TMJ

Temporomandibular Joint Disorders

Many people who suffer from chronic headaches, neckaches, clicking or popping jaws, or facial pain near the cheeks or ears may have TMJ (Temporomandibular Joint) disease. These symptoms are usually related to the bite or how the jaws fit together. TMJ is treated by dentists trained in orthopedics and orthodontics, in addition to advanced general dental techniques. 

We are happy you have chosen our office and would like to welcome you to the world of comprehensive dental care. We are anxious for you to enjoy the benefits of good oro-facial pain treatment. 

Everyone in the practice operates as a team member. We take great pride in each staff member's capabilities and training. We want you to have the same confidence that we do so we may serve you fully. 

We believe that service to our friends is at its best when there is complete, mutual understanding and cooperation, so we ask that you spend a few moments reviewing this booklet. 

The purpose of this page:

Acquaint our patients with why they may have TMJ dysfunction and head and neck pain.  Identify methods utilized in our practice for treating craniomandibular dysfunctions and pain.   Furnish detailed information about the potential options and courses of treatment that our patients may need to consider to alleviate TMJ and related problems.

When drugs don't work for you: 

Many people suffer from dizziness, earaches, face, head, neck shoulder, and back pain. They may also suffer chronic fatigue, irritability, blocked or ringing ears, difficulty in swallowing, temporary loss of memory and arthritis-like joint pains or numbness in parts of the body that seem to have no relation to the teeth. 

The case is frequently unrecognized by physicians whose standard training has not equipped them to understand the relationship between the teeth and jawbone and the alignment of the jaws and rest of the body. Many dentists are also unaware of how closely their work is linked to a patient's general health.  

Consequently, thousands of chronic sufferers go from one medical specialist to another, taking potent drugs which fail to bring relief, even having needless surgery when the pain becomes unbearable or being referred to psychiatrists who cannot help them because these experts are concentrating on the symptoms without recognizing the cause.  

How we can help: 

Dr. Moore understands the delicate relationship between the teeth and the skeletomuscular balance of the head, neck, and back. Dr. Moore has been a member of the American Dental Association and other  international organizations of dentists and physicians dedicated to the study, prevention and treatment of temporomandibular joint dysfunction, latest developments in TMJ research and treatment.  Members of these groups regularly exchange information about the latest developments in TMJ research and treatment. 

Malocclusion and the TMJ:

Your jaw joint which holds your lower jaw in place is suspended beneath your skull by an intricate system of muscles and tendons. 

The jaw joints also known as the temporomandibular joints (TMJ) are some of the most complex in the body. The jaw joint, surrounding muscles, and the fit of your teeth are closely interrelated, each affecting the other as you make every day jaw movements such speaking and chewing. 

The way your teeth fit together is called occlusion. When your teeth are not in proper relation to each other and to your jaw joints, the jaw automatically shifts to a new position in an attempt to compensate for the misalignment of your teeth known as malocclusion. 

It can be seen from the diagram how a misaligned TMJ can affect blood vessels, nerves and muscles, causing severe headache or ear pain. Now also imagine what can happen to the rest of the body. If the jaw is out of alignment, other skeletal structures (such as the neck and spine) can become involved, which can result in other joints, nerves, muscles and blood vessels being affected. As nature tries to compensate for one difficulty, others are likely to arise. 

Structural stress from a misaligned TMJ is the worst kind of physical stress because there is no way the body can find relief for it. An injured limb can be rested, but it is impossible to leave the TMJ inactive. Without realizing it, we swallow hundreds of times a day, and at night we may clench or grind our teeth. Every time those teeth meet in incorrect occlusion, there is stress. To compensate for it, the jaw muscles begin to hold a tense unnatural position; and before long, the tension travels by chain reaction throughout the body. 

Diagnosing the problem:

Before prescribing the proper treatment for your particular problem, a variety of diagnostic procedures may be necessary. A detailed head and neck physical examination is usually necessary and is so detailed as to require one or more hours time. Sophisticated radiographs may be taken of your jaw joints. These radiographs are used as a means of detecting disease and position of the jaw joint. A medical, and head and neck history is also carefully reviewed. Other electronic, computer aided studies may also be used such as sonographic joint vibration analysis and EMG recording. Snoring and sleep apnea are potentially related to jaw imbalances and need to be evaluated by both physicians and dentists specially trained in this area.

Treatment modalities: 

After diagnosing the problem, a variety of treatments may be recommended. Initial or Phase 1 treatments are aimed to eliminate the TMJ pain - the symptoms resulting from the actual problem. In the second stage or Phase II, the actual treatment to correct the problem is implemented. Various TMJ treatments useful in our office are outlined below. 

• Ultrasound (reduction of joint inflammation and muscular relaxation)  
  
• Ionophoresis (pain reduction)  
  
• Electrogalvanic stimulation(muscular relaxation)  
  
• Trigger point injections(pain reduction)  
  
• Moist heat(muscular relaxation)  
  
• Coolants (pain reduction)  
  
• Pharmacologic agents(analgesia, anti-inflammatory)  
  
• Biofeedback (relaxation)  
  
• Nutritional therapy(raises stress levels and immune response)  
  
• Muscle exercises(increases range of motion)  
  
• Functional exercises(strengthens opposing muscle groups)  
  
• Pain Release Splint (PRS) to cushion the TMJ (soft plastic mouth guard that fits the lower teeth)
  
• Neuromuscular Oral Orthotic (clear, hard plastic mouth guard that fits on the lower teeth)
  
  

What we do after the pain is gone, the jaw is stabilized, or maximum medical improvement is reached:

• Occlusal equilibration to even the bite (eliminates physical stress to muscles)  
  
• Comprehensive prosthetic crown and bridge to replace missing teeth even the bite in severe cases, and/or build up the bite if vertical height is needed (eliminates dental stress and causes of pain problems)  
  
• Orthopedic repositioning appliance or oral orthotic which is worn long term on top of the natural teeth (allows muscles to attain a relaxed position)  
  
• Orthodontics (moving teeth to the new improved bite position).  
  
• Oral surgery or arthroscopy of the TMJ for a small percentage of patients (we refer all cases of TMJ surgery to oral surgeons)