Sperbeck DDS - TMJ Disorders

TMJ Disorders
The Doc

What is TMJ?
The term TMJ refers to the jaw joint called Temporal Mandibular Joint, a complex syndrome involving the jaw joint, associated muscles, the joint capsule and other associated tissues.

What is TMD?
Temporal Mandibular Disorder

TMJ Disorders or TMD
A wide range of factors contribute to TMJ disorders, such head and neck trauma, an incorrect bite, stress and grinding of the teeth, orthodontics, ligament laxity and various diseases.
The Doc

Whiplash

Car accidents frequently contribute to TMD (disorders). In whiplash, the TMJ (joint) is injured in the acceleration and unexpected, immediate deceleration of the vehicle. Either direct or indirect injury to the jaw can effect chewing, eating and speech.

Incorrect bite (also know as "Malocclusion".)

An incorrect bite may be produced by a displaced TMJ disc, poor development of the jaws, removal of teeth without replacement, a high dental filling, a poor fitting denture or partial denture.

Grinding

Bruxism, the abnormal clenching and/or grinding of the teeth that occurs during sleep, is the number one cause of occlusal disease and a significant cause of tooth loss. Constant grinding of the teeth puts pressure on the TMJs injuring the ligaments, thus allowing for the disc to dislocate. If grinding continues the TMJ condition will get worse. At the very least, bruxism produces muscle pain, sensitive and worn teeth. One indication that a person is a bruxer is sore jaw muscles or headache when waking in the morning.

Orthodontics

Some people, as a result of orthodontic treatment, or braces, are more susceptible to TMD (disorders). By moving teeth with orthodontic appliances, there is the potential for producing a malocclusion (incorrect bite).

Ligament Laxity

Ligament Laxity simply means "loose ligaments". Often, double-jointed people have Ligamentous laxity. A side effect of ligamentous laxity is that joints in general are more prone to dislocation. Women of childbearing age, with loose ligaments, are more prone to TMJ disorders than men their age. This definitely can happen to the TMJ's. Ligament laxity is a fairly common problem in active young women who suffer with TMJ (and injuries to other joints). Laxity of ligaments can be the result of trauma or over stretching the join.

Stress

Stress has many effects on our bodies. Experts suggest that stress (either mental or physical) may cause or aggravate TMD. People with TMD often clench or grind their teeth at night, which can tire the jaw muscles and lead to pain.

Disease

Various diseases can cause or aggravate TMJ problems. Immune and degenerative disorders such as rheumatoid or osteoarthritis, psoriatic arthritis, and systemic lupus erythematosus can produce inflammation in the TMJ.

What are the symptoms of TMJ disorders?
The most common symptom of TMJ is pain, either facial pain or headaches. However these are not the only symptoms that can be seen. A person can also have noisy joints. They can pop or click, or sound like something is rubbing. Also there can be a limited opening or constricted movements, and tightness. Sometimes TMJ pain is very similar to an ear ache.

Diagnosis of TMJ disorders
Diagnosing TMJ disorders involves a thorough and careful exam. It should be determined if the TMJ disorder is a muscular skeletal discrepancy or an actual TMJ capsule disorder. All the muscles involved in the chewing and stabilization of the jaw are tested. X-rays, like the most current I-CAT single cone technique, help determine the relative health of the TMJ capsule. Other factors like the patients medical history and previous trauma are evaluated. Other possible medical issues involving the ear, sinus, neck or spine problems may complicate the diagnosis. Once an accurate diagnosis is made, then a proper treatment can be planned and rendered.

Treatment
Treatment of TMJ disorders should revolve around stabilizing the damaged jaw joint and placing the jaw in a position that allows the muscles to relax. This is accomplished by utilizing a TMJ splint, sometimes called a mouthguard or nightguard. This will allow the jaw joint to move to a neutral position. Then, careful measurements are made so an accurate diagnosis can be made as to what changes need to be made to stabilize the joint.

Three principals must be accomplished for stability:

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