Jaw pain, a sore neck, constant headaches, or an intense earache are sure signs that something isn’t right. If you’re living with any of these painful symptoms, you may have a TMJ disorder, often called TMD. Thankfully, there are TMD treatment options available to help.
TMD is a disorder of the temporomandibular joint – the jaw joint. The problem is most often caused by your bite. Your “bite” is a delicately engineered machine. The position of your jaw joints, and the way your jaw muscles work and your teeth fit together are critical for a healthy bite.
If any one of them is out of whack, eventually the machine will break down. TMD can cause damage to your teeth (wear, fractures, chips), gum tissues (recession and bone loss), jaw joints (arthritis, noises, locking), and muscles (pain).
Other clinical signs of a TMJ disorder are:
- Pain behind the eyes
- Sensitive or sore teeth
- Shoulder aches
- Ringing in your ears
- Ear congestion or pain
- Dizziness or vertigo
- Clenching or grinding
- Clicking or popping of your jaw joints
- Facial pain
- Limited opening of your mouth
- Difficulty closing mouth
- Worn down or loose teeth
- Cervical neck problems
- Forward head posturing
Whether these signs mean you need TMD treatment or not can only be determined following a comprehensive neuromuscular dentistry exam. It’s common for doctors to diagnose a closely related or overlapping condition instead. For example, we often treat people who have been diagnosed with Meniere’s disease or trigeminal neuralgia. We can get great results for many of these patients.
Investigate the cause to find the right TMD treatment
Dr. Nancy Nehawandian of Top Down Dental in San Jose/Los Gatos focuses on analyzing, diagnosing and treating TMD disorders. Identifying the exact cause of your TMD could help us decide on the best treatment. The three leading causes of TMD are:
- Bad bite
- Muscle spasm
- Joint displacement
She begins by investigating the history of your heath, then she proceeds with a complete analysis of your mouth and jaw, checking the function (or dysfunction) of your masticatory (teeth, muscles, joints) system. This investigation and analysis allows her to plan an effective treatment for you.
When called for, she’ll conduct a series of tests using non-invasive electronic instruments such as the K-7 Evaluation System. Data from these tests will indicate whether your bite is a major contributing factor to your problem. If your habitual bite is a probable cause of your condition or pain, Dr. Nancy Nehawandian will identify your correct jaw position while your muscles are relaxed. This jaw position and its corresponding new bite, called Neuromuscular occlusion, will bring balance back to your jaw joints, your muscles, and your teeth. We also make use of the CS 9300 cone beam CT- a revolutionary imaging tool which allows us to provide our patients with more accurate diagnoses, with more comfort and less radiation – to help us diagnose your condition and recommend the best TMD treatment.
Because TMD and sleep apnea are closely linked, Dr. Nehawandian may also recommend a home sleep test.
TMD Is a Systemic Condition
Although TMD starts in your jaw, its effects reach far beyond there, as you can tell from the long list of far-ranging symptoms. In addition to the wide effects of TMD, the condition overlaps with many related conditions. Some research suggests that TMD can trigger a chain reaction of chronic health conditions through the release of CGRP (calcitonin gene-related peptide). This can link TMD with other chronic pain conditions like fibromyalgia and irritable bowel syndrome (IBS, also called IBD, short for disorder rather than syndrome). Research also links migraine to TMD. In fact, TMD is one of the most common of what we now classify as chronic overlapping pain conditions (COPC).
Perhaps 75% of people with TMD have another COPC, with the following breakdown, according to a National Institutes for Health summary:
- Chronic lower back pain (30%)
- Migraine (30%)
- Irritable bowel syndrome (24%)
- Fibromyalgia (22%)
- Vulvodynia (17%)
- Interstitial cystitis (13%)
- Chronic fatigue syndrome (8%)
- Endometriosis (8%)
We don’t yet know if treating TMD will resolve all of these conditions, but our experience with migraines makes us hopeful.
T-Scan by Tekscan
When called for, she’ll conduct a series of tests using non-invasive electronic instruments such as the K-7 Evaluation System. Data from these tests will indicate whether your bite is a major contributing factor to your problem. The K-7 measures the stress in your muscles, the position and motion of your jaw, and the sound of your jaw. T-Scan supplies a vital complement to the K-7 by measuring the pressure experienced as your teeth come together, giving us a complete picture of your entire jaw system from the cartilage in your joints to the tips of your teeth.
If your habitual bite is a probable cause of your condition or pain, Dr. Nancy Nehawandian will identify your correct jaw position while your muscles are relaxed. This jaw position and its corresponding new bite, called Neuromuscular occlusion, will bring balance back to your jaw joints, your muscles, and your teeth. We also make use of the CS 9300 – a revolutionary imaging tool which allows us to provide our patients with more accurate diagnoses, with more comfort and less radiation – to help us diagnose your condition and recommend the best TMD treatment.
The best TMD treatment for your pain
Therapy can be an effective TMD treatment
Physical therapy such ultrasound, moist heat and ice and exercises sooth, stretch and strengthen your jaw muscles.
Education and counseling can help you understand what’s causing or aggravating your TMD pain, so you can avoid it. Teeth clenching or grinding, leaning on your chin, or biting your fingernails can be TMD pain intensifiers. These aren’t always TMD treatments that will eliminate your condition, but they can help control your symptoms.
A dental orthotic could be your best TMD treatment
An orthotic is, effectively, a splint that you wear over your lower back teeth. It’s comfortable, practically invisible and can give your overworked jaw muscles the rest they so desperately need. Over time, your orthotic can retrain you jaw muscles to relax into a new, healthy bite position. Often, an orthotic is the only TMD treatment required.
Restoration of your teeth might be needed
TMD can often be treated effectively by reshaping your teeth or replacing missing teeth. If your teeth have been worn down due to grinding or clenching, or, if your bite is impacted by missing or broken teeth, Dr. Nancy Nehawandian can restore them by using porcelain veneers or crowns. The added benefit of this TMD treatment is pain relief and an enhanced smile.
If these TMD treatments don’t help, Dr. Nancy Nehawandian might suggest surgery
Surgery should always be considered a last-line TMD treatment.
Arthrocentesis is a procedure that involves needles that will flush your jaw joint to remove debris and inflammatory byproducts. Injecting a corticosteroid into your jaw joint can be helpful. Used less frequently than corticosteroid injections, botulinum toxin (Botox) may relieve the pain associated with your TMJ disorder.
If your jaw pain does not go away with these more-conservative treatment and your TMJ disorder is caused by a structural problem, Dr. Nancy Nehawandian may suggest surgery to repair or replace the joint.
Get diagnosed and get back to pain free living
Dr. Nancy Nehawandian of Top Down Dental in San Jose/Los Gatos is trained in neuromuscular dentistry. She uses state-of-the-art electronic instruments to diagnose your TMJ disorder and non-invasive corrective TMD treatments to eliminate your pain and other symptoms in our San Jose area office. Once the harmony and balance of your teeth, and jaw has been restored, your painful TMD symptoms will simply fade away into a distant memory. Contact our office today, or call us at (408) 354-5600.