Pain management

dental pain management

Temporomandibular joint disorder (TMJ, TMJD or TMD) involves conditions affecting the temporomandibular joint, jaw muscles and nerves on one or both sides of the head that result in jaw, face, and head and neck pain.

The pain and discomfort caused by TMJ disorders may be severe, can be either intermittent or constant, and may last for many years.

TMJ Anatomy

The temporomandibular joint slides and rotates in front of the ear on either side of the head. It consists of the temporal bone on each side of the skull and the lower jaw, which is also known as the mandible.

Four different chewing (mastication) muscles are paired on each side of the head and connect the lower jaw to skull. These muscles enable you to chew, open and close your mouth, and move your jaw forward, backward and side to side.

Because this area of the head and face contributes to chewing, jaw movement and bite (occlusion), TMJ disorders may cause pain at rest or during common movements such as talking, chewing and yawning.

A person may have one or more type of TMD condition simultaneously.

TMJ conditions include:

Myofacial Pain: This is the most common TMD condition that involves discomfort and pain in the muscles that control jaw movement.

Internal Derangement: This TMJ disorder is associated with a displaced disc in the jaw joint, a dislocated jaw or an injury to the condyle, which is the part of the lower jaw that acts like a hinge.

Arthritis: This TMD pain involves degenerative and inflammatory joint conditions.

Note:TMD affects twice as many women as men, and is most prevalent among people between the ages of 20 and 40.

Impact of TMD on Your Bite & Smile Esthetics

Certain causes of TMD also may affect your bite If your dentist identifies problems such as wear, tooth mobility, muscle pain or other signs of malocclusion, your bite may need to be adjusted.

Ensuring a stable bite is essential to your oral health and the long-term durability and functionality of cosmetic restorations such as dental veneers, Lumineers, tooth implants or crowns. Additionally, maintaining a stable occlusion and a proper bite helps ensure that your upper and lower teeth will come into contact in the most comfortable and pain-free manner possible, without unnecessary force that could lead to headaches or fractured restorations.

Causes of TMJ Disorder

  • Unknown causes
  • Bruxism due to Stress
  • Bite problem affecting the joint itself
  • Trauma to the jaw or jaw joint
  • Wear and tear on the teeth caused by aging
  • Scar tissue surrounding muscles
  • Arthritis
  • Low-level infections and auto-immune diseases

Symptoms of TMJ disorder include the following:

  • Pain or soreness in the jaw that is more prevalent in the morning or late afternoon
  • Clicking or popping when opening or closing the mouth
  • Swelling on the side of the face
  • Sensitive teeth in the absence of dental problems
  • An earache in the absence of an infection
  • Difficulty opening and closing the mouth and/or chewing
  • Upper and lower teeth that do not align properly (malocclusion)
  • Stiffness or “locked” feeling in the jaw when talking, yawning or eating
  • Jaw pain when chewing, biting or yawning
  • Recent changes to the bite
  • Frequently waking up with headaches or experiencing frequent tension headaches

Treatments for TMJ Disorder

“Conservative” is the key word when it comes to TMJ treatment The most severe cases may require treatment with splints, mouth guards or other traditional forms of TMD therapy. Only a small percentage of TMD cases require surgical intervention.

Appliance Therapy (Splint or Mouth Guard)

The TMJ splint is worn to reduce stress on the jaw, allow the muscles to function optimally and/or to cover the deflective interferences affecting the bite so that the lower jaw can be repositioned into the socket properly.

laser therapy

Nowadays in most cases pain and discomfort associated with TMJ disorder can be alleviated with self-managed care or nonsurgical treatment with new laser therapy using 5-6 treatment every 2-4 days and then the pain is resolved