TMJ / TMD

The temporomandibular joint (TMJ) is a sliding hinge that connects the lower jaw to the skull and upper jaw, thereby controlling jaw movement. Orofacial system diseases, such as malocclusion, arthritis, jaw injuries, bruxism, and stress, can cause TMJ disorder symptoms, including excruciating pain or tenderness, limited jaw movement, chewing issues, tinnitus, toothaches, and vertigo.

If you are experiencing any of these symptoms of temporomandibular dysfunction (TMD), you should consult an experienced general dentist immediately. At SoCal Dental of Agoura, we will examine your mouth to provide an accurate diagnosis and develop a treatment plan tailored to relieve your symptoms. Here is what you should know about TMJ/TMD.

Overview of Temporomandibular Joint (TMJ) Disorders

TMJ disorders or dysfunctions are orofacial diseases that affect the masticatory muscles and the TMJ. The conditions affect the jaw joints, nearby ligaments, and muscles, causing symptoms such as difficulty controlling jaw movements, headaches, and excruciating jaw pain.

Human beings have two TMJs on both sides of the face, in front of the ears. These slide hinges link the mandible, which is the lower jaw, to the skull and upper jaw. The TMJ, unlike other joints in the body, performs both rotation and translation functions. The TMJ’s translation abilities enable it to slide forward, allowing you to open and close your jaw, chew, and speak.

TMJ disorders or TMDs are very common, with data from the National Institute of Dental and Craniofacial Research showing that TMD affects at most 12 million people nationwide. The disorder is twice as prevalent in females as in males.

There are three forms of TMD. One is myofascial pain, which triggers pain or discomfort in the fascia, ligaments, and the muscles controlling neck, shoulder, and jaw function.

The second type of TMD is internal joint derangement, which involves injury to the condyle, disk displacement, or jaw dislocation. The condyle is the circular end of the jawbone, connecting or linking with the temporal skull bone, while the disk is the cartilage cushion between the skull and the jawbone’s head.

The last form of TMD is degenerative joint disease, such as osteoarthritis or rheumatoid arthritis, which can affect the jaw.

Temporomandibular Joint Dysfunction (TMD) Causes

The human body has at least two hundred bones, composed of small bones, large bones, and joints. If one of these joints or bones is removed or malfunctions, you will likely start experiencing excruciating pain that adversely affects your quality of life.

The TMJ enables rotation and translation, which is the sliding forward of the jaw. The bone section that links with the joint is covered by ligaments or cartilage. These connective tissues are further separated by discs that act as shock absorbers, facilitating smooth jaw movement. You develop TMJ disorder if these discs are displaced or eroded, the cartilage or connective tissues are damaged by arthritis, or the joints are damaged by physical trauma to the TMJ.

The precise cause of TMD has yet to be established, although several studies have shown that the disorder is caused by a combination of factors. These factors include:

• Chronic teeth clenching or grinding (bruxism)
• Stress that triggers jaw tension
• Degenerative joint diseases affecting the TMJ
• Malocclusion or misaligned bite
• Injuries to the jaw, causing disk dislocation or jaw fracture

While it is challenging to manage the factors that contribute to the condition, particular habits can worsen the TMJ disorder. The factors include:

• Poor posture that puts excessive pressure on the muscles, shoulders, and face
• Utilizing your teeth as a bottle-opening tool
• Grinding your teeth during the day
• Sleeping on your stomach
• Overworking the jaw by taking massive bites of food
• Excessive chewing of items, such as pens, nails, or ice
• Extreme gum or ice chewing

TMD Symptoms

Familiarizing yourself with TMD symptoms is the right step towards an accurate diagnosis. TMJ disorders have no known cause, making it critical to understand the symptoms and be able to identify them early before the condition advances. The common symptoms of TMD include:

• Pain in the jaw
• Stiff muscles around the jaw area
• Limited jaw motion due to locked joints
• Pain in and around the ear
• Tinnitus
• Vertigo
• Malocclusion
• Headaches
• Pain in the neck and face
• Chewing difficulties

Many patients who develop the condition report a clicking sound or a grinding sensation when chewing or opening the mouth. However, this should not be a cause for alarm, especially if you do not experience any pain. Instead of a TMD diagnosis, you should have your general dentist inspect the teeth to ensure that the grinding sensation is not caused by teeth malfunction. If dental malocclusion is ruled out as the cause of the symptoms, the general dentist can conduct a TMD diagnosis.

The Procedure for Diagnosing TMD

Untreated TMD can lead to severe complications, making early diagnosis and treatment critical. However, because TMD has no specific cause, there is no standard test for diagnosing it, making it difficult for dental experts to determine the condition affecting your TMJ.

