TMJ (temporomandibular joint) Therapies

The discomfort is real . . . relief elusive

When you experience TMD (temporomandibular joint disorder) or TMD, relief often can be elusive because the cause is multi-layered. Doctors wrote in a recent article in the New England Journal of Medicine, "The cause is now considered multifactorial with biologic, behavioral, environmental, social, emotional and congnitive factors, alone or in combination, contributing to the development of signs and symptoms of TMD."

Here are just a few statistics from that article. As many as 75% of Americans have at least one sign of TMD and, for up to 40% of those people the disorder will resolve itself. Surgery is necessary in very rare situations. TMD is most common in women ages 30-50 years old and may have hormonal connections.

Diagnosis is critical

Because TMD is so complex, thorough diagnosis is critical. We coordinate diagnosis with your physician to study your particular situation with the following steps:

• A thorough physical examination helps us understand your anatomy and other mitigating factors
• Dental x-rays help assess your dental health
• Blood tests help determine hormonal and other connections
• Questionnaires provide us with your perspective on the cause and symptoms you experience
• Doppler studies allow us to hear noises the joint makes. It's a screening device to assess the status of the TMJ.
• In occlusal analysis, we make models of your teeth and jaw function to assess your specific condition
• MRI is the most valuable new diagnostic modality for TMJ. It shows us the connective tissue components and non-hard components in the TMJ. In addition, it shows us the position of the TMJ disk in the joint. Not all MRI clinics have the tools necessary to image the TMJ and we need to provide the clinic with a custom wax bite block to hold your jaw in position during imaging.

Customized treatment

Treatment must be customized for the individual. In our dental office, we focus on occlusion, the way your teeth fit together. The goal is to eliminate tooth-to-tooth interferences and discrepancies in the jaw position. We also coordinate physical medicine, behavioral and self-care treatments.

The complex jaw joint

The way your teeth fit together is called occlusion. When your teeth are not in proper relation to each other and to your jaw joints, the jaw automatically shifts to a new position in an attempt to compensate for the misalignment of your teeth - a condition known as malocclusion (teeth do not fit together properly).

Ideal occlusion is when the teeth fit together in a comfortable relationship and there is no need for the jaw to reposition itself in order to avoid pain and muscle discomfort.

When malocclusion exists, even what looks like a good bite could be at the expense of putting pressure on other jaw joint areas as the jaw shifts to accommodate the teeth. Symptoms of misaligned teeth can be clenching, grinding, premature tooth wear, stress on the muscles and tendons, some of which may occur during sleep. Results of these symptoms are headaches and muscular aches and ringing in the ears and many other problems.

Restoring jaw health

After diagnosing the problem, a variety of treatments may be recommended. Initial phases of treatment are aimed to eliminate the TMJ pain - the symptoms resulting from the actual problem. In the second stage, the actual treatment to correct the problem is implemented. Various TMJ treatments are explained below.

• Splint/Jaw Repositioner Appliances
  Splint/jaw repositioning appliances are not only used in diagnosis, but they are used as treatment to temporarily eliminate the bite disharmony and resulting pain. Then, during the second stage of treatment, orthodontics, crowns or equilibration may be recommended to build the bite to a permanent, healthy, relationship.
  
  
• Occlusal Equilibration
  In occlusal equilibration, the tops of the teeth are reshaped. This is done to alleviate pressure on individual teeth. In occlusal treatment, we remove tooth structure on the inclines of the cusps (chewing surfaces of the teeth). This procedure does not in any way encourage tooth decay. In fact, the tooth structure which we remove is tooth structure which actually should not be there.
  
  People who have received occlusal treatment often remark that they notice that their teeth hit more evenly; their teeth feel more solid. For some, it makes them feel that they once again have a complete set of teeth, which helps them chew much better. They experience a revived sense of comfort now that the teeth are in proper relation and the muscles are more relaxed.
  
  
• Occlusal Restoration
  Occlusal restoration involves the replacement or reconstruction of teeth in addition to the reshaping procedures thus allowing the face and jaw muscles to relax.

Early Treatment is Important

Most chronic conditions start with injury or early development of disease. Many times pain is the late manifestation of progressive disease pathology. Consequently, the importance of early treatment cannot be overstated. TMJ problems can advance in stages and grow progressively worse. Thus, a minor problem now could become a major source of pain in the future. Additionally, chances of successful treatment increase substantially when the early treatment is accomplished.

Insurance Coverage of TMJ Treatment

In Wisconsin, medical insurance must cover TMJ treatment and the usual deductibles and co-payments apply. Dental insurance seldom provides coverage for TMJ treatments. We also offer a variety of financing options.