TMJ Disorder

Managing Stress to Help Your Jaw Rest

You may spend most of your life unaware of the important little triangular-shaped joints located in front of your ears. Lined with cartilage, these joints move with a smooth, gliding motion. Under normal conditions, they join your lower jaw and temporal bone, allowing your mouth to open and close easily. However, stress or an improper bite can cause the joints to dysfunction, exposing nerve endings to create pain. In fact, the temporomandibular joint is highly sensitive to overall physical, emotional, and psychological stress. It is affected by the mechanics of your bite and the condition of your jaw muscles. A little extra stress, a little extra fatigue, a little change in your bite, and you may temporarily knock the whole system out of balance. The resulting TMJ disorder, or TMD, can create a variety of mild to severe symptoms, from jaw clicking and minor discomfort to sharp pain in your temple, ear, neck, and shoulders.

Used with permission by Dr. Curtis Westersund

The condition is very common in our culture, so we evaluate every patient for TMJ dysfunction at their regular dental exam. If we detect a problem, our goals are to arrest it, protect teeth from further damage, and correct underlying bite misalignment. Therapy may involve fitting you with a physiologic bite appliance, suggesting ways to alleviate stress, and recommending symptom relief measures.Typically, TMJ patients need to avoid chewing gum or hard, chewy food, take small bites, and alternate chewing between both sides of the mouth. Good nutrition will help the joint heal more quickly; good posture will also help relieve discomfort. A straight back, relaxed neck, and side-sleeping position are also helpful. To relieve soreness, light temple and jaw massage will stimulate circulation and relax the muscles. If pain is present, we suggest alternating moist heat and cold for 20 minutes to further increase circulation. Over-the-counter anti-inflammatories or analgesics can be very helpful as well.

For more information about TMJ, TMD, or neuromuscular dentistry, call our office. We want help you receive the relief you deserve.


Symptoms of TMJ Disorder

  • Headaches/Migraines
  • Jaw pain
  • Neck/shoulder pain
  • Jaw clicking and popping
  • Limited opening
  • Ear congestion
  • Vertigo (dizziness)
  • Tinnitus (ringing in the ears)
  • Difficulty swallowing
  • Loose teeth
  • Clenching/grinding
  • Facial pain
  • Sensitive teeth
  • Difficulty chewing
  • Postural problems
  • Tingling/numbness in fingertips

Where is the TMJ?

The TMJ is located in front of the ears. It is the area where the lower jaw connects with the skull. The TMJ is the most complex joint in the body.


What Are the Causes of TMJ disorder?

Most cases of TMJ are caused by either a bad bite, which is known as a malocclusion, or some sort of trauma, such as a car accident. When someone has a malocclusion, it means that the teeth and the muscles that move the jaw are not working in harmony. These muscles have to work very hard to get the teeth together. This places excessive strain on the muscles, which results in pain in the face. In turn, these muscles recruit muscles in the neck, shoulders, and upper back to help reduce the strain. This causes strain in these muscles as well. These muscles are then forced into a strained position, resulting in pain in the face, head arms, shoulders, neck, and back. This excessive strain results in a buildup of waste products, such as lactic acid, in the muscles. If you have ever lifted weights, you know after a while, the muscles get tired and start to burn. This is the same process that happens with the jaw muscles.


Treating TMJ Symptoms

A "bad bite, or malocclusion will eventually lead to an imbalance in the relationship of the upper jaw to the lower jaw. The jaw muscles have to work very hard to get the jaws together and even to "posture" the lower jaw at rest. This results in a strained position for the muscles of the jaw. They will compensate by constantly contracting. This will cause muscle spasm, pain and soreness. As they fatigue, there is a buildup of lactic acid and other waste products. These waste products are what cause the spasms and pain. Muscles work together as a team. This is known as muscle recruitment. When the jaw muscles, which are involved with chewing, biting, talking, breathing and head position, have to work too hard, they recruit muscles of the neck, shoulder, and back. The tight, painful contracted muscles of the jaw result in pain in the muscles of the neck, shoulder, and back.

Using state-of-the-art neuromuscular dentistry, we determine if the symptoms you are experiencing are a result of a bad bite. We go through a series of steps to not only relieve your symptoms, but to correct the cause of the symptoms. Treatment usually begins with the relief of muscle spasms and the associated pain. Ultra low frequency TENS (Transcutaneous Electrical Neural Stimulation) is used to relax the muscles.


TENSing accomplishes 3 things:

  1. pumps waste products and lactic acid away from the stressed muscles
  2. Increases blood flow which increases oxygen and energy to the muscle
  3. Allows the muscle to completely relax in its ideal position

After the muscles are relaxed, we start the next phase of treatment, which is called bite stabilization. A temporary appliance (splint), known as an orthotic is fabricated. This orthotic is worn on the teeth and allows the muscles to function in their "relaxed" position. The orthotic phase (Phase 1) usually takes 3-6 months to stabilize. Once you are stable, we can proceed to Phase 2 - long term maintenance.


Long term maintenance can be accomplished by several options:

  1. Coronoplasty - reshaping the enamel of the teeth to bite the relaxed position
  2. Permanent Orthotic - this is used to cover the back teeth and maintain the relaxed position
  3. Orthodontics - move the teeth into the place to maintain the relaxed position
  4. Restorative reconstruction - rebuild the bite using crowns and veneers to maintain the relaxed position
  5. Combination of these options