What is TMJ?
The acronym “TMJ” technically refers to the temporomandibular joint, but is also used to refer disorders associated with this joint. You may see TMJ, TMJD, or TMD used interchangeably to refer to temporomandibular joint disorders. TMJ disorders are not one condition but rather a group of conditions affecting the joint or chewing muscles.
The temporomandibular joint is located just in front of the ears and is the place where the mandible (lower jaw) connects to the base of the skull. It is both a highly complex and unique joint. It has a ball-and-socket configuration similar to the shoulder or hip joints—the “ball” is called the condyle and the “socket” is called the fossa. The unique thing about the TMJ when compared to other joints is that in addition to being able to rotate, the condyle can also slide forward which allows the jaw to open wide. In an ideal bite, the condyle is fully seated within the fossa when the teeth are fully closed together. Between the condyle and fossa is a section of cartilage called a disc that allows the combination of rotating and sliding movements. Connecting to the condyle, fossa, and disc are a series of ligaments that offer support and stability. Finally, there are four separate chewing muscles that connect to different areas of the mandible to control jaw movements when talking or chewing. As you can see, this is a complex joint that relies on a number of anatomic features working together in order to function properly. A dysfunction in any one of these parts can lead to symptoms of TMJD.
What are symptoms commonly associated with TMJ disorders?
The specific symptoms experienced by each patient can vary depending on the cause of TMJ dysfunction. Some of the more common symptoms include:
- Clicking or popping of the TMJ
- TMJ pain
- Muscle pain
- Inability to open the jaw widely
- Locking of the jaw – either in an open or closed position
- Headache, especially in the temple region
- Pain when chewing or talking
- An uncomfortable bite or fit between the upper and lower teeth
How can bite splints be used to treat TMJ?
Bite splints are designed specifically for each patient according to their unique condition and desired outcome. In a general sense, the goal of bite splint therapy for patients suffering from TMJ is to reduce strain on the temporomandibular joint and its associated muscles and ligaments. This is accomplished by setting up the bite on the bite splint to allow the lower jaw to relax into its most natural and comfortable position in the joint. We refer to this position as centric relation. It is a position which is repeatable and allows for reduced stress and inflammation of the joint. In patients with some TMJ disorders, the bite splint may need to be adjusted a few times after the initial fitting of the splint to guide and allow the jaw to relax fully to this position. In a patient whose natural bite between the upper and lower teeth doesn’t allow the jaw to reach this centric relation position, a bite splint helps by creating a new biting surface to line up with a better joint position. The ultimate goal is the reduction of pain and joint noises. If bite splint therapy is successful, the patient may be presented with the option to do a limited bite adjustment (called an equilibration) or orthodontics to help the teeth fit together in this improved position.
What other possible treatments are there for TMJ?
In addition to bite splint therapy, other possible treatment options can include physical therapy, home exercises, orthodontics, bite adjustment/equilibration, stress counseling, oral medication, or injections. TMJ surgery may also be indicated as a last resort in severe cases that don’t respond to more conservative treatment options.
I think I might have TMJ, what is the next step?
Dr. Jason Doublestein, Dr. Michael Wierenga, and Dr. Katelyn Trierweiler along with our dedicated staff here at 44 West Dental Professionals are well-trained to diagnose complex TMJ disorders. If you think you suffer from TMJ, give us a call at (616) 530-2200 to set up a consultation today.