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TMJ Management

 

           

Now, things are getting complicated.  Problems in the TMJ (temporomandibular joint) involve imbalances in the bite, bone structure, muscles, and/or nerves of the facial area.  Also referred to as TMD (temporomandibular dysfunction) syndrome, many different symptoms can occur and many different factors stimulate problems in this area.   Treatment may be just as varied.  Here we go:

Common symptoms

Headaches, normally of the "tension" variety.  Often in the temples
Earaches or some sensation of fullness or stuffiness in the ears
Joint noises - popping, clicking, or "squishing" noises when chewing or moving the jaw
Others:  the symptoms may be widely varied, including neck, shoulder, upper back or head tenderness.  Even lower back or chest pain occasionally is involved, but is very rare.

Causes

At this time, there is no definitive information as to the cause of TMJ dysfunction.   There are some common factors, and the more present the more likely symptoms will occur.  The most frequent are:

Major bite problems, such as a crossbite or underbite
Trauma to the head, neck, or lower jaw.  Whiplash, etc.
Some bite patterns, particularly the lower teeth held tightly inside the upper arch
The majority of sufferers are female
Age is typically about 25-45 (this can vary to any age)
Grinding or clenching of the teeth routinely
Physical and emotional makeup which transfers stress to body tension
Family history of TMJ problems
Loss of bite support from natural teeth by removal or gum disease

Treatment

Treatment of TMJ can span a wide spectrum, and the response varies by patient.  In our office, we participate in more conservative treatment, usually support for the jaw during the damaging movements of clenching or grinding.  This is usually accomplished with an appliance called a "splint,"  which allows the forces to be distributed and balanced in a non-injuring manner.  There are other names, such as "night guard," "bite guard," "grinding appliance," "jaw brace," and "MORA," as well as some others.  In general, all allow the muscles and teeth to rest in a more acceptable position. 

In cases where more aggressive intervention is required, referral to practitioners who treat this area of dysfunction is normal for our office.

The Final Word

This is such a complicated area that the information here is severely limited.   Information is also constantly surfacing about this area of health care, and great differences of opinion exist with the dental community.  Deep research is indicated for patients who wish to know more about TMJ problems.  Please consult a professional or professional references.  There is a tremendous amount of poor information in the popular and professional media about TMJ, and no 30 sec. sound bite will cover the smallest part of the story.  Please be careful with the sources of information before you jump into treatment of this area.

 

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Copyright © 1998 Stephen C. Durbin, DDS, PC
Last modified: May 20, 1998