TMJ disorders can develop for a number of reasons. Clenching or grinding one’s teeth may result in a significant amount of stress that can cause damage to the temperomandibular joints as well as spasm in the muscles used to close the lower jaw. Injuries and arthritis can also damage the joint directly or stretch & tear the muscle ligaments surrounding this important joint. As a result of excessive forces from clenching and grinding, the cartilage disk that functions as the “cushion” of the temperomandibular joint can slip out of position. This may cause a misaligned bite, pain, clicking, or grating noise when you open your mouth, or even trouble opening your mouth wide.
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 frequent headaches or neck aches?
- Does the pain get worse when you clench your teeth?
- 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?
- Have you ever injured your neck, head, or jaws?
- Have you had problems (such as arthritis) with other joints?
- Do you have teeth that no longer touch when you bite?
- Do your teeth meet differently from time to time?
- Is it hard to use your front teeth to bite or tear food?
- Are your teeth sensitive, loose, broken or worn?
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.
There are various treatment options that Dr’s. Pruitt, Miller, Stowe, Steinbicker & Taylor can utilize to improve the harmony and function of your jaw. Once an evaluation confirms a diagnosis of TMJ disorder, Dr’s. Pruitt, Miller, Stowe, Steinbicker & Taylor will determine the proper course of treatment. It is important to note that treatment always works best with a “team” approach of self-care combined with professional care.
The initial goals are to relieve the muscle spasms and joint pain. This is usually accomplished with a pain reliever, an anti-inflammatory, or a muscle relaxant. Self-care treatments can often be effective as well and include:
- Resting your jaw and eating soft foods, avoiding chewing gum & ice, etc.
- Keeping your teeth apart when you are not swallowing or eating
- Applying ice and heat
- Exercising your jaw
- Practicing good posture
- Using “moist heat” compresses (such as a wet, warm wash cloth) to help relieve muscle spasm
Stress management techniques such as physical therapy may also be recommended, as well as a clear plastic appliance known as a nightguard. A nightguard (or splint) fits over your top or bottom teeth and helps keep your teeth apart and also prevents against premature tooth wear, thereby relaxing the muscles and reducing pain. This appliance can help you stop clenching or grinding your teeth and significantly reduces muscle tension at night. It also helps to protect the cartilage and joint surfaces of your joints as well as the biting/ chewing surfaces of your teeth.
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. Doctors Pruitt, Miller, Stowe, Steinbicker & Taylor do 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.
Bruxism is an oral parafunctional activity that commonly occurs in most people at some point in their lives. The two main characteristics of this condition are grinding of the teeth and clenching of the jaw. These actions usually occur during a person’s sleeping hours, but occasionally they occur during the day.
Bruxism is one of the most commonly known sleep disorders. Chewing is a neuromuscular activity controlled by a subconscious process, but more highly controlled by the brain. During sleep, the subconscious process may become active, while the higher control is inactive (asleep), resulting in bruxism. The most common symptoms are earaches, headaches, depression, eating disorders, anxiety, and chronic stress.
Why should I seek treatment for Bruxism?
- Gum recession. Bruxism is a leading cause of gum recession and tooth loss. Grinding can damage the soft tissue directly and lead to loose teeth and deep pockets where bacteria are able to colonize and decay the supporting bone.
- Facial pain. Grinding can eventually shorten and blunt the teeth. This can lead to muscle pain in the myofascial region and in severe cases, incapacitating headaches.
- Occlusal trauma. The abnormal wear patterns on the occlusal (chewing) surfaces of the teeth can lead to fractures, which, if left untreated, may require restorative treatment at a later time.
- Arthritis. In the most severe cases, bruxism can eventually lead to painful arthritis in the temporomandibular (TMJ) joints that allow the jaw to open and close smoothly.
Though there is no known cure for bruxism, there are a variety of devices and services available through our office to help treat bruxism:
- Mouthguards. An acrylic mouthguard can be designed from custon impressions to minimize the abrasive grinding action during normal sleep. Mouthguards must be worn on a long-term basis to help prevent tooth damage.
- NTI-tss device: This device only covers the front teeth and must be fitted at our office. The idea behind the NTI-tss is to prevent grinding the rear molars by limiting the contraction of the temporalis muscle in the jaw.
Parafunctional habits such as clenching and grinding can have significant effects on the health and comfort of your smile- please contact us if you have any questions on how our family and pediatric dentist may help you with any TMJ issue at Winston Smiles Phone Number (336) 765-1881