TMD Treatment at San Antonio Oral Surgery
Most of us tend to overlook the temporomandibular joint's function and purpose until it gives us cause for concern. This important joint can create many problems in our ability to speak and chew properly if it gets injured or infected. If the simplest tasks like opening and closing your mouth become difficult due to discomforts such as muscle pain or headaches, you may have a Temporo Mandibular Disorder, also known as TMD.
Dr. Jeffrey Wert of San Antonio Oral Surgery and Dental Implants understands the frustrations of discomfort extending to the head, back, and shoulders and uses his extensive knowledge to treat TMD.
From conservative treatment to advanced TMJ surgery, our comprehensive treatments are designed to alleviate and correct the complications associated with compromised jaw movement. Contact us today to schedule your TMD consultation!
Understanding the Temporomandibular Joint and Disorders
Your temporomandibular joint is a hinge that connects your jaw to your skull's temporal bones in front of each ear. It allows you to move your jaw up and down and side by side, allowing you to talk, chew, and yawn. Perhaps you have experienced pain in your jaw area sometimes, or maybe your dentist or doctor has told you that you might have TMD. TMD is not a single disorder but a group of painful conditions that affect the temporomandibular joint and the chewing muscles.
How Will I Know if I Have A TMD Disorder?
There are many reasons for developing TMJ disorders. You may have been involved in an accident or experienced trauma to the jaw. You also could clench or grind your teeth or tighten the muscles of your jaw by habit or from stress.
Here is a quick and simple three-step test you can try right now:
- Place a finger over the joint in front of your ear.
- Open your jaw slightly.
- Then open wide until you can feel the joint move.
Chances are you may have a temporomandibular joint disorder if you hear a grating, clicking, or crackling noise, or if it is tender when you press.
We recommended asking yourself the following:
- Do you wake up with sore, stiff muscles around your jaws?
- Do you have frequent headaches or neck aches?
- Does the pain get worse when you clench your teeth?
- Is it difficult or painful to open your mouth, eat, or yawn?
- Does your jaw click, pop, grate, catch, or lock when you open your mouth?
- Have you ever injured your neck, head or jaws?
- Are your teeth sensitive or worn?
- Have you had problems (such as arthritis) with other joints?
- Do your teeth meet differently from time to time?
What Causes TMD?
Unfortunately, there is no single cause for TMD. Anything that causes tension in the jaw and temporal muscles can cause TMJ problems. Multiple factors often coincide in causing the disorder and pain. An injury to the jaw, face, head, and neck are some of the most frequent causes of onset TMD pain.
Grinding or Clenching Your Teeth
Bruxism can develop when you unconsciously clench your jaw or grind your teeth. Some people experience this while awake, typically induced by stress or concentration, and others suffer from the condition during sleep. Over time, because of the intense pressure being put on your teeth, your bite position can change. This often leads to jaw misalignment, creating other associated issues, like TMD.
Individuals with arthritis throughout the body can quite often experience arthritis of the TMJ.
Often considered a major cause of TMD, stress influences involuntary movements throughout the body, such as teeth clenching and grinding as well as tensing the neck, head, and shoulders.
Signs and Symptoms
There may be a variety of symptoms associated with TMD. Pain is the most common symptom, especially in the chewing muscles and/or jaw joint.
Other symptoms are likely to include:
- Locked or limited movement in the jaw
- Pain that extends to the jaw, face, neck and shoulders
- Uncomfortable popping, clicking, or rough sounds when opening and closing the mouth
- A sudden, significant change in the position of the upper and lower teeth.
- Hearing problems
How Is TMD Diagnosed?
There is no one standard test for diagnosing TMD because the exact causes and symptoms are not clear. Typically, doctors, dentists, and oral surgeons make a diagnosis based on traditional symptoms, particularly jaw pain. When you visit San Antonio Oral Surgery for an experienced TMD diagnosis, you can expect the following process:
Medical History Evaluation – Our Surgeons will begin by reviewing your medical history. Many oral health conditions such as tooth decay, sinus issues, arthritis, and/or gum disease are also looked at to gain a better perspective of your specific situation.
Physical Examination – A physical examination of your jaw is conducted to determine potential causes. We will check for pain or tenderness in your jaw joints and listen for clicks, pops, or grating sounds. We also make sure your jaw works correctly, not locking when you open or close your mouth. We will also test your bite and check for facial muscle tenderness and function.
Diagnostic X-Rays – We will do the necessary imaging to evaluate your jaw joints and surrounding structures in order to establish a working diagnosis and the correct treatment.
What are My Options for Treating TMD?
Conservative Treatments - used to relieve symptoms of TMD include:
- Eating soft foods
- Applying ice or heat packs to the area
- Avoiding strenuous jaw movements such as wide yawning, gum chewing and loud singing
- Learning special relaxation and stress reduction techniques can also help patients cope with the pain that often involves TMD problems.
Other conservative treatments include:
- Physical therapy that is focused on gentle muscle stretching and relaxing exercises
- Short-term use of muscle relaxers and anti-inflammatory drugs
- Night-guards or splints
Advanced Treatment Options
Conservative therapies are useful for temporary pain relief and muscle spasms; however, they are not "cures" for TMD. If other treatments fail or do not provide sufficient relief, advancing to more invasive procedures can be necessary.
Three common types of surgical treatment that could alleviate your TMD:
- Injecting anti-inflammatory medications (steroids) in to the joint spaces that surround the jaw joints - performed in the office
- Lavaging the joint - washing out the joints and place steroid medication - performed in the office
- Arthroscopy - looking in the joint with a small camera (like knees) for diagnosis and treatment based on findings - performed in an outpatient facility with general anesthesia.
The need and type of or surgical treatment are determined by your response the conservative treatment and your specific situation.
Bruxism and Clenching
Bruxism refers to an oral parafunctional activity which occurs in most humans at some point in their lives. The grinding of the teeth can occur either during the day or at night. Clenching is when a person activates the closing muscles of the jaw without grinding the teeth.
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.
Reasons for the treatment of bruxism and clenching
Occlusal trauma – The abnormal wear patterns on the occlusal (chewing) surfaces can lead to fractures in the teeth, which may require restorative treatment.
Muscle pain – The grinding associated with bruxism can lead to muscle pain in the facial region and can include severe headaches.
Treatment options for bruxism
Mouth guards or Splints – An acrylic mouth guard can be designed from tooth impressions to reduce the frequency of clenching and grinding; also to minimize the abrasive action of tooth surfaces during sleep. Mouth guards use could require long-term use to help prevent tooth damage, damage to the temporomandibular joints and help to stabilize the occlusion.
Other methods of treatment include relaxation exercises, stress management education and biofeedback mechanisms.
Our Oral Surgery practice provides compassionate, experienced, and innovative TMD treatment for patients throughout San Antonio and the surrounding communities. If you would like more information about our TMD treatment options, we encourage you to contact Dr. Jeffrey Wert and his team today!