TMJ temporomandibular joint (TMJ’s) are the joints located just in front of each ear and they are involved in the movements of the lower jaw. Basically, each joint is a ball-in-a-socket arrangement. The ball is part of the mandible (lower jawbone) and the socket is part of the temoral bone of the skull. The joint is named for the two bones ( the temporal bone and the mandible) that make up this joint. For this reason tempormandibular joint is abbreviated: TMJ. Anyone who may have TMJ disorders with symptoms of pain and/or jaw dysfunction need proper diagnosis and treatment for these problems.
Do You Have a TMJ Disorder?
Are you aware of grinding or clenching your teeth?
Do you wake up with sore, stiff muscles around your jaws?
Do you have pain on the sides of your face or in the temple areas?
Do you have pain in front of one or both of your ears?
Is the pain worse when you chew food?
Does stress make your clenching and pain worse?
Does your jaw click, pop, grate, catch, or lock when you open your mouth?
Is it difficult or painful to open your mouth, eat or yawn?
Do your teeth meet differently from time to time?
Are your teeth sore, especially when you awake in the morning?
The more times you answered "yes," the more likely it is that you have a TMJ disorder. Understanding TMJ disorders will also help you understand how they are treated.
Trouble with Your Jaw?
TMJ disorders develop for many reasons. You might clench or grind your teeth, tightening your jaw muscles and stressing your TM joint. You may have a damaged jaw joint due to injury or disease. Injuries and arthritis can damage the joint directly or stretch or tear the muscle ligaments. As a result, the disk, which is made of cartilage and functions as the “cushion” of the jaw joint, can slip out of position. Whatever the cause, the results may include a misaligned bite, pain, clicking or grating noise when you open your mouth or trouble opening your mouth wide.
There are various treatment options that Dr. Casciato can utilize to improve the function of your jaw. Once an evaluation confirms a diagnosis of TMJ disorder, Dr. Casciato will determine the proper course of treatment. It is important to note that treatment always works best with a team approach of self-care joined with professional care.
Correct diagnosis is essential because there are different types of TMJ problems, with different methods of treatment. The most common types of TMJ disorders are those involving the muscles and ligaments around the joint (Myofacial Pain Dysfunction) and those involving derangement or breakdown of the structures inside of the joint (Internal Derangement and Degenerative Joint Disease). A combination of these types of TMJ disorders can frequently occur.
TMJ disorders occur from a variety of causes, including major trauma as in auto accidents, minor trauma as with teeth clenching, and systemic joint disease as with rheumatoid arthritis.
Early diagnosis of TMJ disorders will usually result in less involved treatment. Unfortunately, diagnosis can be difficult because TMJ mimics so many other medical problems. The good news is that there have been dramatic recent advances in the diagnosis and treatment of TMJ disorders.
Most patients respond to properly performed nonsurgical treatments (including rest, soft diet, medications, physical therapy, night guards, TMJ splint therapy, and stress management.) And for those patients who require surgery, various procedures are performed by Dr. Casciato to allow for improved function and decreased symptoms.
The initial goals are to relieve the muscle spasm and joint pain. This is usually accomplished with a pain reliever, anti-inflammatory or muscle relaxant. Steroids can be injected directly into the joints to reduce pain and inflammation. Self-care treatments can often be effective as well and include:
Resting your jaw
Keeping your teeth apart when you are not swallowing or eating
Eating soft foods
Applying ice and heat
Exercising your jaw
Practicing good posture.
Stress management techniques such as biofeedback or physical therapy may also be recommended, as well as a temporary, clear plastic appliance known as a splint. A splint or night guard fits over your top or bottom teeth and helps keep your teeth apart, thereby relaxing the muscles and reducing pain. There are different types of appliances used for different purposes. A night guard helps you stop clenching or grinding your teeth and reduces muscle tension at night and helps to protect the cartilage and joint surfaces. An anterior positioning appliance moves your jaw forward, relives pressure on parts of your jaw and aids in disk repositioning. It may be worn 24 hours/day to help your jaw heal. An orthotic stabilization appliance is worn 24 hours or just at night to move your jaw into proper position. Appliances also help to protect from tooth wear.
What about bite correction or surgery?
If your TMJ disorder has caused problems with how your teeth fit together, you may need treatment such as bite adjustment (equilibration), orthodontics with or without jaw reconstruction, or restorative dental work. Surgical options such as arthroscopy and open joint repair restructuring are sometimes needed but are reserved for severe cases. Dr. Casciato does not consider TMJ surgery unless the jaw can’t open, is dislocated and non-reducible, has severe degeneration, or the patient has undergone appliance treatment unsuccessfully.
No one treatment can resolve TMJ disorders completely and treatment takes time to become effective. Dr. Casciato can help you have a healthier and more comfortable jaw.
