TMJ and Orofacial Pain

Temporomandibular disorders (TMD) are a common source of facial, headache and tooth pain. There are two basic types of TMD: muscle generated pain, and jaw joint generated pain. It is quite common to suffer from both types simultaneously. It is important to note that these pain conditions are often incorrectly referred to as “TMJ.” TMJ is the abbreviation used for the temporomandibular joint, also called the jaw joint, and is not a disease condition — it is an anatomic structure.

Temporomandibular Disorders (TMD)

TMD SYMPTOMS include pain or discomfort in or around the ear, jaw joint, and/or muscles of the jaw, face, temples and neck, on one or both sides. The pain may arise suddenly and progress with fluctuating frequency and intensity over months to years. Clicking, popping, grating (crepitus), locking, limited opening or deviating jaw movement, chewing difficulties, and headache are also associated with TMD.

Causes for TMD

TMD rarely has a single cause. It is usually a combination of factors in an individual that eventually overwhelms their body’s ability to adapt. These factors include tooth clenching and grinding (bruxism), head and neck muscle tension, facial muscle overload (from gum chewing or finger nail biting habits, etc.), jaw injuries (trauma), and inflammatory joint disease (arthritis). All of these factors are worsened by a dental malocclusion. When teeth don’t fit correctly, a huge stress is placed on the entire head and neck as extra muscle energy is used to avoid tooth contacts that will damage the crooked and crowded teeth.

However, the body’s inherent mechanism to protect the teeth leads to damage and pain in other structures. Many scientific studies on the general population have shown that signs and symptoms of TMD are significantly lower in orthodontically treated patients than in people who never had braces. Having orthodontic therapy and a correct bite does not eliminate your chance of developing TMD, but it significantly lessens your chance of developing a TMD.

A sound bite, obtained through orthodontia, increases your body’s ability to cope with the insults placed on our head, neck and jaws through everyday life stress and traumas.

Treatment for TMD

Treatment varies depending on the findings of an extensive history and physical examination. For most patients treatment begins with an orthotic device, commonly called a bite splint. A splint is acrylic and covers all the teeth in one jaw while it normalizes the fit of the opposing teeth. This device is custom made by our in-office dental lab, which gives us complete quality control. The splint works to relieve pain and inflammation by allowing the muscles to relax, and eliminating excess muscle pressure in the jaw joint. It is important to note that the boil and bite sports mouthguards will not relieve TMD symptoms and many studies have shown they may worsen your problem. The same is true of devices commonly sold in drug stores.

For some patients, a bite splint, may be the only therapy needed to gain significant relief and return to normal function. For others, additional therapy is required. These adjunctive therapies may include physical therapy and judicial use of medications. There are also some patients with a joint dysfunction who benefit from referral to an oral surgeon, but this determination is made after bite splint therapy has been used for several months.

Do I need braces for my TMD?

This varies for each patient. After successful splint therapy we can determine if orthodontia is in the patient’s best interest to maintain a healthy and pain free function. There are certain types of malocclusion where orthodontics is the primary treatment method, as the patient will not improve due to the aberrant forces of the malocclusion. It must be remembered that a correct, stable bite is always healthier for the mouth, head and neck.