Temporomandibular Joint (TMJ)
The Temporomandibular Joint (TMJ), which connects the lower jaw to the skull, is responsible for the movement of the jaw, and the opening and closing of the mouth. This is the most used joint in the entire body and it affects our ability to talk, to chew and to swallow.
Patients visit many health care providers in search of answers to their problems as the following symptoms of TM dysfunction (TMD) masquerade as many other
- Headaches, neckpain or stiffness
- Earaches, congestion or ringing in the ears
- Clicking, popping or grating sounds when opening and
closing the mouth
- Tired jaws or pain when chewing
- Limited jaw opening or locking
- Dizziness and fainting
- Difficulty closing the teeth together
- Difficulty in swallowing
- Facial pain or pain behind the eyes
- Numbness in the hands
- Back Pain
If you have any of these symptoms you could possibly have a problem with your jaw (TMJ). Prolonged spasm of facial muscles can lead to chronic muscle pain and trigger points (knotted muscles), which can send pain to different areas of your body such as as neck, eyes, ears, shoulder or lower back which can make it difficult to diagnose.
TMD frequently occurs when the lower jaw is not in its proper relationship or position to the upper jaw. This often results in a dislocation of the protective disc (anteriorly displaced), as the lower jaw assumes a position further back as shown in the diagram above.
Some of the most common causes are:
- Clenching or grinding habits
- Lower jaw too far back causing an anteriorly displaced disc
- Deep dental overbite, bad bite and/or teeth missing
- Trauma to the head or neck, automobile accidents or a whiplash injury
- Bad posture
- Intubation procedures in hospitals
Your Initial Visit
Your teeth dictate the way your jaws relate to each other. If the jaw is dislocated, this can lead to numerous symptoms of TMD. Your first visit involves acquiring a complete medical and dental history and a TMJ Health Questionnaire, which helps indicate the seriousness of your problem. Further tests involve evaluation of the degree of muscle soreness upon palpation as well as whether the movements of the jaw are normal. The Joint Vibration Analysis is a simple three minute test to determine the level of jaw joint dysfunction. Further diagnostic testing includes complete head, neck and posture evaluation utilizing state-of-the-art tomographic x-ray equipment to assist with visualization of the jaw joints and other related structures. Measurements of dysfunctional muscle activity and abnormal jaw movements will be achieved using the latest in computerized diagnostic modalities including EMG and Jaw Tracking. These tests will assist us with making the proper diagnosis.
Patients benefit from the non-surgical conservative treatment we provide. Once a thorough diagnosis has been made, we will begin a personalized treatment program which includes reduction of inflammation and muscle spasms in conjunction with an easy to wear, comfortable dental orthotic (splint). The orthotic covers the lower teeth holding the jaw in proper alignment, reducing tension in the jaw joints, allowing them to heal.
Patients who clench or grind will need to wear special nighttime splints in order to reduce painful muscle spasms, headaches and other symptoms. Frequently a team approach involving medical doctors, neurologists, ear, neck and throat specialists, chiropractors, and therapists is necessary to diagnose and treat patients with jaw joint, neck and spine dysfunctions.
The objective of Phase 1 would be to stabilize the lower jaw in its correct position in order to reduce the patient's symptoms, improve range of motion of the jaw and reduce muscle soreness. Sometimes a second phase of treatment will be necessary. We will discuss the various treatment options following the successful completion of Phase 1 jaw stabilization.