TMD Treatment

iStock_000010826377Small.jpg Is it difficult or painful to open your mouth?

Does your jaw occasionally lock, so it is stuck open or closed?

Do you notice clicking or popping when you open your mouth?

You may have a temporomandibular disorder (TMD). These disorders include problems of the chewing muscles, the jaw joint (called the temporomandibular joint or TMJ), or both.

TMJ is becoming much more prevelant in today's stressful society. A doctor can prescribe an occlusal orthotic bitesplint or "bite guard" to treat your symptoms.

Here are some key symptoms linked to TMD:

Unusual sounds
- Clicking, grinding or popping sounds when you open your mouth are common in people with TMD. The sounds may or may not be accompanied by pain.

Locking or limited movement - The jaw joint is similar to a ball-and-socket joint except that the socket itself is movable. The jaw joint sometimes may lock in an open or closed position. You may have difficulty opening your mouth either because the joint is locked or because of pain.

" Ear" pain - You may think you have an ear infection, but ear pain may be related to jaw joint inflammation or muscle tenderness. Pain from TMD is usually felt in front of or below the ear.

Headaches - People with TMD often report headaches. Your dentist can help to determine if your specific headache symptoms are a result of TMD. In some situations, you may need to consult a physician to help diagnose and treat certain headaches not related to TMD.

Morning stiffness or soreness - If your jaw muscles are stiff and sore when you wake up, it may by a sign that you are clenching or grinding your teeth in your sleep. Clenching or grinding teeth can exhaust jaw muscles and lead to pain.

Difficulty chewing
- You may have difficulty chewing as a result of a change in your bite, the way your upper and lower teeth fit together. This shift in your bite may be related to TMD pain.

Teeth Grinding - Also known as "bruxism", grinding or clenching your teeth and the resulting excessive wear of the enamel can lead to a host of dental problems.

In many cases, teeth grinding occurs unintentionally during sleep. Teeth grinders, or bruxers, often also bite their fingernails, pencils and chew the inside of their cheeks.

About one in three people suffer from bruxism, which can easily be treated.

Teeth grinding over time can lead to hypersensitive teeth. Bruxers experience jaw pain, tense muscles and headaches, along with excessive wear on their teeth. Forceful biting when not eating may also cause the jaw to move out of proper balance.

Signs of bruxism Some of the signs of bruxism include:

Tips of the teeth look flat. Teeth are worn down so much that the enamel is rubbed off, exposing the inside of the tooth (dentin).

Pain in the temporomandibular joint (TMJ)- the jaw - which may manifest itself as a popping and clicking sound.

Tongue indentations. Anger, anxiety, pain and frustration can trigger teeth grinding.
Previous injuries and related conditions - A recent injury to the jaw joint or one from many years past can lead to TMD symptoms. Arthritis in the joint also may arise from injury. Arthritis already affecting other joints may affect the jaw joint and lead to TMD.

Others
- Though the research is controversial, a feeling of fullness of the ears or ringing in the ears may sometimes be related to TMD. In these cases, consultation with an "ear, nose and throat" physician can help establish the final diagnosis.

If these symptoms sound familiar, talk to your dentist. Your dentist will test your ability to open and close your jaw, examine other jaw movements, and feel the jaw joint and muscles for pain or tenderness. The dentist will listen with a stethoscope in front of the ear for any clicking, popping or grinding sounds and will feel the jaw joint while you open and close it.

While it is advisable to discuss any TMD symptoms with your dentist, occasional discomfort in the jaw joint and chewing muscles is quite common and usually not a cause for concern. However, if you are diagnosed with TMD, the good news is that simple self-care practices are highly effective in relieving the discomfort. These include eating soft foods, applying heat or ice packs and avoiding extreme jaw movements. Effective, conservative treatments include nonsteroidal anti-inflammatory drugs, muscle relaxants, physical therapy and oral appliances.

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