TMJ Dentist in Calgary: Painless Treatments for TMJ / TMD
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If you suffer from jaw pain, headaches, migraines, popping or clicking in your jaw or other TMJ disorder symptoms, Dr. Jennifer Silver can help!
The temporomandibular joint is the jaw joint. You can feel it if you place a finger in front of each ear and open and close your mouth. These joints are where the lower jaw (mandible) connects to the upper jaw (maxilla) – the fixed part of the skull.
The jaw joint is the most flexible joint in the body. It has three movement directions:
- Up and down
- Forwards and back
When the jaw is misaligned, a host of painful and limiting symptoms may occur. These are related to TMD (alternately called TMJ), a broad term covering any temporomandibular joint disorder.
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What is TMJ/TMD?
Temporomandibular joint disorder (abbreviated as TMJ or TMD) is not a single condition, but rather a number of conditions that are caused by jaw misalignment. This neuromuscular disorder often results in migraine-like headaches and other painful symptoms, yet remains one of the most commonly overlooked causes of chronic facial neck and shoulder pain.
It is not uncommon for TMJ/TMD sufferers to visit their physician for help. This may result in prescriptions for painkillers, but any relief offered by medication can’t help but be temporary. Unless the underlying problem is addressed, TMJ pain will simply not go away.
Clicking or popping noises when chewing
Grinding noises when moving the jaw
Pain and/or swelling around the jaw joint
Limited jaw movement
Running through the jaw is the trigeminal nerve
The largest of the cranial nerves – and it is pressure placed on this nerve from jaw misalignment that can cause many of the symptoms of TMD that occur outside of the immediate area of the jaw.
If you are struggling with any of these, please call our Calgary office at 403-278-1415 to schedule a neuromuscular evaluation with Dr. Silver.
Other symptoms caused by TMJ/TMD that may seem unrelated to the jaw joint include:
Chronic, migraine-style headaches
Tinnitus (ear ringing)
Ear pressure or pain without the presence of infection
Pressure behind the eyes
Generalized facial pain
Pain in the neck, shoulders, or back
TMJ/TMD may also cause increased tooth sensitivity, difficulties swallowing and, when left undiagnosed and untreated, changes to your posture. Equally worrisome, the painful symptoms of TMD can last for years, becoming progressively worse with time. That is why the proper identification of your TMD symptoms is so very important.
TMJ Risk factors
A “risk factor” is a condition that increases your chances of developing a TMJ. It is possible to have TMJ without having any of the risk factors, but the more risk factors you have, the more likely it is you will develop this disorder. Common risk factors for TMJ:
If your teeth are not in proper alignment, your jaw muscles will experience constant stress trying to shift your bite back into a manageable position, leading to TMJ.
Stress causes many people to habitually grind or clench their teeth at night, and sometimes even during the day. This constant wear can change the shape of your teeth and bite, eventually causing TMJ.
Some people are born with facial bone deformities that affect how their jaw functions and/or how their bite comes together.
If you suffer from bad posture due to a spinal misalignment or other issues with body mechanics and stability, TMJ is a common result.
Following whiplash injuries in car accidents also known as MVAs patients can develop TMJ symptoms
Certain arthritic conditions can damage the cartilage that lines your joints, changing and degrading bone, resulting in TMJ.
This condition involves inflammation of your synovial membrane, which lines the temporomandibular joint.
Jaw or facial injuries
TMJ can occur any time one of your facial bones suffers a traumatic injury, such as a fracture or dislocation.
Women are three times more likely to develop TMJ than men.
To properly diagnose TMJ, Dr. Silver will use a combination of hands-on evaluation and advanced dental technology including:
Electromyography (EMG’s) Using small pads placed on your face and neck, we analyze the electrical activity within muscles associated with the posture of your jaw and neck. This helps us to see if they are fatigued and how each muscle group relates to not only your jaw alignment but also your posture. Yes, the way you stand and hold your shoulders impacts how your teeth fit together and in turn the alignment of your jaw.
Sonography Electrical sonography lets Dr. Silver study the sounds emitted by your jaw joint movements to uncover irregularities undetectable with other types of testing.
K7 Computerized Jaw Scanning Jaw scanning equipment uses magnetic technology to measure and record movements of the jaw, and to help us estimate your ideal jaw position. The ideal position is where the muscles are relaxed. Relaxed muscles are happy muscles. Unhappy, unrelaxed muscles are just grumpy and painful.
Myo-Monitor A safe, electrical impulse relaxes and stimulates jaw muscles so our team can evaluate the movements that occur during different muscle activity phases.
