Procedures

TMJ (Temporomandibular Joint Dysfunction), Bruxism 

Temporomandibular Joint Dysfunction Syndrome (TMJ) is a common condition affecting a wide variety of people. TMJ is characterized by severe headaches, jaw pain of varying degrees, grinding teeth, and an intermittent ringing in the ears. The vast majority of TMJ sufferers are unaware that the root cause of these problems is something that a dentist can effectively treat.

The symptoms of TMJ are debilitating and can greatly interfere with every day life. The comfort and general well being of the patient is at the heart of the dental practice, so pain relief is the first consideration of the dentist. The dentist is able to test, diagnose, and devise an immediate plan to treat the underlying causes of the TMJ disorder.

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Reasons for treating TMJ

TMJ sufferers report that their symptoms generally worsen during periods of prolonged or unexpected stress, and that intense outbreaks of the condition can lead to neck pain and dizziness.

The most common cause of TMJ is the malalignment of teeth in conjunction with bruxism (teeth grinding and clenching). It is possible for the dentist to realign or adjust the teeth without the need for painful or expensive surgeries. The realignment/adjustment is one factor that helps with the pounding headaches, the jaw pain, and the dizziness.

Nighttime grinding is common when individuals have difficulty breathing through the nose or suffer from other forms of sleep disordered breathing such as sleep apnea. Teeth grinding will eventually erode the structure of the teeth and may lead to periodontal problems like bone loss, gum problems, and eventually loose teeth. 

It is important for anyone experiencing the symptoms of TMJ and/or teeth grinding to visit the dentist for an exact diagnosis and treatment.

What does treating TMJ involve?

Initially, the dentist will thoroughly examine the jaw area, the patient’s bite, take X-rays, and review the patient’s history in order to make an accurate diagnosis and recommend necessary treatment.

Once a firm diagnosis is attained, there are several ways in which relief can be provided. Once night-time breathing issues are ruled out a custom molded bite guard (orthotic) can be fabricated to stop teeth grinding or to properly position the jaw. A bite relationship analysis may be recommended by the dentist. The dentist can also provide advice on relaxation techniques which will lessen the effects of stress. As a last alternative, the dentist is also able to prescribe muscle relaxants.

A better option is to change the shape of the teeth and get rid of the bad bite completely, often called “realignment.” This is especially useful because it alleviates TMJ symptoms and may improve the aesthetic appearance of the teeth as well. Realignment involves adjusting the relationship between how the upper teeth come together with the lower teeth. This may require new restorations and/or adjusting the natural teeth as well. It is not a painful procedure, and it is one the dentist has performed with great success numerous times. As with any procedure, the dentist will be happy to answer questions and discuss symptoms, options, and treatments.

Bruxism

Bruxism refers to an oral parafunctional activity that occurs in most humans at some point in their lives. Grinding of the teeth and clenching of the jaw are the two main characteristics of this condition, which can occur during the day or at night.

Bruxism is one of the most common known sleep disorders and causes most of its damage during sleeping hours. The clenching and grinding which accompanies bruxism is symptomatic of a malfunctioning chewing reflex, which is turned off in non-sufferers when sleeping.  For sufferers, deep sleep or even naps cause the reflex nerve control center in the brain to turn off and the reflex pathways to become active.

Typically, the incisors and canines (front 6 upper and lower teeth) of opposing arches grind against each other laterally. This side to side action puts undue strain on the medial pterygoid muscles and the temporomandibular joints.  Earache, depression, headaches, eating disorders, and anxiety are among the most common symptoms of bruxism; these symptoms also accompany health issues such as chronic stress, Alzheimer’s disease, and alcohol abuse.

Bruxism is frequently misdiagnosed or not diagnosed at all, because it is only one of several potential causes of tooth wear. Only a trained professional can tell the difference between bruxing wear and wear caused by overly aggressive brushing, acidic soft drinks, and abrasive foods.

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Reasons for the treatment of bruxism

Here are some of the main reasons why bruxism should be promptly treated:

  • Gum recession and tooth loss – Bruxism is one of the leading causes of gum recession and tooth loss. It damages the soft tissue directly and leads to loose teeth and deep pockets, where bacteria can colonize and destroy the supporting bone.  
  • Occlusal trauma – The abnormal wear patterns on the occlusal (chewing) surfaces can lead to fractures in the teeth, which may require restorative treatment.
  • Arthritis – In severe and chronic cases, bruxing can eventually lead to painful arthritis in the temporomandibular (TMJ) joints (the joints that allow the jaw to open smoothly).
  • Myofascial pain – The grinding associated with bruxism can eventually shorten and blunt the teeth.  This can lead to debilitating headaches and muscle pain in the myofascial region.

Treatment options for bruxism

There is no single cure for bruxism, though a variety of helpful devices and tools are available. Here are some common ways in which bruxism is treated:

  • Mouthguards – An acrylic mouthguard can be designed from tooth impressions to minimize the abrasive action of tooth surfaces during normal sleep.  Mouthguards should be worn on a long-term basis to help to stabilize the occlusion as well as prevent damage to teeth and to the temporomandibular joint. 
  • NTI-tss device – This device is fitted by a health professional and only covers the front teeth.  The goal of the NTI-tss is to prevent the grinding of the rear molars by limiting the contraction of the temporalis muscle.
  • Botox® – Botox® can be injected into the muscles to relax and weaken them. Botox® is an excellent treatment for bruxism because it weakens the muscles enough to prevent grinding but not enough to interfere with everyday functions like chewing and speaking.

Other methods of treatment include relaxation exercises, stress management education, and biofeedback mechanisms. When the bruxing is under control, there are a variety of dental procedures such as crowns, gum grafts, and crown lengthening that can restore a pleasant aesthetic appearance to the smile.

If you are experiencing any concerns about TMJ or bruxism, we encourage you to contact our office today to schedule an appointment.


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