain or muscle fatigue, but if they’re caused by bruxism (clenching and grinding) you would still need to see a dentist to have a bite splint made. Physicians can prescribe muscle relaxers or pain medications (the same as dentists) but they’re not able to fit you with a custom oral appliance to manage TMJ disorder.

When you’re discussing your condition with our Calgary dentist, be sure to include any past injuries as such factors can affect the cause of your TMD.

Does TMJ cause tooth pain?

Although TMJ disorder is usually linked to jaw pain, headaches, and earaches, it can also cause tooth pain in some cases.
Since your teeth are held in place with hundreds of tiny ligaments surrounding the root, extensive clenching and grinding (bruxism) can lead to stretching and straining of these small fibers. Over time, your teeth can feel sore or even slightly loose.

Don’t confuse tooth mobility with TMJ disorder, though. In most cases any loose teeth are at a bigger risk of having gum disease. So, if you notice teeth that are looser than normal, let our Calgary dentist know right away.

Most tooth soreness caused by TMJ disorder is noticed first thing in the morning when you wake up. Your teeth, jaws, and overall facial muscles may all feel fatigued or sore. If that’s the case, both TMJ disorder and sleep apnea need to be ruled out by an experienced dentist.

Excessive grinding caused by TMJ disorder can also cause broken and chipped tooth enamel along the gumlines. When that happens, the inner layer of tooth is exposed and can be more sensitive to stimuli such as temperature changes. If you notice pain when you eat, tell us.

How do you test for TMJ?

TMJ diagnosis is an investigative process where various factors are ruled out. There is no “test” for TMJ disorder. Rather, a thorough soft and hard tissue exam and series of dental X-rays are needed. As part of your exam, other factors such as your tooth and jaw alignment and how they bite together will also need to be evaluated.

Sometimes diagnosing TMJ is a process of elimination. We may decide that signs point to symptoms of sleep apnea or stress, then take steps to address those factors and thereby improve your TMJ disorder. Or if it’s obvious that your joint is having to move atypically because your teeth don’t bite together properly, our Calgary dentist may prefer to start out by aligning your bite with orthodontic appliances.

In rare situations, the cause of your TMJ may be difficult to diagnose. Physical therapy, special exercises, massage, muscle relaxers, or even injectables can play a part in reducing symptoms until the underlying cause is found. Be sure to communicate your symptoms and keep a log documenting them to find links related to your lifestyle.

How do I get my jaw to stop clicking?

Jaw clicking is a symptom of TMJ disorder. It happens when the disc inside of your temporomandibular joint (TMJ) slips or pops while you’re opening and closing your mouth. The clicking noise can also be due to the bony extension of your mandible (lower jawbone) not fitting properly into place when it’s moving.

Clicking jaws can sometimes be corrected with rest, bite splints, or orthodontic treatment that aligns your teeth into a desirable position. But if TMJ clicking is severe or painful – which is quite rare – oral surgery could be necessary.

Our Calgary dentist will need to take an X-ray or CT scan of your TMJ to see what’s going on inside and around them. We’ll also feel the joint as you move your jaw up and down and side to side, to pinpoint any atypical movement within the joint itself.
If you notice that your jaw clicks at specific times or if you move your mouth a certain way, make every effort to avoid repeating the clicking and popping that’s going on. In worst-case scenarios, a popping jaw could get stuck in an unnatural position.

How can a dentist tell if you have TMJ?

Dentists have a detailed understanding of how the teeth, jaws, and the TMJ work together. During your dental exam, we’ll feel either side of your TMJ to assess whether it’s moving normally or shows signs of a joint disorder. If there are any symptoms of popping, clicking, joint stiffness, pain, etc., then we’ll order an X-ray or CT scan to see what’s going on inside and around your TMJ.

More often than not, TMJ disorder is accompanied by headaches, a limited range of motion (where you can’t open your mouth all the way) and worn-down teeth. Overuse from bruxism or sleep apnea might be best managed with a bite splint or night guard, and we can fit you with one of those appliances at this time.
Occasional TMJ pain is common for most people, especially if you have a stressful day or aren’t sleeping well. But if it becomes so severe that it impacts your day-to-day activities, you could have actual TMJ disorder (TMD.) Let our Calgary dentist know if symptoms persist for more than a few days.

Can clenching jaw cause tooth pain?

Yes. Just like clenching and grinding can cause pain in the muscles and ligaments around your TMJ, it can also strain your teeth. Each tooth has tiny ligaments across the root, connecting the teeth to the soft and bony tissues around it. Essentially, those ligaments stretch and pull – be it at microscopic levels – to allow the tooth to respond to biting pressure.

But when you’re clenching, grinding, and biting down really hard more than normal, it can strain those tiny ligaments and make them sore. Although the area isn’t bruised, it may take a week or two for them to recover.

In the meantime, biting down on teeth with sore ligaments can make the them hurt. The soreness could be isolated in one area of your mouth, or across your entire bite. When there’s too much strain, the outer layer of your enamel can chip away, causing “abfractions” in the areas closest to the gums. As the enamel thickness decreases, the tooth becomes sensitive. Normal foods and drinks can send painful sensations shooting through those teeth.

Is TMJ covered by medical or dental?

Most TMJ treatments are dental in nature. As such, they’re covered by your dental insurance benefits. For example, we might recommend a bite splint because you’re grinding your teeth, which is causing your jaw pain. Bite splints are dental appliances and made in our Calgary office, rather than prescribed by a medical doctor. And since they’re fitted and delivered by a dentist, your medical insurance doesn’t usually cover them.

On the other hand, if you have some type of degenerative issue going on inside of your jaw joint, you might require oral surgery to treat it. Since that’s a procedure only an oral surgeon can perform, both your medical and dental benefits should overlap to cover the necessary procedure.

To get a general idea of the costs related to treating TMJ, we encourage you to seek a consultation with our Calgary dentist. From there we’ll determine the likely causes and options available to correct them. At that time, you’ll have a better idea as to whether your treatment falls under medical or dental.

At Macleod Trail Dental, we are invested in our patients’ dental health. We provide a wide range of professional services to help keep your mouth, teeth, and gums as healthy as possible.

To find out more about our TMJ treatments, give us a call at 403-253-1248.

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