If Dr. Silver finds your symptoms are caused by TMJ, the next step is to draw out a detailed and customized treatment plan tailored to your specific needs. TMJ can be caused by a number of factors, and our diagnosis process is designed to determine what exactly is causing your symptoms. With a solid treatment plan, we can take strides in making your TMJ symptoms a thing of the past.
- Your TMJ treatment options depend on the unique circumstances of your condition. In some cases, the uncomfortable symptoms of TMJ can be relieved by creating a nighttime grinding appliance to help protect the muscles, teeth and jaw joints from the forces of nighttime grinding.
- Patients whose TMJ is caused by bite conditions or significant jaw alignment problems that are not alleviated by use of a nighttime grinding appliance may benefit from the use of an oral appliance worn during the day. In all cases, TMJ treatment will occur in phases, allowing for long-term results and a lasting relief from pain.
The two phases of TMJ treatment are:
1. Bite Stabilization: Using neuromuscular dental technology, Dr. SIlver will determine the bite position that best allows your jaw muscles to relax. You will then be fitted with an orthotic, which is a small piece of customized plastic that trains your jaw and helps it find its natural biting place. The orthotic is fitted over your lower teeth and is constructed to meet the specifications you need. This orthotic may be removable or fixed again depending on your situation.
Once your headaches and other symptoms have eased, Dr. SIlver will move on to a long-term solution.
2. Long-Term Solutions: The exact nature of your long-term treatment will depend on the severity of your TMJ problem. Dr. Silver will design the solution that will do the most to make sure your symptoms are completely alleviated.
- Coronoplasty/Equilibration – This is the simplest course of treatment and is used when your bite is only slightly misaligned. Dr. Silver will re-shape and smooth the enamel of your teeth, thus correcting your teeth and bite, alleviating your headaches without needing an anesthetic.
- Permanent Orthotic – If needed, Dr. Silver can bond an orthotic designed to maintain a relaxed, natural bite to your teeth or a removable long-term orthotic.
- Reconstruction – Used if your teeth are severely damaged or if the misalignment is significant, full smile reconstruction involves layering porcelain onto your teeth to maintain your bite.
- Braces – If your TMJ symptoms are caused by a misaligned bite but your teeth are healthy, Dr. Silver might recommend fixing the problem with braces or Invisalign®.
Occasionally a combination of the above options will be needed to provide long-term stabilization.
Left untreated, temporomandibular joint disorder can lead to progressively worsening pain and increase in symptoms. It can also contribute to oral health problems including premature wear of your teeth and periodontal disease. TMJ is a degenerative disease. It does not get better without treatment. Occasionally symptoms such as pain and noise may resolve, but the condition continues to degenerate without proper care.
Dr. Silver utilizes advanced technologies and treatment options for neuromuscular conditions like TMJ. If you are struggling with symptoms or if your existing TMJ treatment is not working, please call our Calgary, Alberta office at (403) 278-1415 to schedule a treatment consultation right away.
You might also be interested in: Neuromuscular Dentistry
Neuromuscular problems are not simply limited to the jaw joint area. Spinal misalignment, postural issues, muscle problems, and other body issues can have an effect on your bite.
Dr. Silver performs a comprehensive exam, including the following body mechanics and stability testing, to ensure a proper TMJ/TMD diagnosis. Treatment options may include chiropractic care, physical therapy, massage therapy, dental restorations, orthodontics, and other therapies based on the evaluation findings.
Dr. Silver will assess the patient’s posture in relation to the lower jaw, neck, and cranium to identify any problems. If chiropractic issues are suspected, Dr. Silver may refer you to a NUCCA chiropractor for an in-depth analysis before you seek neuromuscular dental treatment. If you come in to see us and your shoulders are not even, your hips are rotated or, one leg is longer than the other we need to correct this. The effect this misalignment will have on your overall posture from the way your teeth fit together to how your head sits on your shoulders to how you stand is unbelievable.
The muscles of the jaw, neck, head, back, and extremities play a role in the health of your bite. An evaluation of these muscles will be performed by palpation to assess painful muscles and potential trigger points ( areas of muscle that may refer pain)
If Dr. Silver is concerned you may have a craniocervical issue he will refer you to a NUCCA chiropractor for assessment.
Special attention is paid to the nerves that carry out movement in the head, neck, and back. In some cases, neurological issues may present symptoms similar to TMJ/TMD.
Services are provided by General Dentists
Commonly Asked Questions
What is the best treatment for TMJ?
TMJ disorder can be caused by a variety of reasons. Determining the underlying factors is the first step to finding the best treatment.
