Posts for tag: tmj disorders

PersistencePaysOffinFindingReliefFromChronicJawJointPain

Tenderness; headaches; difficulty chewing; excruciating pain. These are a few of the symptoms you could endure with a jaw joint or temporomandibular disorder (TMD or TMJ). This group of disorders disrupts the daily lives of millions of people around the world.

This month is TMJ Awareness Month, to shed light on these debilitating conditions and how best to manage them. Although controlling TMD isn't always easy, it can be done with the right blend of treatments.

The temporomandibular joint—actually a pair of joints connecting the lower jaw to the skull on either side of the face—is "ground zero" for TMD. These are ball-and-socket joints similar to the hip or shoulder, but with a unique addition—a cushioning disk that lies between the adjoining points of the two bones that temper the forces generated when you eat, speak or bite down.

Researchers believe TMD can arise from a variety of sources, including traumatic injury, psychological stress or mechanical dysfunction within the joint and cushioning disk. These problems can create blood flow constriction, which in turn causes the accumulation of chemical waste byproducts in the jaw muscles. This in turn and cause the muscles to spasm and become inflamed and sore.

Treatments are also as numerous as the possible causes of TMD. But for the most part, they range along a continuum of conservative to aggressive approaches.

On the conservative end, doctors treat TMD as a joint problem and borrow heavily from orthopedics. These types of treatments include the use of anti-inflammatory and muscle relaxing medications, icing or heating, stretching exercises, physical therapy and massage. Dentists may also provide mouth guard appliances for patients with clenching or tooth grinding habits to decrease biting forces.

On the more aggressive end are interventions like orthodontics or dental work. But, while these were common recommendations 20-30 years ago, it's no longer thought to be necessary for treating most TMD disorders and should not be recommended as a cure or solution for TMD.  At the furthest extreme is actual jaw surgery to relieve symptoms or repair damage within the joints. The latter, however, has not yet amassed a solid track record, and should be considered as a last resort.

Finding the right combination of therapies to give consistent relief sometimes requires a bit of trial and error. Most doctors recommend starting first with the most conservative methods before considering more aggressive measures. You should also undergo a complete dental exam to see if teeth or gum problems are contributing to your symptoms.

TMD can make your life miserable. But with some persistence and patience, you can find what works for a life without pain and dysfunction.

If you would like more information about managing TMD, please contact us or schedule a consultation. To learn more, read the Dear Doctor magazine article “Seeking Relief From TMD.”

ThinkTwiceBeforeConsideringBotoxforChronicJawPainRelief

Chronic jaw pain can be an unnerving experience that drains the joy out of life. And because of the difficulty in controlling it patients desperate for relief may tread into less-tested treatment waters.

Temporomandibular disorders (TMDs) are a group of conditions affecting the joints connecting the lower jaw to the skull and their associated muscles and tendons. The exact causes are difficult to pinpoint, but stress, hormones or teeth grinding habits all seem to be critical factors for TMD.

The most common way to treat TMD is with therapies used for other joint-related problems, like exercise, thermal (hot and cold) applications, physical therapy or medication. Patients can also make diet changes to ease jaw function or, if appropriate, wear a night guard to reduce teeth grinding.

These conservative, non-invasive therapies seem to provide the widest relief for the most people. But this approach may have limited success with some patients, causing them to consider a more radical treatment path like jaw surgery. Unfortunately, surgical results haven't been as impressive as the traditional approach.

In recent years, another treatment candidate has emerged outside of traditional physical therapy, but also not as invasive as surgery: Botox injections. Botox is a drug containing botulinum toxin type A, which can cause muscle paralysis. Mostly used in tiny doses to cosmetically soften wrinkles, Botox injections have been proposed to paralyze certain jaw muscles to ease TMD symptoms.

Although this sounds like a plausible approach, Botox injections have some issues that should give prospective patients pause. First, Botox can only relieve symptoms temporarily, requiring repeated injections with increasingly stronger doses. Injection sites can become painful, bruised or swollen, and patients can suffer headaches. At worst, muscles that are repeatedly paralyzed may atrophy, causing among other things facial deformity.

The most troubling issue, though, is a lack of strong evidence (outside of a few anecdotal accounts) that Botox injections can effectively relieve TMD symptoms. As such, the federal Food and Drug Administration (FDA) has yet to approve its use for TMD treatment.

The treatment route most promising for managing TMD remains traditional physical and drug therapies, coupled with diet and lifestyle changes. It can be a long process of trial and error, but your chances for true jaw pain relief are most likely down this well-attested road.

If you would like more information on treating jaw disorders, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “Botox Treatment for TMJ Pain.”

By Dr. Dulat
October 20, 2018
Category: Oral Health
Tags: jaw pain   tmj disorders  
TrytheConservativePathtoJawPainReliefFirst

If you have chronic jaw pain, you know how difficult eating, speaking or even smiling can be. Many sufferers will do anything to gain relief, even surgery. But before you go down that road, consider the traditional conservative approach to temporomandibular disorders (TMD) management first—it could provide the most relief with the least risk of side effects.

The temporomandibular joints connect the lower jaw to the skull on either side of the head. These ball and socket joints also contain a cushioning disk to facilitate movement. This disk is believed to be the primary focus for jaw pain problems known collectively as TMD.

Doctors now believe injury, stress, metabolic issues, jaw anatomy defects or similar factors trigger the chain reaction of muscle spasms, pain and soreness that can erupt during a TMD episode. A TMD patient may experience pain within the jaw muscles or joints themselves, clicking sensations, or an inability to open the jaw to its full range.

TMD therapy has traditionally followed an orthopedic path—treating jaw joints like any other joint. In recent years, though, a more aggressive treatment model has emerged that promotes more invasive techniques like orthodontics, dental work or jaw surgery to relieve discomfort. But the track record for this model, especially concerning jaw surgery, remains hazy at best and offers no guarantee of relief. These techniques are also irreversible and have even made symptoms worse in some patients.

It’s usually prudent, then, to try conservative treatments first. This can include pain and muscle relaxant medication, jaw exercises, stretching and massage, and dietary changes to reduce chewing force. Patients with teeth grinding habits may also benefit from a bite guard worn at night to reduce the biting force during sleep and help the joints relax.

By finding the right mix of treatments, you may be able to find significant relief from TMD symptoms with the conservative approach. If not, you might then discuss more invasive options with your dentist. But even if your dentist recommends such a procedure, you would be wise to seek a second opinion.

TMD can definitely interfere with your quality of life and peace of mind. But there are ways to reduce its effects and make for a happier life.

If you would like more information on managing chronic jaw pain, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “Seeking Relief from TMD.”