Temporomandibular Disorder, referred to by many as TMJ, is painful and can be caused by a number of factors. We help our patients in ways that are unique to their diagnosis – treated with appliances, bite alteration to align with jaw joints, tooth reshaping and more.
What is TMJ?
Dr. Darren McKeever: TMJ is a very common term referring more to something that the professionals would refer to as TMD, Temporomandibular Disorder. What we’re referring to is there is some problem with the jaw joint. The joints which lie literally right in front of your ears on both sides of your head. Very often people will have discomfort and they’ve heard the term TMJ and they’ll come into the office and they’ll say, “I have TMJ” or, well, you’re really, everyone has TMJ’s but let’s find out if you really have a problem. Then we refer to it as TMD, Temporomandibular Disorder.
What are the symptoms of TMJ or TMD?
Dr. Darren McKeever: Either one, I’m not a stickler for the words. I mean dentists love to use fancy Latin and Greek terminology but if you’re not getting the point across then what’s the point of sounding impressive? Communication is more important to me than sounding great, as you can tell. Most common symptoms of TMJ is usually some form of discomfort. That is what tends to get people thinking that they have a TMD issue. There a lot of other things that we look for but more often than not, the most symptoms we see are some form of discomfort associated with the jaw joint. Either muscular discomfort in the muscles that work the jaw joints; sometimes direct pain emanating from in front of the ears; sometimes it can even feel like a sinus issue radiating forward into the cheekbones or straight up the side of the head; I’ve even had patients who have had some of the muscular symptoms of TMJ where the problem was only detectable in the back of their head from those muscles. They’re kind of varying in what some of the symptoms are but more often than not, it’s some form of discomfort.
What causes TMJ? Are there certain risk factors?
Dr. Darren McKeever: Well, more often than not and by and large, the causes of TMJ issues are trauma. Now there are a small amount of TMD issues where anatomic structures may not have developed properly and now you have an anatomic disparity between maybe one joint on one side of the head or the other side of the head; but more often, the problems that lead to TMD are traumatic. The trauma can come in two classifications. Either macro-trauma, you fell off your bike when you were a kid, you got hit accidentally in the jaw. A car accident that causes whiplash doesn’t necessarily only cause it in your neck, it can cause it in the joint. Those we refer to as macro-traumas, significant trauma.
From my experience, more often, micro-trauma is the biggest cause of TMJ disorders. Micro-trauma can be anything from your bite is out of balance, you have missing teeth, when you close your teeth don’t mesh properly, or you can even have teeth that are somewhat loose and every time you bite, your jaw joints are trying to figure out “Well, where is the normal closure for my teeth?” Those are issues that we refer to as micro-trauma. Sometimes micro-trauma can just be the fact that people clench or even grind their teeth in their sleep. From my experience, that is an extremely common form of trauma and it’s the most diabolical because more often than not, given the fact that literally 1/3 of all adults, clench or grind their teeth in their sleep, very few are aware of it. Very few want to actually believe that they’re doing it because it happens in a point in your day when you really don’t know what you’re doing. You’re asleep.
What should people do if they think they might have TMJ?
Dr. Darren McKeever: In my opinion, the only thing you should do is find a competent dentist who has training in evaluating the TM joints. By and large, and this is my opinion, a significant amount of dentists have a very rudimentary understanding of TMD based on what they learned in dental school. The situation that leads to TMD can be incredibly complicated. Although in my opinion, the base understanding is very very simple. There are some areas where the aberration that leads to TMD can be very very specific and uncommon. You really need to have a real good understanding of not only how to treat it but how to diagnose it. If you can’t figure out exactly what the cause is, you’re just basically groping around in the dark trying to find an answer for the cure.
How is TMJ treated and is there anything people can do at home to help deal with TMJ?
Dr. Darren McKeever: Well more often than not, the most common treatment for TMD is some type of bite alteration because like I said, most TMD is caused through micro-trauma, it’s not necessarily macro-trauma. When we talk about the bite, it can be as simple as re-positioning the teeth to establish a proper bite that is harmonious with the way the jaw joints want to work which would be orthodontia. It could be reshaping the teeth because they are so close to what the jaw joints want to work with in a harmonious effort that you just literally have to polish them, selectively to get them to fit properly. Sometimes it’s a matter of, you have to restore the teeth. Missing teeth can lead to a collapse in the bite, teeth will shift when that happens.
You may have to restore missing teeth or even teeth that are breaking down because you have been clenching for years. Sometimes it can be more complicated than that. There can actually be bone derangement in the jaw joint. The bone can actually breakdown, just like in somebody’s knee or somebody’s hip. In those cases, we don’t normally go in and do a knee replacement on a jaw joint so-to-speak but you can actually have to have some type of surgical intervention. Those issues are a lot less common to see that. Sometimes it does result in someone having to have surgical intervention. In terms of what people can do at home to deal with TMJ, unfortunately, if you don’t have a good diagnosis and you don’t know what the cure or the treatment is going to be, the best thing you can do at home is to make a phone call. Call a dentist who knows what he’s talking about and seek treatment.
If you are interested in speaking with Dr. Darren McKeever, visit www.mckeeverdentalcare.com or call 973-839-8180 to schedule an appointment.