About ten million Americans suffer from TMJ / TMD Disorders. Symptoms such as headaches, neck pain, earaches, tenderness of the jaw, and/or facial pain often share a common source. People with this disorder suffer from what is known technically as temporomandibular joint but more simply TMJ / TMD or jaw joint disorders by those of us that hate big words. These disorders can have many causes that we will discuss on this page and that we have outlined below.
Fortunately, TMJ disorders can be successfully treated. Our success rate has improved substantially and we are very impressed with the newly FDA approved device called an NTI+ Appliance. As far as we know, no other dentist in Encino, Tarzana or Sherman Oaks is using NTI appliances despite there advantages.
The Chewing Muscles and Jaw Joints
The structures that allow for you to open and close your mouth are very unique among all the other joints of the body. This complex system works as one unit when you chew, speak, and swallow. These structures include the muscles, ligaments, bones, cartilage, and the joints found on the sides of the head. Family and general dentists study head and neck anatomy in detail and know the subject.
Five pairs of muscles must work together for you to open and close your mouth smoothly. These muscles also control forward, backward, and side-to-side movements of the lower jaw. The names are complicated and irrelevant so we will skip them. Why waste your time? In addition, these movements are centered on the TMJ. These important joints have two sections, separated by a cartilage disk that makes possible the hinge and sideways slide actions needed to open the mouth widely.
If any problems prevent this complex system from moving smoothly through the usual daily activities and are not working together as a unit, a TMJ disorder will result. In addition, tension in the muscles can disrupt the delicate balance of the system. Just one small part can disrupt the whole functioning. In our area, Encino, Tarzana, Sherman Oaks and Woodland Hills, this is common situation.
Signs and Symptoms of TMJ Disorders
TMJ disorders have a number of signs, things that can be observed, and symptoms, things that are felt. Some of the most common are included in the following list.
- Pain when yawning, chewing or opening the mouth widely
- Certain types of headaches, neck aches, and shoulder pains
- Jaws that get locked open
- Pain in or around the ear and forward of it
- Difficulty in opening one’s mouth widely
- Tenderness of the jaw muscles, especially at the temples
- Clicking/popping sounds when one opens or closes their mouth
Navid Safaei DDS can frequently determine the cause of your symptoms by conducting certain tests. Often included in the evaluation is medical history, a clinical examination of the entire oral-facial area, x-rays, and molds of your teeth to study the bite movements. A thorough diagnosis is an important step before treatment. It can save wasted time and effort on unneeded treatment by ensuring that you receive the treatment appropriate for your particular problem.
Causes of TMJ Disorders?
TMJ disorders are often caused when the chewing muscles and the parts of the joints do not work together properly. When this occurs, the muscles can begin to spasm. This can lead to a process that untreated results in damaged tissues, both hard and soft, pain and muscle tenderness. Dentists in Sherman Oaks, Tarzana,and Encino generally treat simpler TMJ cases.
Trauma such as blows to the jaw or face, and diseases such as osteoarthritis and rheumatoid arthritis may cause TMJ disorders. Factors relating to the teeth and bite are also common causes of TMJ disorders. Among these factors are on this list:
- Problems in the way the teeth fit together or bite. Improperly aligned teeth can sometimes place the chewing muscles under stress and cause them to go into spasm, thus setting off a harmful cycle of pain and disruption.
- Oral habits, such as nail biting and ice chewing and similar can damage the bite and work together to cause TMJ disorders.
- Oral habits such as clenching the teeth or grinding the teeth are a very common cause of painful joints. Clenching is when a person squeezes their teeth together tightly, often for some time. It is often due to stress. Grinding, called bruxism by dentists is a similar heavy pressure on the teeth but usually occurs during sleep. These habits can fatigue the muscles and cause them to go into spasm. The spasm causes pain, which in turn causes more spasms.
- The end result of this spasm-pain-spasm cycle eventually will be a TMJ disorder. Many people unconsciously “clench” their teeth during the day, often in response to known or even unknown stressors. This would apply only to people who have stress in their lives!
What is the Treatment for TMJ Disorders?
The teeth, chewing muscles and the joints can all be involved in a TMJ/TMD disorder all at the same time. The treatment will vary depending on the cause. Your dentist will determine what type of treatment is needed for your particular situation. We prefer for treatment to begin with the simplest care and progress to more complex care as needed. We know several TMJ specialist dentists in Encino and Tarzana available for consultation in extreme cases.
When pain and other problems remain, a more involved treatment may be needed. An example would be when the teeth are far out of normal position and orthodontic care is needed. At time surgery may be needed to repair damaged structures. In our long experience over 75% of the time a conservative treatment will improve if not resolve the problem.
Some common methods of treating TMJ disorders are listed below.
- Elimination of Spasms and Pain with applying moist heat to the face provides much relief. The use of prescribed muscle relaxants or other medications is also good treatment. Massaging the muscles and eating soft, non-chewy foods is a useful aid. Bite (Occlusal) opening acrylic splints are often used as a non-invasive first step. Splints help to eliminate the harmful effects of clenching or grinding of the teeth and are our preference.
- Use of the NTI Appliance. The new appliance changes the jaw position by re-educating the muscles to function from a more relaxed position. This helps break the cycle of spasm and pain.
- Counseling or Relaxation Training. Many times counseling is used along with other forms of treatment. If emotional stress is the factor that causes clenching or grinding of the teeth, then that stress needs to be reduced or eliminated. Certain mind/body techniques are helpful in muscle re-education and relaxation.
- Changing the Way the teeth fit together. If your bite is uneven, it can be adjusted by selectively reshaping the teeth. At times, orthodontic appliances may be needed to move improperly aligned teeth.
- Surgery – The parts of the TMJ itself may become injured or arthritic. In addition the bones and soft tissues of the TMJ may shift because of a blow to the head. Occasionally, in cases such as these, surgery may be needed to correct the TMJ problem.
- Physical therapy. Some physical therapists are well trained in the relief of muscle tightness and spasm. Each has their own regimen of care. Dr. Safaei has studied with a Tarzana dentist that is a leading expert in TMJ at USC in Los Angeles.
Those of us who provide treatment for TMJ disorders are concerned about your health and comfort. In many cases the pain, headaches, and other symptoms associated with TMJ disorders are successfully treated. Please remember, TMJ disorders are very treatable and you do not need to suffer.
Please contact us today.