Q & A about TMJ

Many people have experienced pain or popping in their jaw, but how common is it, and should we be concerned? As it turns out, TMJ is very common and when diagnosed early many patients can receive proper treatment and kiss that awful popping sound goodbye.

I’ve heard of TMJ, but what is it?
Temporomandibular disorders are medically known as TMD, however, the general public typically refers to issues in this area as TMJ. The temporomandibular joint connects the lower jaw to the skull. Controlled by five muscles and acting somewhat as a hinge, these allow your to move your jaw up and down, side to side, and front to back. As you continue to open wide, move front to back or side to side the round end of the lower jaw slides along the socket. The joint is protected during these movements by a soft tissue disc.

Why do people have problems with their TMJ?
TMJ can be brought on by a number of factors. Trauma from a car accident or a blow to the head or chin may seem obvious, but yawning, gum chewing, or dental treatment can also trigger TMJ symptoms. One of the most common causes of TMJ is nighttime clenching or grinding your teeth, which can be triggered by an uneven bite and is commonly linked to high stress levels. Other causes may be arthritis or a degenerative breakdown of the joint itself.

My joint ‘pops” but it doesn’t hurt. Should I be worried?

You may not be worried about the actual popping, but chances are, you’re worried about something. Here’s where that link between TMJ and stress comes into play. Popping in your joint is not normal, it’s actually a sign of the protective disc being displaced prior to the lower jaw sliding forward. This could be a sign that one or more of the muscles that control the joint is in constant tension and is causing disharmony with the joint. The frequent popping may cause head, neck and back aches that you may not have associated with your jaw. If you only notice it a few times a year, pass this article on to a neighbor and keep enjoying a stress free life.

When should l seek treatment?
TMJ can be progressive so seek treatment if:

  • your jaw pops frequently (on a weekly basis)
  • it’s painful to open, or a grinding sound occurs when opening
  • you experience headaches (especially temporal), back pain, or neck pain
  • you have tender or tight cheek muscles
  • you cannot open wide (more than 4cm – grab a ruler and mirror)
  • you experience tooth or sinus pain
  • you have worn or cracked fillings or teeth

What Next?
The first step is getting your TMJ diagnosed. This can be done by your primary care doctor but it is much more common for your dentist to evaluate, diagnose and begin
treatment. Some insurance plans require a diagnosis before treatment may be covered.

Treatment Options
lt’s typical to start with an x-ray of the joint so we can rule out deterioration. Most times an acrylic bite guard will be made for nighttime grinding or day wear if you know you clench throughout the day. The splint has to be fitted so that the joint is in the most relaxed position. Over the counter splints can cause more harm than good and should only be worn to protect teeth when the TMJ is asymptomatic. Following your dental treatment you will most likely be given a referral for physical therapy. 

Why Physical Therapy?
Success of treatment is much higher when splint therapy is combined with physical therapy. It is important to be conservative and yet treat symptoms early, because there is a very poor prognosis for patients that have to undergo TMJ surgery. The key to successful treatment is patience and persistence, after all it is the most complex joint in the body!

This article was written by Dr. Scott Robinson DOS. The staff at Robinson Dental have been longtime friends of Northern Physical Therapy. If you’re looking for a dentist in the Coopersville or Wayland areas, Robinson Dental is the place to go!

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