TMJ – Jaw Disorders
Dr. Heidi focuses on the treatment of jaw disorders, more commonly known as TMJ. In addition to her training in general and family dentistry, Dr. Heidi is also a specialist in handling tooth and jaw alignment, having completed advanced dental courses in orthodontics (the study and handling of tooth alignment and problems associated with proper bites) and TMJ.
The term "TMJ" is the acronym for "TemperoMandibular Joint". This is the ball and socket joint that allows the lower jaw to open, close and move sideways when chewing and speaking. Everyone has two of them, and they are located about one centimeter in front of the ears.
What is TMJ disorder?
Temporomandibular Joint Disorder or TMJ Syndrome, is an umbrella term covering a variety of conditions associated with the inflammation of the Temporomandibular Joint, which connects the lower jaw to the skull. Dysfunction of this joint can cause significant pain and damage.
Click on a link to learn more:
- Diagnosing TMJ
- Treatment options for TMJ
- Symptoms of TMJ disorder
- Some causes of TMJ disorder
- More about TMJ
Assisting patients with temporomandibular joint disorders (TMD) is one of Dr. Heidi's specialties, and in many cases she can relieve pressure, headaches and jaw pain that does not respond to other types of treatment.
At your initial exam with Dr. Heidi, she will check your jaw as well as the state of your teeth and gums to locate any signs of mal-occlusion (lack of alignment of your teeth and jaw bones). Dr. Heidi uses a state of the art TMJ analysis system from Bio-JVA to aid in her diagnosis.
Bio-JVA Joint Vibration Analysis is based on simple principles of motion and friction: When smooth surfaces rub together, little friction is created...and little vibration. If these surfaces become rough, then friction and vibration are created when these surfaces articulate
Dr. Heidi uses Bio-JVA to analyze a patient's jaw function.
How it works
Human joints have surfaces which rub together in function. Smooth, well lubricated surfaces in a proper biomechanical relationship produce little friction and little vibration. But surface changes, such as those caused by degeneration, tears, or displacements of the disk, generally produce friction and vibration. Different disorders can produce different vibration patterns or “signatures”. PC-assisted vibration analysis helps identify these patterns and helps you distinguish among various TM disorders.
If you are one of the many people suffering from TMJ, Dr. Heidi will advise you on treatment options which can include night guards to protect your teeth from grinding, Invisalign to adjust your teeth and bite into place or, in some cases, traditional braces.
In any case, the handlings are tailored to the individual needs of each patient so that they can have a comfortable bite and chew and talk without pain.
- Pain relief: Ibuprofen has been used for temporary relief of pain in the temporomandibular joints and headaches associated with TMJ pain. If the pain is more neurological in nature, the pain will not respond well with these drugs.
- Gentle jaw stretching and relaxing exercises you can do at home. This is the choice for TMJ related to stress, excessive gum chewing or temporary pain of the TMJ.
- Nightguards are the most widely-used treatment for TMJ. They can be used to alleviate pain right away and also to prevent teeth from continued enamel wear and root exposure due to teeth grinding, clenching or bruxism.
- Tooth reconstruction. This is used for those with collapsed bites, when missing teeth are not replaced or where excessive enamel wear has already occurred. Teeth reconstruction involves restoring the teeth to the correct size, height and shape in order for the jaws to line up properly. This relieves TMJ pain and creates a beautiful smile.
- Invisalign or traditional braces is used to correct crowding and teeth malalignment.
- Surgery can be done to reposition the TMJ’s to a more favorable location, correct a lower face asymmetry, or remove tumors.
- Sore jaw muscles and joints especially right after waking up in the morning.
- Clicking and/or popping sounds in the jaw joint when opening or closing the mouth.
- Chewing surfaces are flat and/or worn down through the tooth enamel. This exposes the second, soft and yellow layer of the tooth.
- Incisal edges of teeth are worn and sensitive to cold or tooth brushing.
- Loose or broken teeth, crowns or bridges
for no particularly obvious reason.
- Generalized feeling of tooth pain.
- Grinding, clenching or bruxing.
- Repetitive unconscious jaw movements called teeth grinding or bruxism
- Teeth are not aligned properly (i.e. upper and lower teeth do not fit together and contact in the proper place).
- Failure to replace missing teeth, and the resultant facial and joint collapse.
- Excessive gum chewing or nail biting
- Jaw trusting – a habit of moving the jaw forward, backward, or side to side.
- Arthritis or other disease or lesions of the joint.
In many cases the first time a person realizes they have TMJ is when they get a painful popping in their jaw or their jaws lock up and will not open and close properly. These are both extreme instances and cases of TMJ can and should be diagnosed much earlier. Some of the specific situations Dr. Heidi looks for include:
Bruxism (grinding teeth) – Many people clench and grind their teeth at night without know it. This can be because the person's teeth don't line up properly or even because their muscles are too tight to allow the joint to move freely.
Occlusion (tooth alignment) – More serious problems with TMJ start simply with a person's teeth not lining properly, giving them a bite that feels off in a given direction. This can worsen over time, and can often be handled simply by locating the teeth in the mouth that don't fit properly and adjusting these with a new crown or veneer. In some cases braces or Invisalign may be a better solution.
Headaches – Unexplained headaches can come from malocclusion. When you bite down forcefully your teeth may not come together properly, and this forces your jaw backwards. The lower jaw moves and this can pinch the nerves and blood vessels. Your jaw is ultimately connected to nerve which runs to your temples, and this can be a source of headaches or migraines.
Nightguards – A nightguard is a custom made, highly technically fabricated appliance placed on the upper teeth to relieve pain of the jaw joints, to prevent wear of tooth enamel, and to protect teeth, crowns and bridges from breaking or getting loose. It also helps prevent teeth grinding and/or clenching. It must be custom-made by a dental lab. Avoid the use an over-the-counter nightguard, because these are not made for your teeth. If a nightguard is not custom fit it can cause more harm than good.