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The Importance If TMJ Treatment

The jaw joint, also known as the temporomandibular joint (TMJ), 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 problems. That’s why it’s vital to seek help sooner rather than later when suffering from temporomandibular joint disorder, also known as TMD.

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What is TMJ Disorder (or TMD)?

Temporomandibular joint disorder (TMJ/TMD) 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.

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TMJ Symptoms

Wondering if you suffer from TMJ disorder? Symptoms can include:
  • Clicking or popping noises when chewing
  • Grinding noises when moving the jaw
  • Pain or swelling in the face and joints that reach the neck and shoulders
  • Limited jaw movement
  • Pain in your jaw when talking, chewing, or yawning
  • Complete lockjaw
  • Sleep Apnea
  • Headaches and dizziness sometimes leading to nausea and vomiting
  • Difficulty swallowing
  • Pain in the ears, ringing, or clicking sounds coming from inside the ears
  • Hearing loss or ear pain that is not from an ear infection

If you’ve noticed one or more of these signs, you could have the TMJ disorder. Some patients have a mild or acute form of the condition, where the pain and discomfort may last for just a short time. However, if the symptoms last for longer than a few months, you should seek treatment.

What causes TMJ?

Some of the primary causes of TMJ disorder include:
  • An injury like a fracture or dislocation of the jaw bone, or trauma of the cartilage disc
  • Bruxism or grinding teeth in your sleep that leads to swelling and muscular spasms
  • Osteoarthritis that leads to the wearing away of the cartilage and jaw bone
  • Rheumatoid arthritis where the body’s immune system attacks the bones and causes them to erode
  • Repeated clenching of the teeth because of chronic stress
  • Infection in the facial bones
  • Ailments like bone cancer
  • Improper development of the jaw bone and its alignment from birth

How We Diagnose TMJ

Sometimes diagnosing TMJ is a process of elimination. However, we’ll always begin by conducting a physical examination of your mouth to identify the cause.

Next, we may order an x-ray and/or ultrasound to determine the extent of the problem. If needed, we may also opt for more extensive CT scans or an MRI to understand the structure of the soft tissues and bones. If we suspect you have an infection, we’ll run blood tests to check your white blood cell count. These diagnostic tests reveal the possibility of ailments like lupus, gout, or arthritis.

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.

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TMJ Treatments

Your TMJ treatment options will 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.

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

Other long-term TMJ treatment solutions include:

  1. 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.
  2. Permanent Orthotic — If needed, our dentists can bond an orthotic that is designed to maintain a relaxed, natural bite to your teeth. Alternatively, depending on your situation, they may provide a removable long-term orthotic.
  3. Mouth Reconstruction — This method is used if your teeth are severely damaged or if the misalignment is significant.
  4. 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 lasting relief from pain.

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:
  1. 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.
  2. 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.
  3. Jaw deformities — Some people are born with facial bone deformities that affect how their jaw functions and/or how their bite comes together.
  4. 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 outcome.
  1. Arthritis — Certain arthritic conditions can damage the cartilage that lines your joints, changing and degrading bone, resulting in TMJ.
  2. Synovitis — Synovitis is a condition that involves inflammation of your synovial membrane, which lines the temporomandibular joint.
  3. Jaw or facial injuries — TMJ can result at any time one of your facial bones suffers a traumatic injury, such as a fracture or dislocation.
  4. Gender — Women are three times more likely to develop TMJ than men.

FAQs

Professional treatment is usually the only option for fixing TMJ problems, but in some situations, there are steps you can take at home to alleviate joint soreness and overuse.

If you’re experiencing TMJ pain at home, 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.

It depends! 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.

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 TMJ pain. However, if you have a 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 TMJ.

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 fibres. 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 your 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 the tooth is exposed and can be more sensitive to stimuli such as temperature changes. If you notice pain when you eat, tell us.

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.

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.

Yes, just like clenching and grinding can cause pain in the muscles and ligaments around your TMJ, it can also cause strain on 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. 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.

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 made in our dental office, rather than prescribed by a medical doctor. 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.

If for any reason these measures are not effective or do not offer TMJ pain relief, then we may recommend oral surgery on the joint. One example of when surgery is needed is if there are structural irregularities inside of the TMJ itself, which we can see on a CT scan or X-ray.

Deciding to get oral surgery for TMJ needs to be a well-thought-out process and requires lengthy recovery time. In most cases, a team of dental providers or surgeons will evaluate your jaw to determine the best type of surgery and create a care plan for you to review. Surgery is usually one of the last recommended treatment options for TMD, and only when there’s severe discomfort or the condition interferes with your daily quality of life.

About The Caring Dentists of Macleod Trail Dental

Our dentists use their expertise in general and cosmetic dentistry to provide the best, most caring care possible. They love answering dental questions and finding the right solutions for all of our patients. If you need a new dentist in SW Calgary that you can trust, Macleod Trail Dental is here to help!

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