#155. 100 Anderson Road SE Calgary, Alberta T2J3V1 Monday –Thursday 7:00 am to 4:30 pm 403-278-1415
TMJ specialist Calgary

TMJ Treatment

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
  • Sideways
  • 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.

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.

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:

  • Misaligned bite
    • 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.
  • Bruxism
    • 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.
  • Jaw deformities
    • Some people are born with facial bone deformities that affect how their jaw functions and/or how their bite comes together.
  • Bad posture
    • If you suffer from bad posture due to a spinal misalignment or other issues with body mechanics and stability, TMJ is a common result.
  • Car Accidents
    • Following whiplash injuries in car accidents also known as MVAs patients can develop TMJ symptoms.
  • Arthritis
    • Certain arthritic conditions can damage the cartilage that lines your joints, changing and degrading bone, resulting in TMJ.
  • Synovitis
    • 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.
  • Gender
    • Women are three times more likely to develop TMJ than men.

If you have one or more of the risk factors above and suffer from known symptoms of TMJ, now is the time to schedule a consultation with Dr. Jennifer Silver. During our complex neuromuscular disorder diagnosis process, we will thoroughly evaluate your condition, developing a treatment plan that will help you find relief from your symptoms.

Symptoms of TMJ/TMD:

  • Clicking or popping noises when chewing
  • Grinding noises when moving the jaw
  • Pain and/or swelling around the jaw joint
  • Limited jaw movement
  • Complete lockjaw
  • Sleep Apnea

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.

Diagnosing TMJ/TMD

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.

Treating TMJ

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.

Postural evaluation

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.

Muscle evaluation

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)

Craniocervical evaluation

If Dr. Silver is concerned you may have a craniocervical issue he will refer you to a NUCCA chiropractor for assessment.

Neurological evaluation

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

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