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Temporomandibular Dysfunction (TMD) and Treatment of the Temporomandibular Joint (TMJ)
What is TMD?
Temporomandibular dysfunction, known as TMD, is a cycle of pain, muscle spasms, and jaw joint problems that results when the teeth, chewing muscles, and jaw joints do not work together in harmony. This cycle can be started by clenching or grinding the teeth, a bad bite caused by missing or poorly aligned teeth, trauma to the joint, arthritis, or emotional stress.
Symptoms of TMD
Symptoms may include headaches, worn teeth, painful muscles in the face, neck, and shoulders, clicking and popping of the jaw joint, earaches, pain behind the eyes, difficulty opening and closing the mouth, ringing in the ears, tingling hands, and other problems.
Diagnosing TMD
When diagnosing problems with your bite, we may use advanced technology to measure the function of your jaw muscles and the movement of your jaw joint. Depending upon the situation, this technology may include tomograph, sonography or joint vibration analysis, electromyography, jaw tracking, and a TENS unit.
Tomographs
Tomographs are specialized x-rays that give us a detailed view of the jaw joint. This allows us to check the health and position of the bones of your jaw joint.
Sonography or Joint Vibration Analysis
The sonograph or joint vibration analysis equipment measures the sounds in your jaw joint as you open and close your mouth. These measurements can help us identify joint damage or other problems.
Electromyography
With electromyography, we can measure the tension in your chewing muscles. When muscles are tense or strained, they give off tiny electrical currents.
Jaw Tracking
To track your jaw movements, we'll place a tiny magnet just below your lower front teeth. The sensor array then records the movement of the magnet when you move your jaw open and closed, side to side, and forward and backward.
TENS Unit
To make sure your muscles are in the most comfortable position, we use a TENS unit to send a mild, ultra-low frequency pulse into your chewing muscles to relax your jaw muscles and reduce pain. You will wear the TENS unit for about 45 minutes, and when treatment is complete, we'll repeat the electromyography to determine if your muscles are more relaxed.
Once your muscles have relaxed, we will use the TENS unit and jaw tracking equipment together. The TENS will make your jaw move slightly along its most relaxed path of closure, and the jaw tracking equipment will draw a line that displays that path. This shows us the jaw position that will allow your jaw joint and muscles to be the most stable and comfortable at rest and when chewing, talking, and swallowing.
Treatment of TMD
After the diagnostic workup is completed, we'll create a treatment plan that will enable your bite to stay in this comfortable, stable position. Treatment often follows two phases.
Phase One
This phase of treatment is aimed at relieving your pain and stabilizing the bite with a custom-crafted, temporary orthotic. The orthotic is a splint that corrects the relationship of biting surfaces of the upper and lower teeth and gently repositions the jaw.
You will wear the orthotic for several months until your jaw joint heals and the chewing muscles get into the habit of resting, chewing, and swallowing in their most healthy and relaxed position. During this phase, we will give you instructions on using the orthotic, check on your progress, and periodically adjust the orthotic as necessary.
Phase Two
Depending upon your situation, phase two can consist of several more permanent treatments, such as wearing a durable orthotic long-term, replacing missing teeth, and placing crowns or veneers on existing teeth. The placement of crowns or veneers on some or most of the teeth is often the best choice as this will correct the shapes of the biting surfaces and the relationship between the upper and lower teeth. Sometimes we may use a combination of these treatment methods to give you a healthy, pain-free, comfortable, and natural-looking smile.
For more information about TMD and treatments, please visit the Patient Education Center.
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