Posts for tag: tmj disorders
Have you noticed a clicking, popping, or grating sound when you open or close your jaw? As many as 36 million U.S. adults experience this phenomenon in one or both of the joints that connect the lower jaw (mandible) to the skull.
While the sounds may be disconcerting, there’s generally no cause for concern in the absence of other symptoms. They’re most likely caused by a harmless shift in the position of the disk inside each temporomandibular (jaw) joint, and it can diminish or disappear entirely over time. But, if you’re also experiencing persistent discomfort, severe pain, or limited function in your jaw (which can include getting it “stuck” in an opened or closed position), then you may be suffering from a temporomandibular joint disorder — part of a complex set of conditions affecting one or both jaw joints, muscles and/or other surrounding tissues. (You may have heard the condition called TMJ, which is actually the abbreviation for the temporomandibular joint itself. Health care professionals prefer TMJD or TMD.)
Depending on the severity, TMD can interfere with your ability to speak, chew and even make facial expressions. The cause is unclear, but genes, gender, environment, stress and behavior are believed to play a role. It can also be symptomatic of a larger medical problem, such as fibromyalgia, which can produce pain all over the body.
Management Options for TMD
TMD traditionally was viewed as a bite problem (malocclusion) requiring mechanical correction — e.g., through orthodontic braces or surgery. But the current therapeutic model approaches TMD as an orthopedic problem (joint inflammation, muscle soreness, strained tendons and ligaments, and disk damage) and favors a sequence of conservative, reversible procedures — hot or cold compresses in the jaw area, soft foods, physical therapy/massage, medication, and/or a bite guard to decrease pressure on jaw joints from tooth clenching and grinding — prior to more aggressive, irreversible treatment alternatives.
If you would like more information about TMD, please contact us or schedule an appointment for a consultation. You can also learn more about the subject by reading the Dear Doctor magazine articles “Seeking Relief from TMD” and “Chronic Jaw Pain and Associated Conditions.”
Chronic jaw pain can make eating, speaking or even smiling difficult. What's more, finding the right treatment approach can be just as difficult.
This is because TMD (Temporomandibular Disorder: named for the joints on either side of the lower jaw) actually describes a wide range of possible problems with the joints and connecting muscles. Any of them can result in impaired jaw function, radiating pain or even headaches.
We'll need to conduct a full dental and facial exam to accurately diagnose your jaw pain's cause. Even then, the way may still not be clear: there's considerable debate among dentists about the best treatment approach. Two basic schools of thought prevail, one conservative and non-invasive and the other more aggressive and interventional.
The conservative approach seeks to alleviate symptoms in a variety of ways, including recommending softer foods to give muscles and joints time to relax, applying cold and heat to ease soreness, massage of the jaw joint muscles, gentle stretching and jaw exercises. We may also prescribe medications like ibuprofen and other non-steroidal anti-inflammatory drugs for pain and swelling relief, and sometimes muscle relaxers to reduce spasms. If your pain stems from clenching or grinding habits, we could fit you with a custom bite guard you wear while you sleep to reduce the forces on your teeth.
The more aggressive approach is much more invasive. These methods include altering the bite or teeth position with orthodontics or dental work or surgically altering the joints themselves or the shape of the jaw. If you're recommended one of these more aggressive treatments, you should know they're not commonly used to treat TMD and they're irreversible. There's also no guarantee you'll gain relief from your symptoms, so by all means get a second opinion before undergoing any procedures.
For most people the best course of treatment is to start with the least invasive techniques, which are usually very successful. If they don't relieve your pain and limited function, we may then consider escalating treatment to more irreversible procedures to help you find relief from this unwelcome condition.
If you would like more information on jaw joint pain and how to treat it, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “Seeking Relief from TMD.”
If you have chronic jaw joint pain you may have heard of using Botox to relieve discomfort from temporomandibular disorders (TMD). Before you seek out this remedy, though, be sure you know the facts beforehand.
TMD is actually a group of conditions affecting the joints, muscles and overall structures of the jaw. People with TMD often experience sharp pain and reduced range of motion of the jaw joints. Although we don't know the exact causes, we believe stress (accompanied often by teeth grinding habits) is a major factor for many patients.
Treatments run the spectrum from conservative to aggressive. Conservative treatments include cold and heat packs, therapeutic exercises, and muscle pain or relaxant medication. On the more aggressive side, patients undergo surgery to reorient the lower jaw. Most people gain a significant amount of relief from conservative therapies; the results aren't as positive with surgery.
Botox falls on the aggressive side of treatments. Approved for use by the Food and Drug Administration for cosmetic uses, the drug contains botulinum toxin type A, a bacterial toxin that can cause muscle paralysis. It's often injected into facial structures to paralyze small muscles and temporarily “smooth out” wrinkle lines. Only recently has it been proposed to help relieve jaw pain.
The jury, however, is still out on its effectiveness with jaw pain. The double-blind testing performed thus far hasn't produced any relevant clinical results that the injections actually work with TMD.
And there are other complications. Some people injected with Botox encounter pain, bruising or swelling at the injection site, and some have severe headaches afterward. Botox is also a temporary solution, not a permanent cure — you'll need another injection a few months later to maintain the effect. You might even develop antibodies that diminish the drug's effect and require higher subsequent doses to compensate.
This and other concerns should give you pause before seeking out this remedy. The best strategy is to try the traditional treatments first, which are also the least invasive. If there's no significant relief, then talk to us and your physician about other options.
If you would like more information on treatment options for TMD, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “Botox Treatment for TMJ Pain.”