An experienced general dentist will begin diagnosing by asking about your symptoms and medical history. The dental expert will ask about your symptoms, including how severe your pain is, the areas affected, what makes it worse, and what relieves it. Besides, the dentist will ask whether you feel any other pains, such as neck pain or headache.

The dentist will palpate your TMJ region to identify any areas of pain. This way, the examination can help the dentist diagnose your teeth and know whether further tests are necessary. Additional tests include MRI, CT scans, and X-rays.

An X-ray of the jaw and teeth can detect issues that might not be visible to the naked eye. CT scans provide detailed images, while an MRI reveals problems with the jaw or surrounding tissues.

In rare cases, the dental expert may recommend arthroscopy of the joint. This test involves passing a small camera, called an arthroscope, through a cannula (small tube) to examine the joint clearly, where the disease is to be diagnosed.

TMD Treatment

TMJ disorder has many grey areas, making it challenging for dentists to provide a detailed treatment plan. Clicking or popping sounds in the TMJ might be normal, especially if they are not accompanied by pain, meaning you do not require a TMD diagnosis or treatment. Additionally, some of the symptoms that indicate you have TMD might disappear on their own without seeking treatment. Also, because there is little information on TMD causes and treatments, it is advisable to avoid highly invasive treatments, such as surgery or other procedures that could permanently interfere with your TMJ, teeth, and bite function.

Once you have been accurately diagnosed with TMJ disorder, your dental expert can administer a surgical or non-surgical procedure.

Some TMD symptoms are temporary and can resolve on their own with proper self-care. Chewing gums, grinding teeth, clenching the jaw, and chewing pencils can trigger TMJ disorder symptoms. Once your dentist makes you aware of the cause of the problems you are experiencing, they will recommend stopping the poor oral habits that are causing your disorder. Becoming self-aware of the triggers is critical in avoiding TMD.

Similarly, the dentist will recommend avoiding excessive jaw muscle use if they suspect it is the cause of your TMD. The best way to achieve this at home is to stick to softer foods and avoid large bites by cutting them into small pieces. Also, your dental expert can recommend exercises to relax the jaw muscles.

When you experience excruciating pain at home due to the disorder, dentists recommend applying a cold pack or compress around the jaw area experiencing the pain for relief. Apart from the compress, you should exercise to strengthen and stretch the muscles around the jaw.

Another home remedy is taking the dentist’s prescription or over-the-counter medications to relieve pain.

If these recommendations fail to manage your symptoms, your general dentist will explore other alternatives, such as:

Physical Therapy (PT)

If you are experiencing pain or a locked jaw, your dental expert will recommend physical therapy, such as:

• Regular massage
• Undertaking special exercises that focus on the jaw
• Learning relaxation of the jaw muscles
• Using a mild electric current taped to the skin around the jaw to reduce dental aches
• Using ultrasound treatment
• Manual therapy that entails the use of hands to stretch muscles and connective tissues around the TMJ.

Hiring a dentist who offers physiotherapy for TMJ disorder will be an advantage because you will receive all the dental services under one roof, saving you time. Furthermore, it will be easier to monitor your treatment and progress.

Intraoral Devices

Dental appliances that you wear in the mouth and do not interfere with the bite or teeth are called intraoral devices. The appliances include:

• Mouthguards
• Splints
• Bruxism splints
• Occlusal splints
• Stabilization splints
• Interocclusal splints

Wearing these appliances should not cause pain. So, when devices begin to cause pain when you wear them, visit a dentist for examination.

Complementary or Alternative Treatments

Your dentist can recommend complementary treatment, such as acupuncture and transcutaneous electrical nerve stimulation (TENS), alongside modern medicine. Acupuncture is a form of traditional Chinese medicine that involves the insertion of tiny needles into energy channels, or acupoints, to restore energy flow and balance, thereby alleviating pain and muscle tension. Conversely, TENS is battery-powered equipment that generates electrical impulses from electrodes attached to your skin, altering your pain perception.

These treatments work alongside drugs that help decrease inflammation, pain, and muscle tension, which include:

• Pain relievers such as acetaminophen.
• Anti-inflammatory drugs (NSAIDs) like ibuprofen and naproxen.
• Muscle relaxers to help control jaw clenching and grinding.
• Antidepressants for chronic pain management.