For one, TMJ disorder (TMD) is sometimes caused by bruxism. Bruxism is excessive grinding and clenching, usually because of stress or subconscious habit. In this case, our Calgary dentist would want to fit you with a bite splint or night guard to alleviate tension on your teeth and jaw muscles.
Crooked teeth are another condition that can lead to TMJ disorder. When you’re not biting and chewing efficiently, all of those irregular movements can start to affect your jaw joints. If that’s the case, orthodontic treatment (braces) could be the best option.
To find out what the best treatment is for your TMJ pain, be sure to schedule an exam with our Calgary dentist. We’ll thoroughly evaluate your teeth, jaws, and surrounding facial anatomy to determine the next best steps to take!
How long does it take for TMJ pain to go away?
TMJ pain tends to be something that comes and goes, or “flares up” at key times. If you clench your teeth a lot, are undergoing stress in your everyday life, or have a habit of using chewing gum or eating firm foods, that strain can lead to muscle soreness around your TMJ.
As with any type of muscle or joint soreness, it can take a day or two for the pain to go away. The key is to get plenty of rest and take it easy. For people with TMJ disorder, that also means using an appropriate splint or therapy to discourage joint strain and overuse.
In the meantime, you can apply a warm compress to the side of your mouth and take an over-the-counter anti-inflammatory (such as ibuprofen) as directed. But the key is to keep the pain from recurring. So, if you catch yourself clenching, be sure to wear your bite splint!
If you’re not treating the true cause of your TMJ and it’s related to something like tooth misalignment, the pain may not improve until you finally complete orthodontic treatment.
Where is TMJ pain felt?
TMJ pain isn’t always limited to the area where your jaw joints are. It’s actually quite common for the discomfort to radiate well into your forehead, scalp, ears, neck, shoulders, back, and your teeth.
Since bruxism (clenching and grinding) is a primary factor with TMJ disorder, it’s important to look at the condition as a series of muscles contracting over and over. Each of those muscles has an entry point where they connect to your body. If one end is at the TMJ, the other is elsewhere. That’s why it’s so common for your neck and shoulders to tense up if you’re constantly tightening your jaw.
Headaches and earaches are common symptoms of TMJ disorder. Even if you visit an ENT and have no apparent signs of an ear infection, you could have serious ear pain because of how close your ears are to your TMJ.
And of course, it’s possible to feel pain in and immediately around your TMJ. Joint stiffness, popping, clicking, and limited range of motion are some of the most common symptoms to accompany any soreness.
Does TMJ show up on CT scan?
When our Calgary dentist orders a CT scan or panoramic (full mouth) X-ray, your TMJ is visible on the image. We use this information during your exam to evaluate your jaw anatomy, function, and screen for signs of disorders.
If you have a TMJ condition related to joint deterioration, anatomical anomalies, or some type of degenerative disc disease, there will likely be visible signs of the condition on your CT scan/X-ray.
However, a physical examination is still necessary. Our Calgary dentist will feel either side of your jaw as you open and close, checking for atypical movement and signs of TMJ disorder. Some of these conditions aren’t visible on an X-ray, but the images help to provide a comprehensive assessment of the situation at hand. For instance, muscle strain because of bruxism (clenching and grinding) won’t show up on an X-ray, but it might on a CT scan or during your exam.
Diagnosing TMJ disorder requires several different approaches, ranging from the way your teeth bite together to discussing the symptoms you’re experiencing. 3D images like CT scans give us a more complete look of what’s going on inside of your mouth.
How do you assess for TMJ?
Screening for TMJ disorder starts with an exam where our Calgary dentist palpates (physically feels) each side of your mouth nearest the joint. From there, we’ll watch how your jaw functions, including how widely you can open and if there’s any deviation to one side or the other. Symptoms like popping or clicking are also noted. We’ll also feel the muscles around your jaws, face, and neck to see if there’s any tenderness or signs of overuse.
We’ll also take an X-ray such as a panoramic or CT scan to capture the anatomy of your TMJ to see if there’s anything structurally wrong with the joint.
Your teeth will be checked for signs of clenching and grinding (such as flat, worn enamel or broken dental work) which is a common cause of TMJ.
Once we pinpoint the suspected cause of your TMJ disorder and make a diagnosis as to how severe it is, our Calgary dentist will discuss which treatment options are available. Be sure to let us know of any symptoms that you’re experiencing, so that no risk factors go unnoticed.
How long does it take for TMJ to go away?
