Procedures

TMJ Disorders

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.

If you are looking for TMJ treatment in Grass Valley, CA, please consider calling our office for a consultation. During a consultation visit Dr. Leighty can answer your questions about TMJ treatment and help you determine if you may be suffering from a TMJ disorder.

TMJ disorders are a family of problems related to your jaw joint. If you have had symptoms like pain or a "clicking" sound, you might be relieved to know that these problems are more easily diagnosed and treated than in the past. Unless accompanied by pain or locking problems, jaw noise itself may be harmless. Half of the world’s population has noise in their jaw joints as a normal condition.

Pain or difficulty in opening or chewing may occur when the joints of the jaw and the chewing muscles (muscles of mastication) do not work together correctly. TMJ disorder can be exceedingly complex however, and there is not any particular treatment that works for all TMJ problems. Patients may require behavior modification, dental treatment, medicines, counseling, or physical therapy for effective treatment. Sometimes joint surgery is necessary. Proper TMJ treatment often requires time and a concerted coordinated effort between the patient and several specialists. Dr. Leighty can help you with evaluation of your TMJ and assist you in understanding your treatment options.

Trouble with Your 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.

Do You Have a TMJ Disorder?

• Are you aware of grinding or clenching your teeth?
• 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?
• Does stress make your clenching and pain worse?
• Does your jaw click, pop, grate, catch, or lock when you open your mouth?
• Is it difficult or painful to open your mouth, eat or yawn?
• Have you ever injured your neck, head or jaws?
• Have you had problems (such as arthritis) with other joints?
• Do you have teeth that no longer touch when you bite?
• Do your teeth meet differently from time to time?
• Is it hard to use your front teeth to bite or tear food?
• Are your teeth sensitive, loose, broken or worn?

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.

Treatment

There are various treatment options that Dr. Leighty can utilize to improve the harmony and function of your jaw. Once an evaluation confirms a diagnosis of TMJ disorder, Dr. Leighty 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 stop parafunctional habits, unload or relax the joint, and lessen muscle spasms. This is usually accomplished with behavior modification, and various anti-inflammatory medications. Steroids are sometimes injected directly into the joints to reduce pain and inflammation. Self-care treatments can be very effective:

25 TMJ Dos and Don’ts

1. Eat soft foods and avoid hard foods. This includes bread with crusts, pizza, raw vegetables, or any foods that require high biting force or prolonged chewing.

2. Cut all foods into small pieces so you don’t have to open wide.

3. Do not bite foods with your front teeth.

4. No chewing gum.

5. Do not bite your nails or chew on pencils.

6. Do not bite your lower lip.

7. If you wear lipstick, do not push your lower jaw forward to apply.

14. Avoid moving your jaw in such a way that it clicks or pops.

15. Treat your jaw as if it were sprained. Move your jaw gently and protect it at all times.

16. Keep a journal of your jaw pain. Be sure to write down what you were doing or where you are when it hurts. In other words, try to learn ‘what makes your jaw hurt,’ and ‘what makes it better.’

17. Breathe through your nose, not your mouth.

18. Limit your jaw opening to one thumb width, especially when laughing, shouting, singing, coughing, or sneezing.

19. Be especially careful when yawning. Use your hands if necessary to keep your jaw from opening wider than one thumb width.

20. When blowing your nose, keep your teeth apart.

21. Maintain correct posture. Keep your head, neck, and shoulders in a straight line.

22. Avoid heavy lifting, pushing, or straining of your back.

23. Try to avoid stressful situation.

24. Try various relaxation, massage, or temperature (heat or cold) therapies.

25. Be gentle with your jaw when kissing.

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 or just at night to move your jaw into proper position. Appliances also help to protect from tooth wear.

What about bite correction or surgery?

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. Dr. Leighty 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.