TMJ health services
The discomfort is real . . . relief elusive
When you experience TMD (temporomandibular joint disorder), relief often can be elusive because the cause is complex. From a recent article in the New England Journal of Medicine: "The cause of TMD is now considered multifactorial with biologic, behavioral, environmental, social, emotional and cognitive 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. So, after seeing your physician, see a dentist who understands occlusal disease and treatment. A physical examination, dental xrays, questionnaires and Doppler studies are some initial diagnostics. Sometimes MRI and CT scans are needed to allow for visualization of the jawjoint. From these imaging techniques, a more accurate diagnosis and prognosis can be made regarding the symptoms' source. An occlusal analysis often is recommended to assess the relationship of your teeth to your jaw joint. Models of your teeth are made and then accurately related to the position of your joints.
Malocclusion often the cause
Much of TMD is a muscular pathology not a joint pathology and may be the result of malocclusion or occlusal disease. Ideal occlusion is when the teeth fit together in a comfortable, balanced relationship. When there is malocclusion the jaw muscles may be hyperactive and discomfort and/or pain are often the result.
A splint may relieve your symptoms
When treatment is needed, splint therapy often is recommended to relieve your immediate discomfort. Splints are hard plastic mouth guards that are fabricated by a jaw health doctor. There are two types: One adapts to your needs, one controls your jaw.
Permissive Centric Relation (CR) Splints balance the occlusion. A permissive splint allows freedom for the mandible to slide forward and back which allows your TMJ to seat in its best anatomic position. The permissive splint can calm hyperactive muscles. Because your teeth contact all around, teeth have no reason to keep repositioning the joint and activating the muscle and discomfort can be diminished or alleviated.
Next steps . . . achieving harmony
To get relief and allow for the diagnosis of the discomfort source, expect to wear the splint 24 hours each day for a period of time. Your speech should adapt to the splint. Physical therapy and medications may also be recommended. Then the appropriate occlusal therapy can be planned and might include:
- Occlusal equilibration which reshapes the tops of the teeth. This is done to alleviate pressure on individual teeth and balance the bite.
- Occlusal restoration involves the replacement or reconstruction of teeth in addition to the reshaping procedures thus allowing the face and jaw muscles to relax.
- Sometimes the interference is too great for equilibration or restoration so orthodontics or braces are recommended to move the teeth into proper balance.
Finding care for your TMJ
Achieving a stable, balanced occlusion in harmony with the TMJs and associated musculature relieves many people's symptoms. To achieve that goal, look for a dentist who can identify the imbalance and correct it. For more in-depth information regarding this approach to treating TMD symptoms and the relationship to occlusion you can visit these websites:
Before you change your smile
When you begin to change your smile, careful consideration of your occlusion is important. So before you change your smile, see a dentist who can analyze your occlusion and determine the best restorations to maintain your jaw health.
