TMJ Problems Linked to Facial Pain, Headaches, Worn Teeth
Researchers have found that over 75% of ALL head, neck or facial pain is from muscles caused by bite problems. This information is from the textbook: Functional Occlusion: From TMJ to Smile Design by Peter E. Dawson, DDS, 2006.
TMJ Dysfunction
Many people suffer from pain in the face, head, neck, and shoulders, without knowing the cause. Previously, many patients seeking medical cures for these types of problems were told it was "all in their mind." They saw multiple specialists seeking a cure. Then after years of unsuccessful treatment, they learned to live with the pain, usually with the aid of over the counter drugs, such as aspirin or Tylenol.
Today, however, it is now known that a condition termed TMJ (temporomandibular joint) syndrome accounts for a large number of these previously uncured and painful symptoms. Correcting the source of the problem, rather than symptom the treating, is at the heart of TMJ treatment.
With new knowledge and technology, dentists are now able to diagnose and treat TMJ problems which previously have been over-looked. Additionally, the medical profession is becoming more aware of dentistry's involvement and physicians are referring patients to dentists, who are knowledgeable in TMJ treatment.
Malocclusion and the Temporomandibular Joint
Your jaw joint, which holds your lower jaw in place, is suspended beneath your skull by an intricate system of muscles and tendons. The jaw joints, also known as the temporomandibular joints (TMJ) are some of the most complex joints in the body. The jaw joint, surrounding muscles, and the fit of your teeth are closely interrelated. Each affects the other as you make everyday jaw movements such as speaking and chewing.
The way your teeth fit together is called occlusion. Ideal occlusion is when the teeth fit together in a comfortable relationship allowing the jaws and muscles to remain in a relaxed position. When your teeth are not in proper relation to each other and to your jaw joints, the jaw automatically shifts to a new position in an attempt to compensate for the misalignment of your teeth – a condition known as malocclusion, meaning teeth do not fit together properly.
When malocclusion exists, even what looks like a good bite could be at the expense of putting pressure on other jaw joint areas as the jaw shifts to accommodate the teeth. Signs of misaligned teeth may be clenching, grinding, shifting teeth, loose teeth, premature tooth wear, and chipped or fractured teeth. There is stress on the muscles and tendons, which often occurs during sleep. Symptoms include headaches, muscular aches and pains in the face, neck, shoulders and back. They can also result in dizziness, ringing in the ears, and earaches.
Diagnosing the Problem
Before prescribing the proper treatment for your particular problem, a variety of diagnostic procedures may be necessary. A cone beam CT scan (x-ray) may be taken of your jaw joint. This provides a clear picture of your own particular TMJ anatomy in 3D and the position of the various structures within the jaw joint. The visual cone-beam CT scan is also used as a means for detecting diseases in the jaw joint.
In order to study the relationship of the patient's teeth and joints, it is necessary to see how the joints guide the jaw without interference from the reflexes and muscles which are always accommodating to the fit of the teeth. To do this a record is taken measuring the relationship of the teeth to the jaws. Once this record of the joint guidance is taken with models and impressions it can be reproduced on an instrument called an articulator. This tool simulates your own particular jaw movements and your bite coming together. The bite can be studied for disharmonies and other interferences and adjusted on the models. Restorative procedures such as crowns, bridges, or implants may be waxed into place in order to harmonize the bite.
Jaw repositioners/splints may also be used. These appliances are worn for a given period of time. The appliance is refined and adjusted until it eliminates the bite disharmony and pain. With this diagnostic tool, the bite does not initially get altered until the problem is accurately diagnosed. Permanent treatment would then be prescribed to duplicate the effects of the appliance, e.g. equilibration or occlusal adjustment, orthodontics, or restorative procedures such as crowns.
Treatment Modalities
After diagnosing the problem. a variety of treatments may be recommended. Initial phases of treatment are aimed to eliminate the TMJ pain – the symptoms resulting from the actual problem. In the second stage, the actual treatment to correct the problem is completed. The different TMJ treatments are explained briefly below.
• Occlusal Equilibration
In occlusal equilibration, the biting surfaces of the teeth are reshaped. This is done to alleviate pressure on individual teeth. The reshaping procedure has been found to be the solution for many conditions which cause discomfort in the head, neck a
nd shoulders and breakdown of the dental structures. Occlusal equilibration is like having a pebble in your shoe. When there is
an irritant present (the pebble) your foot automatically adapts to the pebble – e.g. you may walk with a limp. With malocclusion, an existing interference (as with a tooth too high for comfort), the jaw also adapts to the particular uncomfortable tooth fit. During equilibration, the irritant (too high of a tooth) is reshaped for a better fit.
• Occlusal Restoration
Occlusal restoration involves the replacement or reconstruction of teeth with crowns, veneers, or fillings in addition to the reshaping procedures (which eliminate high spots on the teeth), thus allowing the face and jaw muscles to relax.
• Splint / Jaw Repositioner Appliances
Splint / jaw repositioning appliances are not only used in diagnosis, but they are also used as treatment to temporarily eliminate the bite disharmony and resulting pain. Then, during the second stage of treatment, orthodontics, crowns or equilibration may be recommended to build the bite to a permanent, healthy, relationship.
Early Treatment is Important
The importance of early treatment cannot be overstated. TMJ problems can advance in stages and grow progressively worse, much like heart disease. Heart disease starts off silently as atherosclerosis starts building up painlessly in the vessels around the heart, but will suddenly cause a heart attack. Similarly, a minor problem in the TMJ could become a major source of pain in the future. Additionally, the chance of successful treatment increases substantially the earlier treatment is accomplished.
Insurance Coverage of TMJ Treatment
Most dental insurances do not offer coverage for TMJ treatment. Some TMJ coverage may be offered through your medical insurance. We do ask that payment is made at the time of service unless other payment arrangements have been made. Ask us about Care Credit and Springstone payment options. At Oak Brook Smiles, we will be happy to submit a claim on your behalf and you will be reimbursed directly by your insurance company.