Richard Cañizares, DMD
Prosthodontics and Cosmetic Dentistry
Marlene Rivera, DMD
Some common symptoms include pain in or around the ear, tenderness of the jaw, clicking or popping noises when opening the mouth, or even headaches and neck aches.
Two joints and several jaw muscles make it possible to open and close the mouth. They work together when you chew, speak, and swallow. These structures include muscles and ligaments, as well as the jaw bone, the mandible (lower jaw) with two joints, the TMJ's.
The TM joint is one of the most complex joints in the body. Located on each side of the head, these joints work together and can make many different movements, including a combination of rotating and translocational (gliding) action, used when chewing and speaking. Several muscles help open and close the mouth. They control the lower jaw (mandible) as it moves forward, backward, and side-to-side. Both TM joints are involved in these movements. Each TM joint has a disc between the ball and socket (see diagram). The disc cushions the load while enabling the jaw to open widely and perform rotating and translocational movements. Any problem that prevents this complex system of muscles, ligaments, discs and bones from working together properly may result in a painful TMJ disorder.
Diagnosis & Treatment
Our dentists can help identify the source of the pain with a thorough exam and appropriate x-rays. Often, it's a sinus, toothache or an early stage of periodontal disease. But for some pain, the cause is not so easily diagnosed. The pain could be related to the facial muscles, the jaw or temporomandibular joint, located in the front of the ear. Treatments for this pain may include stress reducing exercises, muscle relaxants, or wearing a an oclussal Splint.
Several conditions may be related to TMD, but they can be quite varied, and they are often difficult to pinpoint. TM disorders can result when the jaw muscles or jaw joints are affected.
Some TM problems result from arthritis, dislocation, and injury. All of these conditions can cause pain and dysfunction. Muscles that move the joints are also subject to injury and disease. Injuries to the jaw, head or neck, and diseases such as arthritis, might result in some TM problems. Other factors that relate to the way the teeth fit together—the bite—may cause some types of TMD. Stress is thought to be a factor. TMD affects women of childbearing age more than men, or older men and women.
Diagnosis is an important step before treatment. Part of your clinical examination includes checking the joints and muscles for tenderness, clicking, popping or difficulty moving. Your complete medical history may be reviewed, so it is important to keep your dental office record up-to-date. Your dentist may take xrays and may make a cast” of your teeth to see how your bite fits together. Your dentist may also request specialized x-rays for the TM joints. Depending on your case, the dentist may refer you to a physician or another dentist.
There are several ways the TMJ disorders may be treated.
An occlusal splint (bite splint) is used to determine if improvement of the occlusion, or a repositioning of the jaw, would improve the symptoms. If this is achieved, the occlusal splint can be continually worn, or the occlusion can be corrected to eliminate the need of the occlusal splint.
Correction of the occlusion may require selective grinding on the chewing surfaces of the natural teeth; crowns and fixed bridges; orthodontic treatment; and/or surgical repositioning of the jaws or teeth. Orthodontic treatment would be available by an orthodontist and surgical procedures would be available by an oral surgeon
Typically, prosthodontic treatment of TMD problems involves treatment of the muscles associated with the joints and treatment of the occlusion. Procedures designed to relax the musculature and improve the occlusion can often relieve the TMD symptoms. Severe TMD problems usually require a coordinated treatment plan with other health professionals in addition to the prosthodontist.
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