TMJ (temporomandibular joint) disorders are a family of problems related to your complex jaw joint. If you have had symptoms like pain or a "clicking" sound, you'll be glad to know that these problems are more easily diagnosed and treated than they were in the past. These symptoms occur when the joints of the jaw and the chewing muscles (muscles of mastication) do not work together correctly. TMJ stands for temporomandibular joint, which is the name for each joint (right and left) that connects your jaw to your skull. Since some types of TMJ problems can lead to more serious conditions, early detection and treatment are important.
No one treatment can resolve TMJ disorders completely and treatment takes time to become effective. Drs. Sullivan, Ritto and Tiwana can help you have a healthier and more comfortable jaw.
TMJ disorders develop for many reasons. You might clench or grind your teeth, tightening your jaw muscles and stressing your TM joint. You may have a damaged jaw joint due to injury or disease. Injuries and arthritis can damage the joint directly or stretch or tear the muscle ligaments. As a result, the disk, which is made of cartilage and functions as the “cushion” of the jaw joint, can slip out of position. Whatever the cause, the results may include a misaligned bite, pain, clicking, or grating noise when you open your mouth or trouble opening your mouth wide.
The more times you answered "yes", the more likely it is that you have a TMJ disorder. Understanding TMJ disorders will also help you understand how they are treated.
There are various treatment options that Drs. Sullivan and Ritto can utilize to improve the harmony and function of your jaw. Once an evaluation confirms a diagnosis of TMJ disorder, Drs. Sullivan and Ritto will determine the proper course of treatment. It is important to note that treatment always works best with a team approach of self-care joined with professional care.
The initial goals are to relieve the muscle spasm and joint pain. This is usually accomplished with a pain reliever, anti-inflammatory, or muscle relaxant. Steroids can be injected directly into the joints to reduce pain and inflammation.
Self-care treatments can often be effective as well and include:
Stress management techniques such as biofeedback or physical therapy may also be recommended, as well as a temporary, clear plastic appliance known as a splint. A splint (or nightguard) fits over your top or bottom teeth and helps keep your teeth apart, thereby relaxing the muscles and reducing pain. There are different types of appliances used for different purposes. A nightguard helps you stop clenching or grinding your teeth and reduces muscle tension at night and helps to protect the cartilage and joint surfaces. An anterior positioning appliance moves your jaw forward, relives pressure on parts of your jaw and aids in disk repositioning. It may be worn 24 hours/day to help your jaw heal. An orthotic stabilization appliance is worn 24 hours/day or just at night to move your jaw into proper position. Appliances also help to protect from tooth wear.
If your TMJ disorder has caused problems with how your teeth fit together, you may need treatment such as bite adjustment (equilibration), orthodontics with or without jaw reconstruction, or restorative dental work. Surgical options such as arthroscopy and open joint repair restructuring are sometimes needed, but are reserved for severe cases. Drs. Sullivan and Ritto does not consider TMJ surgery unless the jaw can’t open, is dislocated and nonreducible, has severe degeneration, or the patient has undergone appliance treatment unsuccessfully.
Corrective jaw surgery treatment planning has three essential goals
Oral and maxillofacial surgeons tend to treat the x-ray that they are looking at rather than the face itself. For many of these surgeons, numbers drive treatment planning, rather than having a firm understanding of how the surgical movements of the upper and lower jaw impact the final form of the face. This is important not only looking at the front view, but also in the profile view.
FacesFirst is our unique philosophy. It places the emphasis on the final position of the upper jaw. The upper jaw, or maxilla, is what dictates the smile. It is incredibly important to place the upper incisors in their ideal position. The vertical position of the upper jaw will dictate how much tooth is shown at rest as well as smiling. Maximizing the width of the upper jaw fills out the smile line, making it far more aesthetic and eliminating areas where the cheek can be seen when one is smiling broadly. The smile is everything.
The upper jaw dictates the final position of the lower jaw and therefore the facial profile. With FacesFirst, the upper jaw determines the smile aesthetics and the lower jaw determines the profile aesthetics. Harmonious positioning is the key to the best possible aesthetic outcome.