TMJ Treatment by NYC Dentists
Do you grind your teeth at night, or clench them during the day? Do you often get head and neck pain, have sore jaws while chewing, have pops or clicks in your jaw joints, or sensitive teeth? Temporomandibular Joint Disorder, also referred to as TMJ or TMD, affects many people’s quality of life and can present itself through symptoms like these. TMJ is the source of chronic pain for many, and can result in severe wear, or fracturing of your teeth and restorations, leading to tooth loss.
What is TMJ?
TMJ stands for temporomandibular joint, or jaw joint. These are the small joints in front of each ear that attach the lower jaw to the skull, and happen to be the most complex joints in the entire body. The area of the face where the TMJ is located is an intricate network of bones, including the teeth, muscles, and nerves. Because of this, TMJ dysfunction conditions affect many areas of the body, from the top of the head in migraine-like headaches to numbness or tingling in the arms and pain in the neck or shoulders.
TMJ Symptoms
- Headaches
- Facial pain
- Jaw pain
- Sore, chipped, broken, or worn teeth
- Clicking or popping in the jaw
- Limited jaw movement
- Chronic pain in the jaw, teeth, face, head, neck, shoulders, or back
- "Ringing" in the ears
- Tooth Grinding
In grinding and intermittent tapping of the teeth, this contact involves movements of the lower jaw and unpleasant sounds which can often awaken housemates. Clenching (or clamping), on the other hand, involves inaudible, sustained, forceful tooth contact unaccompanied by lower jaw movements.
Both clenching and grinding can have adverse effects on the teeth, and especially on restorations (crowns, bridges, inlays, and onlays). To protect your teeth against fracture, an occlusal device, or "nightguard" can be made.
 |
| Fractured porcelain crowns related to excessive clenching and grinding |
What Causes TMJ Pain?
In most cases, TMJ disorders stem from a condition called malocclusion, which means having a bad bite by way of genetic predisposition, dental trauma, or poorly constructed dental work. The term, "malocclusion" means that your upper and lower teeth do not close together in the correct way so as to not cause adverse forces on the musculature and ligaments that hold our lower jaw to our skull. When the teeth are misaligned, they cannot provide the support the muscles in the face need for chewing and swallowing. These muscles are then forced into a strained position, resulting in pain throughout the face, head, neck, arms, shoulders and back. Although a person may have beautiful teeth or had orthodontics to line the teeth up for aesthetic reasons, the muscles and joints may not be positioned in a physiologically neutral and natural position.
How Can TMJ Pain be Treated?
Dr. Gulizio and Dr. Cordoves are trained in neuromuscular dentistry and understand the complex signs and symptoms associated with TMJ/MPD. They will first measure the most relaxed position of your jaw to determine the goal for normal jaw positioning. The bite is then realigned and your teeth may need to be restored to return the jaw and joints to their optimal position. Once the bite is realigned and the jaw is in place, pain that resulted from the imbalance disappears.
Neuromuscular Dentistry
Neuromuscular dentistry is the art and science of finding a person’s relaxed jaw position (their correct bite), and then devising treatments to make it permanent, thus eliminating those painful symptoms. We use sophisticated computer analysis as well as muscle relaxation techniques to diagnose and treat your symptoms. We are often very successful in improving or eliminating the chronic pain and discomfort felt by TMJ sufferers.
The Electromyograph (EMG) is a sophisticated device used to track jaw muscle activity and find the perfect position of rest. Drs. Gulizio and Cordoves will then use a variety of treatment measures to establish your bite in its correct position.
Why is Neuromuscular Treatment Needed?
If TMJ/TMD is left untreated, symptoms can worsen and extend far beyond the jaw and mouth area. Neuromuscular treatment helps those suffering from TMJ/TMD find the ideal at-rest jaw position. Through the use of medication, orthotic devices, and dental improvements, you may be able to permanently restore a well-aligned bite and avoid the symptoms of neuromuscular dysfunction.
TMJ treatment may also include:
- Physical therapy
- Surgical remedies
- Cosmetic dentistry
- Oral appliances
- Medication
- TENS electrical stimulation
Occlusal Guards
Nightguards (also called "occlusal guards") are made of hard acrylic resin, and are customized to snugly fit your upper teeth. Because everyone's mouth is different, it is imperative that impressions be made and jaw records taken so that the nightguard is made properly. Similar over-the-counter appliances are not customized to your teeth, and are therefore not recommended. In fact, some over-the-counter appliances can do more harm than good.
Fabrication of a nightguard involves 2 office visits. At the first visit, impressions of your upper and lower teeth are made and special records are taken to ensure that the nightguard is properly customized to fit your teeth. The second visit involves "fitting" the nightguard to ensure that it functions properly and is comfortable.
Visit Smile Makeovers for before and after pictures that demonstrate our work.
< Back to Solutions