Previously,
patients seeking help for these types of problems would go from specialist to
specialist seeking a cure. Today, however, a condition termed TMJ,
temporomandibular joint syndrome, accounts for a large number of these
previously uncured and painful ailments. These types of pain are symptoms of
the syndrome not the problem itself. Correcting the problem rather than the
symptoms is at the heart of TMJ treatment.
Your
jaw joint is suspended beneath the skull by an intricate system of muscles and
tendons. The jaw joints, also known as temporomandibular joints, are the
most complex in the body.
The way your teeth fit
together is called occlusion. When your teeth are not in proper relation to
each other and to your jaw joints, the jaw automatically shifts to a new
position in an attempt to compensate for the misalignment of your teeth a
condition known as malocclusion (teeth do not fit together properly).
When malocclusion exists,
even what looks like a good bite could be putting pressure or strain on jaw
joint and muscles as the jaw shifts to accommodate the teeth. Symptoms of
misaligned teeth may be clenching, grinding, premature tooth wear and stress on
the muscles and tendons. These may occur while awake or during sleep. These
stresses result in headaches, muscular aches and pains in the face, neck,
shoulders and back, dizziness, earaches and ringing in the ears.
In addition, these common
conditions often relate to malocclusion and cause pain in and around the
temporomandibular joint. There are other conditions which can affect the
function and comfort of this joint and total body health. These conditions
include various diseases such as arthritis, nutritional deficiencies, tumors,
trauma and infections.
Before prescribing the proper
treatment for your particular problem, a variety of diagnostic procedures may
be necessary. A special series of radiographs (x-rays) may be taken of your jaw
joint. This provides a clear picture of your own particular TMJ anatomy. This
radiograph is also used for detecting disease in and around the jaw joint.
After we have fully diagnosed the patient's
condition, there are a number of different types of treatment that we may
recommend. Initial phases of treatment are the muscles to relax and the jaw
joint to become properly hinged. The second phase of treatment has its
goal the correction of occlusion (proper meshing of teeth) so that the teeth
are in proper alignment with the repositioned jaw joint. Various TMJ treatments
are briefly explained below:
Phase I. Treatment
1) Splint/Jaw Repositioner Appliances:
These appliances are used in treatment to
temporarily eliminate malocclusion problems and allow the head, neck and facial
muscles to relax. In order to study the relationship of your teeth and joints,
it is necessary to see how the joints guide the jaw without interference from
the reflexes and muscles which are always accommodating to the fit of the
teeth. To do this, a record is taken measuring the relationship of the teeth to
the jaw. This record of the joint guidance can then be reproduced on an
instrument called an articulator, simulating your own particular jaw movements
and bite relationship. Then, without
interferences from reflexes and muscles, your bite can be studied for
interferences. Necessary treatment can then be prescribed.
A splint is a rigid acrylic mouthpiece that fits over
the biting surfaces of the teeth. This appliance is used to slowly change the
jaw hinge position by changing the biting surface of the plastic. These changes
will continue approximately every two to three weeks for a period of 3 to 6
months.
2) Ultrasound Muscle Stimulation:
These types of therapy may be used during treatment to additionally help alleviate muscle pain caused by TMJ problems. Both of these treatments are performed topically (to the surface of the skin) and can be done routinely in our office.
Phase II Treatment
1) Occlusal Equilibration:
In this procedure, the teeth are reshaped to eliminate misaligned biting surfaces. This is done to alleviate pressure on individual teeth and allow the face and jaw muscles to relax on a permanent basis. This procedure can only be done if after Phase I treatment the tooth fit misalignment is minimal.
2) Orthodontics (Braces):
Once proper jaw alignment has been reached through splint therapy orthodontics may be necessary to achieve a proper tooth fit. Braces must be used if, after jaw repositioning, misalignment is significant.
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