TMD surgery

In case non-surgical treatment and medication do not help alleviate your condition, your dentist will advise you to undergo TMD surgery. Situations where a dentist will recommend surgery include:

• You are experiencing intense, persistent tenderness or discomfort with jaw movement.
• Restricted jaw movement or pain is causing eating and drinking difficulties
• You have a locked jaw
• The jaw immobility or pain is worsening, even with nonsurgical treatments and medications
• MRI, CT scans, or X-rays have confirmed that you have a structural disease around the TMJ

When seeking treatment, it is advisable to partner with a dental expert with TMJ disorder training because they will know what to look for in your medical history, physical examination, and imaging results to determine if a surgical procedure is necessary. Surgery is a last resort. Common surgical procedures used to treat TMD include:

• Arthrocentesis, which entails cleaning chemical byproducts stemming from inflammation by injecting a special fluid in the TMJ area. The surgery is minimally invasive.
• Arthroscopy, which is a surgery performed through a small hole by inserting a cannula fitted with a small camera and surgical tools in the TMJ area.
• Open-joint surgery, which encompasses cutting the skin open to expose the TMJ for surgery. The procedure is highly invasive and is only used when minimally invasive techniques, such as arthroscopy and arthrocentesis, fail due to excessive connective tissue or jawbone growth.

The treatment course your dentist adopts hinges on the specific cause of the TMD and the severity of the persistent symptoms.

 Consequences of Ignoring TMD Symptoms

It is easy to ignore some signs of TMJ disorder, especially if they do not cause excruciating pain. Many people use OTC medications for pain management, but with time, the pain persists even with the medication. What you are unaware of is that the pain relievers only mask the problem, allowing it to progress and cause severe complications.

Many complications, such as bruxism, chronic pain, and chewing difficulties, can be associated with TMD. Some symptoms or causes of the disorder overlap with those of other conditions, making an accurate diagnosis difficult. Problems, such as malocclusion, lead to poor oral hygiene, which in turn triggers other oral conditions, such as tooth decay, gum disease, and cavities.

Severe TMD can even cause facial disfigurement due to an imbalance in facial muscles.

Depending on your situation, it might take some time before your general dentist accurately diagnoses you with a TMJ disorder. With diagnosis being time-consuming, it is advisable to seek treatment early before you develop complications.

Treating TMD Using Botox

Botox is a neurotoxin protein administered nonsurgically on an outpatient basis to treat TMD symptoms, such as headaches, bruxism, jaw tension, and a locked jaw. At least 3 half-hour sessions per month are required. The injections can be administered in the forehead, temples, jaw muscles, or any part of the face where TMD is showing signs. The injections can be painful, with dentists likening the pain to a bug bite. They ease the pain using numbing creams or cold compresses.

After therapy, you must wait at least a month before you start seeing results. The advantage of the treatment, unlike surgical options, is that you can resume daily life immediately after the injection.

Do not rub or massage the injection site for a few hours after the injection, as this could interfere with the flow of toxins into the muscles.

The cost of treatment varies contingent on your oral needs, TMD severity, number of injections, and the dental clinic’s location. Clinics in big cities charge more for the same treatment than those in smaller towns because most clients are wealthy. Additionally, the cost of running a dental clinic in a large city is higher than in a small town. Dentists pass these operational costs on to clients, which explains why costs vary by location.

Botox is not approved to treat TMD. Despite the off-label use and not being approved by the Food and Drug Administration (FDA), the injection has proved to be highly effective in managing symptoms of TMD.

However, the injection has its adverse effects, including:

• Respiratory infections
• Nausea
• Flu
• Headaches
• Temporary eyelid droop

Reasons for Choosing the Right Dentist for Your TMJ Disorder

Many dental patients are afraid of dental clinics and will postpone scheduling appointments until the condition worsens. The fears come from the assumption that all dental procedures are painful. However, when you choose the right dental clinic, you will benefit from the state-of-the-art facilities and equipment intended to make you comfortable and treatment procedures virtually painless.

The right dental clinic has invested in an experienced dentist with specialized training in various dental issues, including TMDs. Therefore, when you visit for treatment, your dentist will ask the right questions about your medical history and symptoms and examine your teeth, jaw, face, and neck to rule out other oral conditions. Also, an experienced dentist can identify early signs of TMD and develop a bespoke nonsurgical treatment plan. Surgical treatment for TMD will only be considered as a last resort if all other options are unsuccessful.

Find a Skilled Temporomandibular Joint Dysfunction Dentist Near Me

TMJ/TMD has no definite nature or symptoms, making it confusing to determine the best time to see a dentist. If you delay treatment, you risk complications, such as malocclusion, jaw clenching, teeth grinding, and throbbing pain.

If you are unsure when to schedule an appointment, you should talk to Socal Dental of Agoura for a no-obligation consultation. We encourage prompt dental visits to catch the disorder early. Our dentist will conduct an accurate diagnosis and develop a thorough approach to manage your symptoms. Call us today at 818-597-0100 to schedule a quick meeting.