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TMJ Therapy and Treatment
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The temporomandibular (jaw) joint is one of the most complicated in the entire body.
It opens and closes like a hinge and slides forward, backward, and from side-to-side.
During chewing, it sustains an enormous amount of pressure. The TMJ contains special
cartilage called a disc that prevents the skull and lower jawbone from rubbing against
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What causes TMJ? |
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If a person’s jaw is not properly aligned and the bite balanced, pain and other
symptoms can develop. This is commonly known as “TMJ”. The human jaw is supported
by a sling of muscles that guide the teeth together in a habitual bite. Even when
your jaw is resting, muscles position it near the normal biting position. If the
bite position is in harmony with the muscles, everything feels good. But if the
muscles have to strain on a regular basis in the "rest" or bite position, serious symptoms can develop.
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Bruxism (Teeth Grinding) |
Do you wake up in the morning with a headache or sore facial muscles? Are your teeth
sensitive to cold or touch? If so, you may be suffering from bruxism, also known
as teeth grinding or clenching.
Bruxism is a subconscious behavior that can occur at any time of the day, and be
aggravated by stress and anxiety. Although people may unknowingly grind their teeth
during the day, it most commonly occurs at night, when the biting force can range
between 100 to 600 pounds per square inch. This incredible force can cause a variety
of dental problems.
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Common symptoms of bruxism include:
- Wearing or breaking of the teeth: Constant grinding and clenching
eventually wears down the teeth, shortening and making them appear flat. The pressure
may also create fractures or cracks in teeth or fillings that will eventually will
cause chips or fractures.
- Gum recession and sensitive teeth: Over time, bruxism wears away
tooth enamel, exposing the dentin and making it sensitive to cold or pressure. At
the gum line, the “rocking” motion of teeth grinding causes the gums to recede and
the neck of the tooth to break away, resulting in a notched area at the gum line.
You can actually catch your fingernail in this area, which may also be extremely
sensitive.
- Sore Muscles, Headaches, Ear Aches: When you “brux”, you use the
muscles in the cheek and temple area. Because of the extreme pressure exerted, these
muscles get overused and are sore when you wake up in the morning. Sometimes you
will feel this discomfort along with a headache or earache. The TMJ joint connecting
the upper and lower jaw may also be tender. The joints also get compressed which
reduces blood circulation. The soreness can make talking and chewing uncomfortable.
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Treatment Options |
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To determine the best course of treatment, an accurate diagnosis is very important.
In most cases, a simple adjustment to your bite positioning, or a mouthpiece (night
guard) that corrects the way your jaw joint closes, is all that is required.
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Night Guard
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If you suffer from bruxism, you may need to be fitted for a Nightguard. There are
different designs to fit the various situations, but you should get a custom-made
guard that can act as a buffer and absorb most of the biting force. It will protect
your teeth from further wear and tear. Another treatment option is a splint to reposition
your bite correctly or a device to act as a clenching suppression system for when
your teeth are grinding. It is very important to have a dentist make the guard to
ensure correct bite positioning. A poorly fitted guard will mis-align your bite.
Your jaw and facial muscles will not be able to relax and actually aggravate your
bruxism.
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Occlusal Bite Adjustment |
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Teeth are meant to fit together like well-designed gears so that they can efficiently
chew against one another. They should come together at the same time, with evenly
distributed force, and without any teeth touching before the others. When teeth
are misaligned significant stress is placed not only on the teeth, but all surrounding
muscle, bone, and joints. Proper adjustment of the bite pattern is necessary to
avoid continued damage. Reshaping gently harmonizes the relationship between the
teeth, jaw joints and muscles. This is referred to by various names including bite
adjustment, occlusal adjustment, equilibration, or selective grinding.
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During reshaping, teeth are marked with an indicator tape with the bite is closed,
and moved in different directions to simulate jaw movement. Our experience and skill
enables us to accurately determine where the teeth will best tolerate normal biting
forces. We then reshape the teeth such that they touch in the proper alignment,
and with evenly distributed all forces. Reshaping is normally accomplished with
carbide or diamond tips and a dental drill. We also ensure that the chewing surfaces
have the necessary “point and groove” patterns to allow food to escape while being
chewed. An improperly flat chewing surface can create excessive force on a tooth,
and simply by recreating a more ideal groove pattern, we can greatly reduce unnecessary
forces on the tooth.
As reshaping progresses, people often notice obvious improvement when they close
their teeth together. This is also a very helpful aspect of the process because
Dr. Morgan and Dr. Rogers want and need your continual feedback in order to achieve optimum results.
Several office visits may be required to get the bite precisely aligned. The major
misalignments are normally reshaped at the initial visit, and “fine-tuning” accomplished
at follow-up appointments.
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