Relieving Headaches TMD/TMJ
Joint and muscle problems of the jaw can be caused by TMD (Temporomandibular Joint Disorder). This joint is also known as TMJ, is located on either side of your head, just in front of your ears. These joints connect your jawbone to the skull. The TMJ is considered one of the most complex joints in the body as it can rotate, move forward, backward and side to side. In a combination of other muscles and ligaments, it allows us to chew, swallow, speak ad yawn. If you have any problems with this area around the TMJ, you may have TMD.
Signs or Symptoms of TMD
Signs or symptoms of TMDs include pain and tenderness in or around the ear, the jaw joint, or the muscles of the jaw, face or temples. Other symptoms are problems opening or closing your mouth, and a clicking, popping, crunching or grinding noise when you chew, yawn or open your mouth. TMDs may be linked with neck pain and headaches. If you have any of these symptoms, contact us.
What can cause TMD?
In most cases, TMD is caused by a combination of factors like jaw injuries and joint disease, such as arthritis. It is believed that bruxism (tooth clenching or grinding) and head or neck muscle tension may make TMD symptoms worse. Stress is also a possible factor. However, it is not clear if stress causes TMDs or is a result of them.
Other things that may lead to TMDs are partial or full dentures that are not the right fit and certain habits such as fingernail biting and pen or pencil biting. This latter fact has led many to believe that many individuals with TMD may be aggravated by an occlusion (bite) which has some irregularities. Although strictly speaking most people have some irregularities (called interferences by dentists), some have more than others. Another complicating factor is the level of parafunction (grinding and clenching) occurring with some individuals. Some people with reasonably small interferences can parafunction to a significant degree, causing symptoms of TMD, while others with huge occlusal problems show no signs of TMD at all as they have a much lower level of parafunction. The resistance of the temporomandibular joint also plays a role, as women (with a much more delicate framework) show a higher incidence of TMD than men. All in all, it is a detailed examination which provides us with the information necessary to determine a treatment protocol.
What Can Be Done To Treat TMD?
Most patients with TMDs get better by themselves without any treatment. To help ease sore jaw muscles, place a cold or warm compress to your jaw and gently massage your jaw muscles. Eat a soft diet, cut food into small pieces and avoid hard, chewy or sticky foods. Try not to open your mouth too wide, even when you yawn. And most importantly, relax your jaw muscles.
When you are relaxed, your teeth should be slightly apart, and your tongue should rest on the floor of your mouth with your lips barely touching or slightly apart. There should be a slight space between your upper and lower teeth except during chewing, speaking or swallowing. If you find that you are tensing your tongue, clenching your teeth, and are getting symptoms of TMD and can’t relax, most people find it helpful to put the tip of their tongue on the roof of their mouth just behind the front teeth. It seems this provides a ‘natural splint’ to the jaw, as the tongue muscle can continue tension without fatigue, and takes ‘the pressure off the jaw’. We’re not sure why this works, but for some, it gives relief until they can get the clenching to a minimum. All of us clench and brux to some degree, and our systems are designed to accommodate for this. It is when the parafunction exceeds the design envelope that symptoms occur. Most people clench their teeth at night, and when we have ‘things going on’ which upset us, our sleep is disrupted. Sleep disruption is the most common precipitator of clenching, and this is evident in our practice where we see a lot of new mothers with TMD. The general axiom is to try to get into a rhythm of attaining a better sleep regimen, reduce night-time clenching, and follow the above directions for daytime parafunction reduction.
How Can Semiahmoo Dental Centre Help You If You Have TMD?
After a thorough examination and, if needed, appropriate x-rays, we may suggest a plan to treat your TMD.
We may recommend wearing a night guard, also called an occlusal splint. It is made of clear plastic and fits over the biting surfaces of the teeth of one jaw so that you bite against the splint rather than your teeth. This often helps your jaw joints and muscles to relax.
An occlusal splint is made of plastic and fits over the biting surfaces of the teeth of one jaw. This is a ‘balanced appliance’ which removes all of the occlusal interferences, providing a smooth flat plane to contact against the lower teeth (sometimes a lower appliance is made to contact against the upper teeth). If the occlusion is the problem, we see a significant reduction of symptoms over a period of days, or weeks, depending on the damage to the joint. This is as much a diagnostic appliance as a treatment appliance, as it only works if an individual’s problem lies in parafunction on a dentition with interferences. If the problem is arthritis (a cartilage/bony degeneration), this will improve the symptoms partially by reducing the force on the joint, but it will not completely eradicate the symptoms. If symptoms completely disappear, we have a number of treatment options open to us, as we then know that the occlusion (bite) plays an important part of the problem. As mentioned above, this could be a poorly fitting denture, new work which needs adjustment, or errors (interferences) in the bite which have slowly developed over time. These can be amended to help in reducing symptoms and reduce the patient’s need for continued splint therapy. Arthritic cases almost always require continued splint therapy to reduce the joint damage over time and to lessen symptoms. For individuals who cannot reduce their clenching, they can continue to wear their splint to reduce the chance of progression to arthritis.
What happens if all this doesn’t work?
If your pain continues and cannot be alleviated by the above therapies, we may refer you to a dental specialist with extra training in TMDs. This could be a specialist in oral medicine or orofacial pain, an oral surgeon, an orthodontist, or a prosthodontist.
To Treat TMD / TMJ Symptoms, Contact Us Here in Our Semiahmoo Practice
We understand the discomfort you may have with TMD symptoms, and we are dedicated to helping you find relief. Call us today at 604-536-6711 to set up an appointment here in our White Rock / South Surrey office.