The TMJ or Temporomandibular Joint is your jaw joint. Almost everyone has two of these! They are very much like knees – almost everyone has a pair and many have at some point in their life had some concerns with one or both knees. The TMJ is complex like the knee joint, and the TMJs are vital for normal jaw function. It is important that your dentist understands the TMJ! All successful treatment begins with stable and comfortable TMJs. These joints must be capable of resisting several hundred pounds of force during chewing, clenching, or hanging by one’s teeth from a trapeze. In fact, one study measured the compressive force of the jaws at up to 975 lbs per square inch. Most people, thankfully, do not put this kind of force on their jaws, or their teeth. The joints must function fluidly so that talking, singing, laughing, and eating is comfortable.
What is TMJ Therapy & Why do I Care?
Sometimes people tell us that they have TMJ. What they really mean is that they have problems with one or both of their TMJs or that they have some type of Temporomandibular Joint Dysfunction. The problems we see most often are the following:
- Pain or clicking of the jaw joints
- Popping or grinding sounds in the jaw joints
- Difficulty opening fully
- Difficulty chewing foods
- Bite seems to be changing over time
- Damage to or wear of the teeth
- Pain in the chewing muscles
- Pain or ringing in one or both ears
- Pain with pressure over one or both jaw joints
Thankfully, most TMJ problems are really muscle problems. And almost all problems with the TMJ start out with muscle imbalances. The TMJ is very close to the ear so that the sounds made in this joint are somewhat amplified. Your TMJ evaluation will probably begin with a discussion of your symptoms and concerns. We will ‘load test’ the TMJs to help evaluate the health of the joint. Your two jaw joints work together as you open and close your mouth and as you chew food. Unless your jaw is fractured, you cannot move one without the other moving at the same time. We will gently test the chewing muscles for any dysfunction or pain.
A splint may be prescribed as part of your TMJ therapy. A full coverage, hard splint is shown here. This type of splint is usually worn at night and at any other time that you may be clenching and grinding your teeth. An even solid bite in harmony with your TMJs is built into the splint and adjusted to be comfortable for you, your muscles, and your TMJs!
Between the condyles and your head is a dense disk composed of layers of collagen fibers pliable enough (when healthy) to conform to the bony fossa where the condyle sits as your jaw and the joint moves. Different kinds of splint therapy may be used to relax the musculature or aid in recapturing a slipped disk. One of these, an NTI, places the forces of your bite on the front teeth only, and this greatly reduces the forces of the muscles contracting during biting or clenching.
The small splint shown above is called an NTI and may be prescribed for you. This appliance cuts down the forces from clenching and grinding and allows healing in the TMJ to occur. We will evaluate the muscles that make chewing possible and that prevent the disk from slipping out of alignment. You may have habits or trauma causing the problems you are experiencing with your TMJ. Dr. Julie Gillis uses a variety of bite splints to help in your TMJ dysfunction treatment. We will sometimes prescribe medications to help you.