TMJ disorder can range from an easy fix to a complex condition that never goes away. It depends on the cause of your TMJ pain and the types of treatments that you’ve used to try to fix it.
For instance, if TMJ disorder is because of overuse, you’ll be advised to avoid chewing gum, eating chewy/firm foods, and possibly told to wear a bite splint to eliminate clenching. Symptoms can improve in as quickly as a few days.
But if your TMJ pain is because of joint deterioration, anatomical problems, or even tooth misalignment, it might take months to treat.
The key to managing TMJ disorder is to pay attention to your symptoms. How often do they flare up? What factors seem to take place? Which foods are you eating? Are you in a particularly stressful situation at work or home? If so, the key to managing your TMJ pain could be in first addressing these underlying factors.
With home care, massage, and non-invasive measures, most TMJ conditions can be minimized within a few days, weeks, or months. Being aware of what causes flare-ups can help you prevent how often and severe they recur.
How do I know if I need TMJ surgery?
TMJ surgery is typically reserved for the most severe types of joint disorder. The standard of care is to first pursue non-invasive and therapeutic options for treating TMJ disorder. These include things like massage, physical therapy, orthodontic treatments, warm compresses, dietary changes, bite splints, injectables, and bite rehabilitation.
If for any reason these measures are not effective or do not offer TMJ pain relief, then our Calgary dentist may recommend oral surgery on the joint. One example of when surgery is needed is if there are structural irregularities inside of the TMJ itself, which we can see on a CT scan or X-ray.
Deciding to get oral surgery for TMJ needs to be a well thought out process and requires a lengthy recovery time. In most cases, a team of dental providers or surgeons will evaluate your jaw to determine the best type of surgery and create a care plan for you to review. Surgery is usually one of the last recommended treatment options for TMD, and only when there’s severe discomfort or the condition interferes with your daily quality of life.
What kind of doctor treats TMJ problems?
In most scenarios, TMJ disorder is treated by a dentist. Since dentists are the only providers
who can fit you with a custom bite guard/splint, seeing our Calgary dentist is the first place to
start. From there, we’ll evaluate your TMJ and determine the underlying source of any muscle pain, headaches, or other range of motion issues. At that point we can determine the most appropriate form of treatment, be it a splint, orthodontic therapy, surgery, or even massage.
When TMJ damage is severe – such as disorder caused by joint deterioration or injury – a surgeon may need to be consulted. It’s important to know that surgery for TMJ disorder is not common, and it’s typically reserved for the most extreme cases.
If you see a medical doctor for TMJ, they might recommend warm compresses, pain relievers, or rest. All three of these options can help, but they don’t correct the cause of your joint pain. Seeing our Calgary dentist can help you rule out possible risk factors so that you can take steps to preventing TMJ pain from recurring.
Is TMJ covered by medical insurance?
Treatment for TMJ disorder usually falls under dental therapies like orthodontics, bite splints, adjustments to existing restorations, or special mouthguards to wear while you’re sleeping. However, there is some overlap in certain procedures to help with TMJ and whether they’re categorized as medical or dental. For instance, physical therapy or injectables.
When you’re planning TMJ treatment with our Calgary dentist, be sure to let us know which types of coverage you have and bring a copy of your insurance card to your appointment. Our treatment coordinators will be able to use your information to provide you with a detailed estimate as to what services are covered, and under which policy.
Most effective TMJ therapies are preventative and non-invasive, making them as affordable as possible. But waiting longer to get help with your joint pain or the effects of worn teeth can add into additional treatment costs later on. If you suspect TMJ disorder, it’s best to have your symptoms evaluated by our Calgary dentist earlier, rather than later.
How can I relieve TMJ pain?
Rest, warm compresses, and an over-the-counter pain reliever like ibuprofen are best for occasional TMJ pain. Avoid eating chewy foods like steak or chewing gum to give your jaws some time to relax. Although not as common, muscle relaxers are sometimes used to help reduce the tension that’s building up to the pain in your TMJ.
Do you suffer from bruxism? When you’re constantly clenching your teeth together or grinding them, it means the muscles around your TMJ are working overtime. Gradually all of that tension takes a toll on the ligaments and tissues around your joint. Wearing a protective night guard (if you grind in your sleep) or a bite splint (for daytime clenching) can help to ease muscle tension and train your jaw to not clench when it’s supposed to be resting.
But what if your teeth and jaws don’t line up properly? If you’re moving your jaw irregularly to eat, that constant movement can lead to joint strain. In those cases, orthodontic therapy may be the best solution to help you eliminate and prevent TMJ pain from coming back.
Schedule a Consult with Dr. Jennifer Silver