Health & Wellness Guide Get Relief from TMD
Beth Troy, DMD, Troy Orthodontics Many people suffer from headaches, tenderness to jaw muscles, and locked jaws. These symptoms often share the common problem of temporomandibular disorders, commonly known as TMD (people may also refer to it as TMJ). There are varying opinions on the causes and treatment of TMD, but the following information may help you find relief from this common condition. The TM joint is made up of ligaments, muscles, bones, and discs. These structures are very specialized and work together when you chew, speak, and swallow. This joint is one of the most complex in the body because there are two joints working together at the same time. Each joint has a disc between the ball and socket joint, which cushions the load of the jaw when opening widely and in regular function. Any problem that prevents this complex system of muscles, ligaments, discs, and bones from working together properly may result in a TM disorder. While some cases of TMD may have clear-cut causes—think trauma or arthritis—most are due to a combination of factors. Discs often slip forward in the joint, leading to clicking or popping when you open or close your mouth. However, this minor problem does not always require treatment when painless. Clenching or grinding your teeth may develop as a response to stress or as part of a sleep disorder. You may not be aware of nighttime clenching or grinding, but you may catch yourself doing this during the day. These habits can overwork the muscles and cause them to spasm, which causes pain, and in turn causes more tissue damage and spasm. This can ultimately lead to a complex cycle of pain and improper joint function. Treatments for TMD vary based on your individual diagnosis. Your dentist may recommend a step-by-step plan, because sometimes only minor treatment may be necessary. In my practice, the first step of treatment typically involves restricting the patient’s diet to softer foods, including avoiding crusty breads and granola bars, and no chewing gum. (You’d be surprised how many people experience complete TMD relief when they stop chewing gum!) For minor pain associated with TMD, I recommend over-the-counter NSAIDs such as Advil or Aleve, as needed. The importance of attempting a low-stress lifestyle to minimize clenching and grinding teeth during sleep is important. For teens, this means not procrastinating about homework. For adults, taking a relaxing bath or shower after work will help to de-stress from the day. The patient should be reevaluated in a month or so. If symptoms show improvement, continue with the current plan. If no relief has occurred, we may fabricate a splint (or mouthguard) to protect the TM joint during nighttime grinding and clenching. Patients may wear this split for months, and many find so much relief that they elect to wear it consistently every night. Sometimes, too much damage to the joint has already occurred, and a consult with an oral surgeon is the next step. Joint surgery may be recommended. If you have symptoms of TMD, consult with your dentist or orthodontist. Minor treatments can yield major relief. n See ad for Troy Orthodontics on page 44.
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