I recently carried out a review of the various TMJ specialist treatment on offer and I counted 55 different types.
I was quite surprised by this, but perhaps I shouldn’t have been, because there are so many different professions treating TMJ Dysfunction –
- Physicians
- RadiologistsProsthodontists
- Kinesiologists
- Biofeedback specialists
- Craniofacial pain specialists
- Osteopaths
- Neurologists
- Orthodontists
- Oral and Maxillofacial surgeons
- ENT surgeons (otolaryngologists)
- Accupuncturists
- TMJ Specialst like myself.
TMJ problems are caused by –
- The way the upper and lower teeth meet (the occlusion)
- How often they meet
- What happens when the teeth meet
So TMJ treatment has to revolve around these 3 factors to bring about pain relief.
As a TMJ specialist I call upon the skills and great knowledge of medical colleagues to exclude other possible cause of TMJ pain, but at the end of the day, the occlusion is the culprit and it is the occlusion that has to be altered.
Here are the different types of TMJ treatment, in no particular order.
1. Facial Exercises These are designed to gently work the facial and neck muscles to reduce spasm and encourage normal muscle movement. I mentioned earlier that TMJ problems are caused by the occlusion, over-stressing the TMJs, finally leading to muscle spasm and pain. The muscle spasm is caused by overworked facial muscles or by abnormal movements of the muscles, because the jaw joint is not functioning in the correct manner. The advantages of facial exercises in TMJ treatment are:-
- No cost to you, once you know what to do and how to do it.
- Non-invasive – no dental appointments
- Requires no time off work or college or for other commitments, as the exercises can be carried out at home.
- The treatment is quite pleasant
2. Night Guards Your teeth come together by the actions of certain groups of muscles and this action involves these muscles carrying out some pretty hard work. Like all muscles in the body they need to rest now and again which is fine most of the time but if you clench your teeth, or grind your teeth (bruxism), the muscles cannot rest, because they are always hard at work. This can produce TMJ symptoms. So if you wake up in the morning with TMJ symptoms, there is a very good chance you are either clenching or bruxing during sleep. This is where the night guard comes in handy. They are made of a soft squishy plastic that covers the upper or lower teeth. So when you are asleep and are clenching or bruxing, the muscles do not have to work so hard because of the presence of the night guard.
3. Occlusal Equilibration. Human teeth are designed to meet (occlude) in a very precise way. When this happens, very little stress is transmitted to the TMJs. But if the occlusion is misaligned, meaning the teeth meet in an abnormal fashion (mal-occlusion) abnormal stresses are placed on the TMJs and can, in some cases lead to TMJ pain. This mal-occlusion can be caused by dental neglect, gum disease, poor dental treatment, trauma, or just the way the teeth naturally end up in some people. Treatment involves the careful grinding of certain parts of the teeth with a dental drill to ensure a correct occlusal relationship, thereby reducing TMJ stress.
4. Occlusal Restoration. This really is the next step up from occlusal equilibration. If the occlusion is so bad, occlusal equilibration is not as option – especially if there has been loss of teeth. Therefore occlusal restoration aims to achieve the same end results as occlusal equilibration, but on a grander scale. Treatment could involve fillings, inlays, onlays, crowns, bridges, partial and full dentures. But the end result, as always is to get the TMJs in a neutral position, where minimum stress is placed upon them.
5. Splints. Mouth splints (oral splints) are a little like orthodontic braces, but without the pieces of wire that move the teeth – although they often have small metal clasps that hold the splint firmly in place. The job of a mouth splint is to reduce stress on the TMJs – as indeed are all forms of TMJ treatment. There are many different types of splint and they are often chosen according to the TMJ Specialist’s personal preferences. My own preference is something called an Anterior Repositioning Splint which places the upper and lower front teeth in line, but a few millimetres apart. It would not be practical, or for that matter very interesting to list the different mouth splints as they all aim to achieve the same end result – freedom from pain and other related TMJ symptoms.
6. Other TMJ Specialist Treatments. This is not meant to be a complete list, but rather to give some idea of what options are out there.
- TMJ surgery
- Injections into the TMJ
- Application of heat
- Drugs
- Cold packs
- Psychiatric treatment
