General Dentistry

TMD (aka TMJ) Treatment

TMD (Temporomandibular Disorder)—often incorrectly referred to as TMJ (short for the Temporomandibular Joint)—is the name applied to a collection of symptoms arising from inflammation of the joints and muscles surrounding your jaw.

Your lower jaw attaches to your skull at the temporamandibular joint, and the muscles of mastication (chewing) power jaw movements. Inflammation of the joint and or muscles can cause localized pain, headaches, neck and shoulder pain, ear ringing and even hearing loss, dizziness, painful chewing and/or talking, clicking or grinding sounds and sensations with jaw movement, jaw locking open or closed, and facial swelling.

Causes include injury, whiplash, bruxism (grinding and clenching of the teeth and jaw), arthritis, dislocations, misaligned upper and lower teeth, and myofascial pain syndrome. Some habits can cause or aggravate TMD, such as nailbiting, excessive gum chewing, chewing ice, chewing hard foods, etc. Stress can aggravate the symptoms and TMD can interfere with sound sleep.

TMD can be fairly benign or quite painful and can be short-term or last for many years.

Diagnosing TMD

Great care must be taken in diagnosing TMD as symptoms can also be the result of other conditions such as sinus problems, arthritis, various tooth and gum problems, etc.

Treatment can vary depending on the root cause(s). The rule of thumb is to try the least invasive therapies first as good results can often be obtained from simple treatments such as applying heat or ice to painful areas, performing jaw stretching exercises, eating soft foods, cutting food into small pieces, and taking anti-inflammatory drugs such as aspirin or ibuprophen. (In some cases prescription drugs may be helpful such as muscle-relaxants, anti-anxiety or antidepressant drugs.)

Dental treatments can include interventions (such as Crowns, Bridges or Braces) to correct tooth misalignments and bite surfaces if they are the cause or contributing factors to TMD.

Occlusal Guards

A non-invasive treatment for TMD symptoms resulting from misaligned teeth or bruxism is the use of acrylic mouthpieces called Occlusal Guards. Fitted over upper and/or lower teeth, they prevent upper/lower tooth contact, minimizing the impact of jaw clenching or teeth grinding. They can also adjust your bite position to reduce or eliminate results of poor bite positioning.

Occlusal Guards may be used as Night Guards—worn only when sleeping, or as Splints, worn day and night.

Introduction of Occlusal Guards may be accompanied by a course of anti-inflammatory drugs as well as use of other simple measures to alleviate the immediate symptoms. Occlusal Guards can then function to prevent future symptoms or outbreaks of pain, inflammation, etc. After symptoms have been resolved the Occlusal Guard should continue to be used to prevent future problems.

Dr. Michalos can recommend the appropriate Occlusal Guard option as well as fit the appliance as needed. Dr. Michalos can also recommend other dental interventions if needed. He might also recommend that you consult other medical professionals if your TMD is caused or aggravated by non-oral conditions.