Oral Medicine
TMJ (Tempro-Mandibular Joint Dysfunction)

The term TMJ by most peoples definition is a problem in the JAW JOINT.  TMJ actually means Tempero-Mandibular Joint.  We all have two TMJ's and they are very complicated joints.  It fact they are the most complicated joint in the human body.   Because everyone calls a problem with the joint TMJ then we will also refer to TMJ as a problem in this informations section.  

TMJ disorders can be caused by many things. An example of these causes are automobile accidents which create a side or rear impact causing the jaw direct trauma or the jaw  being opened beyond normal limits as with whip lash.  Additionally TMJ problems can be caused  by GRINDING EXCESSIVELY or BRUXXISM,  CLINCHING,  or developmental problems causing a bad bite.  Also loosing teeth or having dental procedures that create imbalance in the bite can cause serious TMJ problems if left untreated.

Most TMJ problems ( not all) are usually just annoying enough or just painful enough  that the patient will seek help before it becomes a debilitating disorder. However,  if you are reading this then you are interested enough that you may have a probelm or someone you know has a problem.  Most TMJ problems have symptoms such as pain in a joint or both joints when chewing, clicking on one or both sides with or without pain, crepetation (Crackling sound) when opening or closing, inability to fully open, or deviation of the jaw to one side when you open.  First determine the cause.  This is imperative for successful treatment.  The treatments for TMJ problems can be simple or very extensive and expensive.  This is the reason you shouldn't wait  if you feel you have a problem..

The primary problem in most TMJ cases is the position of the joint when the teeth are together.  Even if your teeth are balanced correctly, if the joint is being stressed when you are biting, then the TMJ problem will only continue to get worse over time.   The two TMJ joints (left and right) need to be in a stress free position when you are biting or functioning normally.  If the joints are swollen because of trauma from clinching or grinding or from blunt trauma from  an accident then the bite will not be balanced and continued trauma will exist until the "TRAUMA AND SWELLING " can be controlled.

The most common form of treatment for TMJ problems is an OCCLUSAL GUARD.  These appliances are given different names for different problems but they look nearly the same and only small changes in their functioning makes them different. Some other names are NIGHT GUARD, NTI,  BRUXXISM APPLIANCE,  SPLINT, ETC.   Most appliances fit on the upper jaw, however there are some that fit on the lower jaw.  The best part of any TMJ treatment is that the appliance can not harm you in any way.  It prevents your teeth from coming together and causing more  chronic trauma to the JOINTS.   Very often the teeth and bite will need to be balanced.  This can be simple and take one appointment or complicated taking several appointment until the dynamics of function stabilizes and the joints return to normal with no swelling or inflammation. 

The sequence of treatment varies depending on the cause and amount of existing damage to the joints.  After your dentist decides on the sequence and type of appliance you will need he/she will take molds of your mouth to make the appliance.  This may be done before or after the bite correction depending on the severity of the TMJ dysfunction.  Additional appointments and bite adjustments will be necessary to balance  the appliance as the JOINTS move to that STRESS FREE POSITION.  Often a patient will need to wear the appliance for the rest of their lives because of the developed habit of clinching or grinding at night. This habit is very detremental to the joints and once the TMJ problem is corrected or at least CONTROLLED then the appliance is worn to prevent further damage or a relapse. 

Today with the advent of computer technology, Digital radiography and more sophicated testing TMJ treatments can be very successful.  If treated early the need for invasive treatment can be eliminated.

Tempro-Mandibular Joint Dysfunction Syndrome (TMJ) is a common condition affecting a wide variety of people. TMJ is characterized by severe headaches, jaw pain of varying degrees, grinding teeth, and an intermittent ringing in the ears. The vast majority of TMJ sufferers are unaware that the root cause of these problems is something that a dentist can effectively treat.

The symptoms of TMJ are debilitating and can greatly interfere with every day life. The comfort and general well being of the patient is at the heart of the dental practice, so pain relief is the first consideration of the dentist. The dentist is able to test, diagnose, and devise an immediate plan to treat the underlying causes of the TMJ disorder.

Reasons for treating TMJ

TMJ sufferers report that their symptoms generally worsen during periods of prolonged or unexpected stress, and that intense outbreaks of the condition can lead to neck pain and dizziness.

The most common cause of TMJ is the misalignment of the teeth and jaw position as mentioned above, often called “bad bite.” It is possible for the dentist to realign or adjust the teeth without the need for painful or expensive surgeries. The realignment/adjustment will stop the pounding headaches, the jaw pain, and the dizziness.

The grinding teeth symptom is particularly common and usually occurs at night. The grinding will eventually erode the structure of the teeth and lead to much more severe dental problems in the future. Untreated TMJ is one of the prime underlying factors in eroded jawbones and loose teeth.

It is important for anyone experiencing the symptoms of TMJ to visit the dentist for an exact diagnosis.

What does treating TMJ involve?

TMJ could be a result of several different problems. Bad bite is the most common, but an injury resulting from a blow to the meniscus cartilage is also a possibility. Initially, the dentist will thoroughly examine the jaw area, the patients bite, take x-rays, and review the patient’s history in order to make an accurate diagnosis and recommend necessary treatment.

Once a firm diagnosis is attained, there are several ways in which relief can be provided. A specially molded bite guard can be created to stop teeth grinding during the night. A bite relationship analysis may be recommended by the dentist. The dentist can also provide advice on relaxation techniques which will lessen the effects of stress. As a last alternative, the dentist is also able to prescribe muscle relaxants.

A better option is to change the shape of the teeth and get rid of the bad bite completely, often called “realignment.” This is especially useful because it alleviates TMJ symptoms and may improve the aesthetic appearance of the teeth as well. Realignment involves adjusting the relationship between how the upper teeth come together with the lower teeth. This may require new restorations and/or adjusting the natural teeth as well. It is not a painful procedure, and it is one the dentist has performed with great success numerous times. As with any procedure, the dentist will be happy to answer questions and discuss symptoms, options, and treatments.

If you are experiencing any symptoms of TMJ, we encourage you to contact our office today to schedule an appointment.


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