TMJ

TMJ syndrome is on the rise. Although certain physical changes can take place, usually via accident or by arthritic problems, the majority is due to nondental activity that we cause ourselves. The number one culprit of course being stress.

TMJ stands for tembromandibular joint. It is the joint that connects the mandible, the moving part of our head, to the skull, the non moving part. It's a ball and socket joint that has a piece of cartilage in between for smooth opening movements. It's when this cartilage gets damaged or worn, that some of the problems start appearing. Many of us have no symptoms at all. We just hear a clicking sound in front of the ear, when our jaws are moved or opened. For some, however, this can become a very painful situation. TMJ pain seems to affect more women than men, although both are affected. Symptoms include headache, muscle spasms, non specific jaw pain that usually radiates, inability to open wide, tiredness of the face and unexplained tooth wear and filling breakage, to name a few. We will discuss some of these causes and some solutions below.

Tension, tension, tension...

One of the major causes for TMJ is grinding and clenching. Stress produces, excess energy, which needs an outlet. This excess energy usually is dissipated via grinding, at night, or clenching during the day. Each produces extreme pressure on the muscles and the TMJ joint, ultimately resulting in the damage of the joint. Besides this wear facets, or worn areas on teeth caused by tooth on tooth contact, may start to appear, causing sensitivity in those teeth, especially during chewing. Tooth or filling breakage isn't uncommon either. This rapid destruction can even produce further stress on the TMJ by lowering the bite plain of the bite or occlusion over a period of time as well, creating a vicious cycle.

The key to deaing with this is palliative treatment. Stress needs to be reduced, by either elimintaing the stress or deaing with it more effectively. This includes exercise, biodfeedaback programs or just something as simple as deep breathing or taking an afternoon off from work. To protect the teeth a bruxism appliance such as a nightguard may be recommended by your dentist These appliances are worn at night or anytime of the day when clenching occurs. It prevents tooth on tooth contact and prevents the force of the muscles to perform its isometric exercize during this time.

Stress isn't the only cause

Another common cause for TMJ is that done by parafunctional habits. Parafunctional habits includes things such as fingernail biting, pencil chewing, ice crushing, etc. Obviously these activities not only put pressure on the TMJ joint, but also place the joint into odd positions when force is applied. This can produce a myriad of symptoms, which can only be diminished via the removal of that habit.

TMJ can also be caused by an uneven bite, where all the teeth aren't bearing the same load. All teeth need to have as even a force load on them as possible. If one or two teeth have an abnormal amount of force, occlusal trauma will not only make the tooth senstive, but produce headaches and other problems. In cases like this proper restoration of the bite force is needed. This includes taking care of all defective restorations and to possibly equilibrate, or mechanically adjust, the biting forces on the teeth. This is done by removing heavy bite forces on those teeth that have them in all positions that the teeth can contact each other, to allow proper function and forces to be restored on the teeth.

More serious treatment

Finally accidents and arthritic problems can cause TMJ In cases like these, surgery is sometimes required to eliminate and alleviate the functional problems associated with these anomolies ,as well as the accompanying painful symptoms. Accidents can cause the TMJ capsule either to completely be pulled out of the ball and socket area or have adhesions form between the head and the capsular area, making it very difficult to move the mandible in any direction. In the case of arthritis the actual head or ball joint may need to be replaced in whole and substituted with a prosthetic joint. Fortunately both of these situations aren't readily seen in the majority of TMJ cases and therefore are able to be handled in a more palliative nature.

What can be done?

Some things your dentist can do to help you during painful episodes is to prescribe anti-inflammatory drugs and analgesics. Some of these may include Motrin, Flexeril or Parafon Forte. You can also place ice packs as often as you can tolerate for sharp TMJ pain, while a 20 minute placement of a warm cloth is better for steady, dull aches due to the increase in blood circulation to the area. Massages, a decrease in talking and gum chewing, posture changes and eating a softer diet during TMJ episodes are also beneficial. Your first step, however, is to seek your dentist's diagnosis and opinion. By doing this, you'll ensure rapid treatment and alleviation of your TMJ problems.

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