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TMJ - All About Temporomandibular Joint Disorder

TM disorder describes a variety of conditions affecting the temporomandibular joint - TMJ (the point where the jaw opens and closes) and nerves related to chronic facial pain. These problems are now more easily diagnosed and treated than in the past. Women are twice as likely to be affected than men.

How Is It Caused?

The exact cause of the disorder is unknown. Some factors are related to an improper bite or malocclusion, injury, arthritis, severe stress, or a combination of factors. Clenching or grinding teeth, a condition called bruxism, may develop from stress or as part of a sleep disorder. This can tire muscles and create painful spasms, causing even more pain. Repeated muscle problems may affect the joints, resulting in tissue damage, muscle tenderness, and more spasms, perpetuating a cycle of pain.

What Are Some of the Symptoms?

• Jaw pain or soreness, more noticeable in the morning or afternoon
• Jaw pain while chewing, biting, or yawning
• Earache without an infection, sometimes spreading into the face
• A clicking or grinding noise while opening and closing your mouth
• Difficulty opening and closing your mouth
• A stiff jaw when eating, talking, or yawning
• Sensitive teeth without any signs of dental problems
• Aching on the side of the head and neck pain
• "Locking" of jaw in an open or closed position

How Can This Condition Be Treated?

Proper diagnosis is critical to make sure you receive treatment for your particular condition. Your dentist will recommend treatment after conducting a thorough health history, clinical exam, taking appropriate X-rays, and perhaps confirming the condition through other diagnostic tests.

Your dentist may prescribe a multiple-phase treatment plan. Only minor corrective treatment may be needed. Treatment may be simple or require more steps for alleviating the condition, depending on the degree of severity. Some of these treatments include:

• Taking a non-aspirin pain reliever or prescription medications such as muscle relaxants, analgesics, or anti-inflammatory drugs
• Eating soft foods
• Avoiding chewing gum
• Applying moist heat or ice
• Physical therapy
• Teaching relaxation techniques to control muscle tension
• Stress management training techniques
• Posture training
• Wearing bite plates to eliminate the harmful effects of clenching or grinding the teeth, and a better positioning of the jaws
• Adjusting the bite, known as "occlusal equilibration" involving removing interferences when the teeth touch
• Replacement of defective restorations that prevent the jaws from meeting properly
• Orthodontics, to put the teeth in proper position
• Surgery

In most cases, the symptoms related to TM disorders can be successfully treated to reduce or eliminate your discomfort. Postponement of treatment usually results in more damage to the joint, muscles, or teeth. Be sure to discuss any questions you may have about TM symptoms and treatment plans with your dentist.

By Brian J. Gray, DDS, MAGD, FICO

+Jim Du Molin is a leading Internet search expert helping individuals and families connect with the right dentist in their area. Visit his author page.

Grinding Teeth: Do You Have A Problem With Your Bite?

Problems with the way your teeth fit together occur in many different ways. Some bite problems cause discomfort or even pain, and that pain can masquerade as problems that you would not readily associate with your teeth. Some bite problems can cause major damage to your teeth without producing any obvious discomfort.

There are some pretty simple ways that anyone can detect when a problem with the bite is causing or at least contributing to pain or discomfort.

The clench test: With your mouth empty so there is nothing between your teeth to bite on, close your teeth together and squeeze hard. If clenching your teeth together causes any sign of discomfort in any tooth, you have a disharmony in your bite.

Teeth that are sensitive to cold often get that way from the extra pounding they take if any part of that tooth strikes before the rest of the teeth contact during closure. Use the clench test to see if the extra sensitivity is related to an uneven bite. Squeeze hard. If you can make any tooth hurt by empty mouth clenching, the bite is probably the main reason for the sensitivity. This is a good way to find out if a new filling or crown is "high." If it hurts when you clench, it is probably not in perfect harmony with a correct bite. You should be able to bite hard and grind your teeth together in all directions without feeling discomfort in any tooth if your bite is perfect. The exception to this is if you have advanced periodontal disease, you may have several teeth that can't accept firm biting, but even then, you should not normally feel pain in a single tooth when biting.

If biting hard causes pain or discomfort in the jaw joint, (you may feel it just in front of your ear), you can suspect a possible relationship between your bite and a temporomandibular joint problem. It may be associated with a structural disorder in your TMJ, but more often the pain is coming from certain muscles that move your jaw joints to accommodate a bite that is not in harmony with your TMJs. Your TMJ dentist should be able to diagnose the exact source of the pain.

Look for severe wear on your teeth, as this is another sign that your bite is not in harmony. If you have worn all the enamel off the biting edges of your teeth, you will see a darker colored surface. This is dentin and it will wear down seven times faster than the much harder enamel that you've already worn through. So ask your dentist to evaluate what is causing so much wear. This wear can be especially damaging when it is on your front teeth, so if you notice your lower front teeth have worn down to dentin, have your bite checked. Better yet, don't wait till all the enamel is gone. Correcting your bite may stop or at least slow down the wear process.

By Peter E. Dawson, DDS

+Jim Du Molin is a leading Internet search expert helping individuals and families connect with the right dentist in their area. Visit his author page.