Temporomandibular joint and muscle disorders (TMJ disorders or TMD) cause pain and dysfunction in the jaw joint and muscles that control jaw movement. TMJ disorders affect as many as 12% of people at some point in their lives. While TMJ disorders can often be managed with self-care practices like massage, icing the jaw, avoiding hard foods, and taking over-the-counter pain medication, seeing a dentist is recommended if symptoms persist or worsen. Dentists can provide customized treatment plans to relieve TMJ disorder symptoms through options like night guards, bite splints, Botox injections, orthodontics, and surgery in severe cases.
What is TMJ?
TMJ stands for temporomandibular joint. There are two temporomandibular joints, one on each side of the head, that connect the jawbone to the skull. The TMJs allow the jaw to move up and down and side to side for functions like chewing, speaking, and yawning.
TMJ disorders involve conditions affecting the temporomandibular joints and the muscles, tendons, and ligaments around them. TMJ disorders cause:
- Jaw pain or soreness
- Clicking, popping, or grinding noises when opening and closing the mouth
- Locking of the jaw when attempting to open the mouth
- Difficulty opening the mouth wide
- Earaches or ringing in the ears (tinnitus)
- Headaches or neck aches
TMJ disorders can be caused by injury to the jaw, teeth grinding or clenching, arthritis, and stress. Genetics may also play a role. Women are twice as likely to develop TMJ disorders as men.
Why see a dentist for TMJ?
Dentists diagnose and treat issues involving the jaw, mouth, and surrounding structures. They receive extensive training on the temporomandibular joint and muscles. Dentists can provide customized treatment plans to relieve TMJ symptoms through options like:
- Night guards and bite splints
- Dental repair work
- Botox injections
- Stress management techniques
- Pain medication prescribing
- Physical therapy referrals
- Orthodontics like braces or aligners
- Surgery referrals
Seeing a dentist promptly when you first notice TMJ disorder symptoms can help prevent them from worsening over time. Dentists can also rule out issues like tooth decay, cracked teeth, or gum disease which may be causing similar jaw pain.
Treatments a dentist can provide for TMJ
Dentists have many tools to treat temporomandibular joint disorders. Treatment options may include:
Night guards and bite splints
Custom fitted night guards and bite splints are a common TMJ treatment. These devices are worn over the teeth to keep the top and bottom teeth separated. This allows overused muscles to relax and reduces grinding or clenching pressure on the jaw joints.
Botox
Botox injections can temporarily paralyze facial muscles, reducing the force they exert on the TMJ. Botox can provide several months of TMJ disorder symptom relief in some patients.
Dental repair work
Restoring damaged teeth through treatments like crowns and fillings can correct bite alignment issues contributing to TMJ disorders. Dentists may also recommend selective tooth grinding to improve the fit between the upper and lower teeth.
Managing stress
Since stress and teeth clenching/grinding often go hand-in-hand, dentists may recommend stress management techniques. These may include biofeedback, massage, and cognitive behavioral therapy. For some patients, anti-anxiety medications may be prescribed on a short-term basis along with stress management techniques.
Medications
Over-the-counter pain relievers like NSAIDs (ibuprofen, naproxen) are frequently recommended to ease TMJ discomfort. For moderate-severe pain, dentists may prescribe muscle relaxants or short-term prescription-strength pain relievers.
Physical therapy
Physical therapists can provide pain relief, massage, and stretching exercises to strengthen the jaw muscles and improve TMJ mobility. Dentists often work closely with physical therapists to develop the optimal treatment approach.
Orthodontic treatment
Braces, clear aligners, headgear, and other orthodontic appliances can help balance the bite and take pressure off of strained TMJ tissues. Orthodontic treatment is also done when developmental issues contribute to TMJ disorders.
Surgery
Surgeries like TMJ arthroscopy, arthroplasty, and joint replacement are only used in the most severe TMJ disorder cases that do not respond sufficiently to other treatment approaches. Due to the complexity of these procedures, dentists refer patients to specialized oral surgeons when this advanced intervention is required.
Are there any risks to TMJ treatments?
Most conservative TMJ treatments like night guards, physical therapy, and stress reduction carry little risk when properly managed by a dentist. However, more invasive TMJ interventions do have potential complications including:
- Botox – Can weaken muscles used for swallowing and speaking. Effects are temporary.
- Surgery – Nerve damage, chronic jaw pain, bite changes, and recurrence of TMJ problems are possible.
Always discuss any potential risks and benefits associated with TMJ treatment options with your dentist.
What happens at a dentist appointment for TMJ?
A visit to the dentist for TMJ problems usually involves the following:
- Medical history – The dentist will ask about current TMJ symptoms, pain levels, and impact on jaw function. Dental history and health conditions will also be reviewed.
- Exam – The dentist will examine the jaw joints, facial muscles, teeth, and bite alignment. Movements like opening and closing will be assessed.
- Imaging – X-rays, CT scans, or MRI imaging may be done to visualize the TMJ structure, check for arthritis, and identify bite issues.
- Bite analysis – Bite pressure points may be marked and evaluated.
- Treatment plan – The dentist will discuss treatment options for TMJ disorder relief based on exam and imaging findings.
Follow-up appointments to re-evaluate progress and adjust treatments are usually needed. Dentists may also collaborate with the patient’s primary doctor, physical therapist, and oral surgeon during TMJ treatment.
TMJ specialist dentists
While all dentists receive training in managing TMJ disorders, some pursue additional specialty education. Dentists can become board certified as TMJ and orofacial pain specialists by completing a 2-3 year residency program after regular dental school. TMJ specialists may be a good option for severe, complex, or treatment-resistant cases.
Can TMJ disorders be cured?
There is no definitive cure for most TMJ disorders. However, symptoms can usually be managed successfully with conservative treatments like splints, Botox, physical therapy exercises, and stress reduction techniques. Even when the underlying joint or muscle condition cannot be reversed, keeping the area free of pain is the primary goal.
Maintaining good oral habits can help prevent TMJ disorder recurrence. Tips include:
- Avoiding excessive gum chewing and nail biting
- Using good posture and proper jaw alignment when sleeping
- Easing up on foods that require extensive chewing
- Not resting your chin on your hand
- Quitting teeth grinding and clenching habits
With proper home care and working closely with your dentist, TMJ disorder symptoms can often be controlled well over the long-term.
Conclusion
TMJ disorders affect the complex temporomandibular joints connecting the jaw to the skull. Symptoms include jaw pain, difficulty chewing, and headaches. Dentists can provide custom treatment plans that combine night guards, bite splints, Botox, dental repair work, physical therapy, orthodontics, and surgery in severe cases. Seeing a dentist promptly when TMJ symptoms arise and following their home care recommendations can help control discomfort and prevent progressive joint damage.
