TMD, or Temporomandibular Disorder, is characterized by a collection of symptoms such as chipped or worn teeth, loose teeth or painful jaw muscles and/or joints. Some patients give a history of grinding their teeth at night, noticing clicking in their jaw or feeling that their teeth fit together differently. Many patients with sleep apnea grind their teeth at night to open their airway.
TMJ refers to the temporomandibular joint, the hinge complex that is involved with jaw movement.
At our dental office in Madison, NJ, we conduct a comprehensive exam to diagnose the causes of the pain and breakdown. All jaw pain is not related to the teeth. It may be from stress, strain on muscles or even sleep apnea. Treatment options are based on your symptoms, the factors contributing to the breakdown of your teeth, and what your goals are for your dental health.
Diagnosing the Underlying Issue
It is important to diagnose the cause of the bite problem before designing treatment to address the symptoms. Just relieving pain or repairing broken teeth doesn’t solve the underlying problem. To diagnose your problem, a functional analysis will be done. This analysis is a multi-step procedure that analyzes your bite and provides diagnostic information. Your diagnostic evaluation will look at:
- Difficulty chewing
- Worn teeth
- Changes in the position of your jaw
- Changes in the size and shape of your teeth
- Pain in your jaw, face, neck, shoulders
- Headaches
- Earaches
Diagnosing TMD
Some of the possible conditions and their signs and symptoms that may be diagnosed include:
- Constricted Chewing Pattern
- Thin or chipped front teeth
- Tooth position that has changed over time or spaces developing around front teeth
- Front teeth touch when speaking
- When jaw is relaxed, the lower jaw comes forward
- Pain when eating hard or chewy foods
- Avoidance of chewing gum or bagels
- More comfortable with jaw open
- History of orthodontic treatment especially involving extraction of teeth prior to treatment
- Occlusal Dysfunction
- Bite that results in an uneven wear pattern, with more wear on back teeth
- Discomfort in the jaws that is unrelated to night time grinding or clenching
- Unsure of where to rest teeth
- Sense that there may be more than one place to bite together
- Continued wear of teeth despite the use of a nightguard
- Awareness that bite has changed
- Parafunction
- Associated with unusual habits that cause teeth to rub together
- Thumb or finger sucking
- Cheek, lip or nail biting
- Postural habits (repetitive moving of the jaw to an unnatural spot)
- Use of musical instruments that aggravates jaw
- Bruxism
- Sleep disorder that cannot be controlled voluntarily
- Clenching or grinding of teeth while sleeping
- May be related to stress
- Extreme muscle activity and jaw pressure
- May be associated with other sleep disorders like Restless Leg Syndrome
- Can occur sporadically
Treatment Options
Treatment options may include adjusting the bite, laser therapy for pain, restoring you to your best bite by changing the shape of your restorations, providing appliance therapy, myofunctional therapy or orthodontic treatment. The goal of treatment is to make you comfortable and pain-free and prevent further damage to the TMJ or teeth.
