TMJ Disorders

What is TMJ?

Your upper and lower jaws are held together by a complex joint that moves your lower jaw forward and sideways. When this joint does not work properly, the disorder is called TMD. This condition can be caused by factors within the temporomandibular joint (bone, disc, cartilage) or external factors (muscles of mastication, occlusion).

What are the Signs of TMD?

Some of the most common TMD symptoms include:

  • Misalignment of the upper and lower teeth (a sudden change in the way they fit together)
  • Pain when chewing or yawning
  • Headaches, earaches, pressure behind the eyes
  • Clicking or popping sound when you open or close your mouth
  • Jaws that "get stuck"
  • Tenderness of the jaw muscles

What are some of the causes of TMD?

  • Osteoarthritis
  • Rheumatoid Arthritis
  • Autoimmune Disorders
  • Foreign Body Reactions
  • Tumors or Neoplastic Processes
  • Displaced articular discs
  • Foreign body reactions
  • Previous TMJ Surgeries
  • Hemifacial Microsomia or other congenital deformities

How is TMD Treated?

There are various treatments that may reduce your symptoms dramatically. After we complete the diagnosis, we will create a treatment plan to alleviate your symptoms.Treatment of TMD generally consists of non-surgical and surgical options.Non-surgical options are generally exhausted first. They provide the benefit of being completely reversible and work in approximately 90% of patients with TMD.

These non-surgical options include:

  • Occlusal splint therapy
  • Occlusal adjustments
  • Orthodontics
  • Pain relievers, muscle relaxants, and anti-inflammatory medications
  • Warm moist heat
  • Physical therapy
  • Diet modifications (soft, no chew diet)

If these non-surgical treatments prove ineffective, then surgical treatment may prove necessary. We will perform a thorough history and physical exam to diagnose the source of your TMD. They may also use the aid of advanced radiographic techniques such as MRI and Computed Tomography to further aid in the diagnosis.

Surgical options may include:

  • Arthrocentesis/ Lavage of the Joint space
  • TMJ Arthroscopy
  • Orthognathic (Jaw) Surgery
  • Articular disc repositioning with Mitek Anchors
  • Removal of the disc and substitution with harvested muscle, cartlidge, fat or fascia.
  • Removal of the disc replacement with high grade medical plastic/ synthetic material
  • Total Joint Reconstruction with ribs
  • Total Joint Reconstruction with custom-made CAD/CAM joint prosthesis

TMD can be extremely difficult to treat as the cause is often multifactorial in its origin. There is often more than one cause or combination of causes leading to the problems. Often times correcting a functional problem in the joint, such as repositioning the disc may or may not alleviate the symptoms. It is important to understand this prior to undergoing a TMJ surgery.

We may require the help of a pain management specialist in controlling the extent of your TMD. Often times TMJ pain can be difficult to manage with TMJ surgery alone. This becomes much more important in patients with long standing TMJ pain or TMD. We will work closely with you and your restorative dentist to devise a treatment plan that best fits you as our patient.