Luckily, TMJ/TMD is treatable most of the time.
Simple cases of TMJ can be treated with anti-inflammatory medications and a hot/moist compress.
Treatment for more complex cases usually consist of two phases:
Phase I :
Generally speaking, it includes the fabrication of an orthotic. An orthotic is an acrylic device that is worn on the lower teeth 24 hours a day. The orthotic is designed to reposition the jaw to the correct neuromuscular position.
First we analyze the bite, decide which muscles are causing the pain, and where the current position of the bone is and the disc. All this is done with the aid of advanced equipment like the TENS unit, K7 jaw tracking, Sonography, EMG's and advanced x-rays like Tomography, CT Scans and MRI's of the TMJ.
This will help us determine the best and most comfortable position of the TMJ and the muscles. Once that position is determined, we place the orthotic on the lower teeth to keep the TMJ in that position.
Orthotics usually are worn for 4-6 months or until most of the symptoms are relieved. Once an orthotic is in use, the symptoms start gradually disappearing until we reach a point that both the doctor and the patient are satisfied with. This concludes Phase I of the treatment.
After 4-6 months of relief and when the patient is no longer suffering from any TMD symptoms, Phase II will be considered. Phase II includes any of the following:
- Wearing a long term removable orthotic, full time or part time.
- Replace missing teeth.
- Orthodontic treatment (Braces).
- Restore all the lower and/or upper teeth with crowns and veneers to preserve the optimal occlusion (bite) that was achieved with the orthotic in phase I.
Most of the time, any of the above could be considered and chosen, depending on the patients' preferences and financial capability. If you are currently suffering from TMD, it is too early to think of phase II at this time, since it is important to get you out of your pain and symptoms.
Denture patients with TMJ/TMD:
Many patients complain that when they received dentures, they noticed pain in the jaw, headaches, ear problems and other symptoms. Sometimes taking the dentures out will relieve those symptoms.
If your dentures are not made to the correct bite, or vertical dimension, it will most likely cause these symptoms. Simple adjustments could get rid of these symptoms, but sometimes a whole new set of dentures need to be made according to the neuromuscular principles, to get rid of your headaches or jaw pain.
Electromyographic Analysis (EMG)
We use an Electromyographic Analysis (or EMG) to measure muscle activity on head and neck muscles both at rest and in function. This is done by placing computerized sensors on the skin allowing us to accurately monitor muscle activity.
Hyperactive muscles are common for patients experiencing pain symptoms associated with TMJ problems. Imbalances between right and left sides of the same sets of muscles are also typical. The EMG system is a safe and comfortable method do help detect such issues and getting to the root of a TMJ issue.
Transcutaneous Electrical Neural Stimulation (TENS): This system delivers a precise, regulated, bilateral rhythmic stimulus to both head and facial muscles.
This controlled bilateral stimulation promotes muscle relaxation for relief of symptoms associated with muscle spasms common to some types of TMJ dysfunction.
When pain results from a muscle spasm, TENS offers a safe, drug-free method of treatment relieving many head and neck discomforts through muscle relaxation.
Bite splints (plates) are effective in relieving TMD symptoms.
A bite splint provides an acrylic platform to bite against. Some bite plates move the mandible to a new position.
Generally, splints are worn part-time and for most people night time seems to be the best time to wear them.