TMJ Symptoms come in many forms. The treatment of TMJ problems should be approached and treated in anon surgical therapeutic orthopedic manner. A specific custom precision appliance worn over the lower teeth will be used in your treatment. The information below should provide you some answers to common jaw joint questions and about TMJ appliance therapy. Your jaw joint issues should always be reviewed with a comprehensive clinical evaluation, radiographs, and intraoral photos by a dentist who is both knowledgeable and familiar with a noninvasive approach.
Below are some helpful examples to determine/pinpoint which TMJ symptoms you are suffering from:
-Headaches sometimes in the form of a migraine. Headaches that are occipital, bi-temporal and/or retro orbital (top, sides of your temples and behind your eyes), are the hallmark symptoms of TMJ related headaches, especially when the patient has sensitivity to bright lights (photophobia) and unexplained fatigue. Many patients with migraine headaches are actually suffering from TMJ specific problems.
-Ear pain (ear ache): ringing, itching and stuffy “plugged” ears on both and/or one side. Patients commonly say they feel like they have been to a rock concert with ringing ears (tinnitus) or feel as if they are in an airplane with plugged ears.
– Vertigo, a spinning sensation caused by inner ear inflammation and infection.
– Clicking of your jaw joint when opening or closing your mouth.
– Popping of your jaw joints when opening your mouth.
– Jaw Pain, for any reason other than tooth decay (cavities) or gum disease.
What is TMJ? Muscle cramps and headaches associated with jaw joint (temporomandibular joint or TMJ) dislocation can be accompanied by actual jaw joint pain, head and neck muscle stiffness, jaw stiffness, dizziness, nausea, ringing in the ears and sensitivity to bright lights. Over 50% of sufferers have a family history of long term chronic headaches or migraines. TMJ patients experience severe restriction of blood flow and result in concomitant muscle spasm headaches. If left untreated your TMJ condition can worsen and result in misaligned teeth, flattened worn down teeth, trouble with speech, chewing and even swallowing. TMJ is more commonly associated with misaligned teeth or the way your teeth fit together called malocclusion. You do not have to have natural teeth to experience TMJ symptoms. More times than not, poorly fitting dentures or false teeth, can be the cause.
What is TMD? TMD (Temporomandibular Disorders) are joint, muscle, tendon, and/or ligament disorders of the jaw. This category is generalized to symptoms including but limited to pain, inflammation, limited opening or range of motion, clicking, and/or locking. TMD and TMJ are in the same medical class.
How do I use my TMJ appliances? All day symptoms typically require appliances to be worn throughout the entire day for typically 6-8 weeks in conjunction with cognitive behavioral attention. Nighttime treatment varies based on your specific case and/or diagnosis. A misaligned jaw with chronic locking and clicking may require custom an anti-retrusion appliance to help alleviate the symptoms. Typical decompression of joint spaces help reduce the pain and dysfunction often associated with TMJ. Airway restricting (breathing) sleep disorders may require an appliance which maintains an open airway. There are many appliances for sleep bruxism (clenching and/or grinding). Protective appliances are used for strenuous activities including sports/working out. Many of our patients use their lower appliances while performing everyday functions (working, traveling, etc.).
How do I clean my appliances? We recommend non-abrasive OTC denture cleaners such as Polident to clean and care for your custom appliances. During your dental visits we will use a professional enzyme cleaner to clean your appliance.
Is Physical Therapy recommended for TMJ? Yes, both physical therapy and appliance therapy done as recommended by your Doctor will help reduce any pain associated with your TMJ, improve range of motion, and allow for more normal fluid movements.
Craniosacral Therapy (CST)? This may be an effective in-addition-to treatment option for patients who have had trauma. CST is a form of alternative therapy using gentle massage to manipulate the joints of the cranium to relieve pain and joint dysfunction to essentially improve health and performance.
Do I need to complete all dental treatment before I visit for TMJ? No, at this time only emergency dental treatment should be completed before TMJ therapy. A vital goal of TMJ treatment is to ensure that the mandible (jaw) is in proper alignment. Dr DiVito will therapeutically correct your bite prior to starting general and cosmetic dental treatment and throughout the process will maintain the position where the least symptoms of TMJ are present. Oral appliance therapy for sleep apnea can change the bite. We want to alleviate all airway restrictions and create a bite and jaw position that is harmonious with an open airway.
Should my teeth touch during the day? Your teeth should only touch when you swallow. Remember to try to relax your jaw and try to keep your teeth apart throughout the day.
How do you treat TMJ? Dr DiVito does not use the conventional mouth pieces called “TMJ split” or “Generic Bite Plate” in treating his patients. He uses a Mandibular Stabilization Prostheses (MSP), a highly specific kind of oral orthopedic appliance that bilaterally decompresses the joint space and is custom generated for each patient using both polar and axial corrected 2D and 3D CT scans, with very definite clinical objectives for each individual. The appliances are made from a strong, lightweight, odorless clear acrylic resin material.
There are many options for treating TMJ but any option should be specific to your mouth and conditions. Since TMJ can copycat so many other conditions it is important to consult both your dentist and your physician. If the cause is of dental origin then a custom treatment plan with all the necessary x-rays and muscle testing will guide the patient to the best possible option.
With a custom made MSP a patient normally experiences both stabilization of the jaw and the relief of head, neck, ear, and shoulder pain associated with TMJ. This is because the Fifth Cranial nerve (5 CV), a nerve commonly associated with TMJ symptoms, gets relieved of pressure, trauma, and compression caused from the jaw previously being misaligned.
If you are experiencing painful TMD or TMJ symptoms or are unsure if you have chronic headaches or face pain related to your jaw joint, please contact our office to schedule a consultation or contact us at at www.drdivito.com. You can also call 480-990-1905.
We have developed a custom TMJ Questionnaire to help you determine if you are experiencing signs or symptoms typically associated with TMJ.
Symptoms vary in their presentation and can be very complex. Oftentimes the symptoms will involve more than one of the three components: muscles associated with TMJ, the Temporomandibular joints, and how the teeth are affected by TMJ.
Dr. DiVito is a dentist with advanced training for the non-surgical management of TMJ disorders. He is a native of Phoenix and has practiced in Scottsdale since 1980. His staff is highly trained and experienced in helping manage sick and injured patients. A complete dental examination with appropriate x-rays is usually done to help determine if a victim of head neck trauma has sustained a TMJ injury. Sometimes an MRI study will also be needed to examine the soft structures that are damaged in these injuries. A complete TMJ evaluation can put the victim’s mind at ease about the reason for the jaw and headache pain.
Dr. DiVito and his staff can provide complete non-surgical management of TMJ related injuries and can also treat damaged teeth and oral structures. In the event of head/neck trauma or other accident do not put off an early visit for a TMJ evaluation.
Once the condition has been stabilized and the patient is comfortable, different treatment options are available. Since one treatment does not fit everyone, Dr. DiVito will discuss in detail all of your options for review.