TMJ Disorder

Do you suffer with headaches, dizziness, jaw fatigue, earaches or neck and shoulder stiffness?

It may be temporomandibular joint disorder (TMJ). This is a jaw joint disorder that can be caused by a variety of factors. So many people are misdiagnosed with migraine headaches when, in fact, they are experiencing a TMJ headache.

The TM joint connects the lower jaw (mandible) to your skull which is all held together by muscles and ligaments. When everything functions properly, the lower jaw is in the correct position (normal) . When there is a problem due to a displaced jaw joint, headaches, neck, facial pain and even upper back pain can be the result. Many times TMJ symptoms masquerade as many other conditions - especially migraines.

When the disc in either TM joint is displaced upon opening and closing, the disc goes either forward or backward as the jaw opens and closes. Even mild displacements can cause a clicking or popping sound in the jaw joint. Some of the clicking/popping is painful. For those people who clench or grind their teeth at night, the muscles get sore and tense which may cause pain and/or headaches or neck stiffness. When any of these factors are present, they actually "overload" the normal capabilities of the jaw joint, muscles and teeth which can result in pain and dysfunction. These factors include:

• Trauma to the head and neck
• Stress
• Poor nutrition
• Poor posture
• Malocclusion (bad bite)
• Inherited muscle and bone problems

If you think you may be suffering from TMJ disorder, here is a simple checklist of the most common symptoms. If you experience one or more of these conditions, call us as soon as possible for a screening:

Headaches Teeth that do not meet properly Dizziness Jaw pain Jaw goes to one side when opening Neck pain Pain or pressure behind eyes Tingling or numbness in arms Difficulty swallowing	Facial Pain Limited opening of the jaw Jaw clicking Difficulty chewing Ringing or stuffiness in the ears Blurred vision or pain behind eyes Difficulty swallowing Shoulder stiffness Teeth sensitive to cold

Yes, it is hard to believe that symptoms which include eyes, mouth, throat, ears, jaw and neck are associated with TMJ disorder. There is even a connection between TMJ and sleep disorders. The signal for this can be swallowing difficulty. It is imperative that you be screened by a dentist trained and experienced in these disorders. Our special education and experience is needed to properly diagnose and treat TMJ and snoring/mild to moderate sleep apnea.

Pain complaints may involve the chewing muscles, the jaw joints, headaches or even the teeth. Our office provides the appropriate technology for diagnosis and treatment of TMJ disorders. An imperfect bite can, over time, can result in tension in the muscles of the face and jaw which, when worsened, become painful. When the jaw joints, muscles and teeth are not in the proper balance and alignment, pain is very often the result. That's where we can help! Headaches or neck pain, jaws and/or teeth can be caused by a bad bite (teeth that do not meet when closed). Trauma can also be the cause:

• whiplash injury
• a fall
• blow to the face or neck
• intubation procedure (when tube is placed down the throat for surgical procedures)
• arthritic changes in the joint or natural childbirth (when birthing partner is pulling on your chin from behind) can force the bite to be misaligned.
• bruxing (teeth grinding) or clenching the teeth
• bad habits such as chewing on the end of a pencil during the day, chewing gum or fingernails. This causes tension in the jaw leading to TMJ problems.

Having a comfortable occlusion or "bite" is absolutely critical in the successful management of TMJ disorders.

TMJ disorders can be difficult to diagnose and treat because the problem often crosses over into several different specialties in medicine and dentistry. People who suffer from this disorder have typically visited many different doctors, all of whom may have a piece of the puzzle. Dr. Lau will perform a complete medical and dental history, clinical exam and x-rays to arrive at an accurate diagnosis.

We believe strongly in conservative, non-surgical treatment for TMJ Disorders. The most common conservative treatment suggested is usually an oral appliance (also known as an orthotic or splint). Surgery is a last resort and only needed in about 3% of all cases. Early treatment is critical as well as good patient participation. With the proper treatment and self-participation, most patients can be treated successfully. Benefits of oral appliance treatment include:

1. non-invasive treatment
2. easily accepted by patients
3. significant reduction or elimination of symptoms

The orthotic helps eliminate muscle spasm and pain which occur with bite imbalance. An orthotic also stabilizes the jaw joint to allow for healing and helps balance the bite so the teeth, muscles and joints all work in harmony -- without strain or pain. First, the focus is on addressing the pain and second we work to help patients regain full function. You are also taught self-care techniques to improve your condition between treatments.

Unfortunately, if you ignore TMJ, it doesn't go away but only gets worse. We believe in offering more than a band-aid approach of putting patients on muscle relaxants or pain medications which only result in temporary relief. Our focus is to address the jaw joint factors related to the pain by restoring proper function and improving overall health.

Supplemental treatments and physical medicine therapies may be suggested. Pain complaints may involve the chewing muscles, jaw joints or even the teeth. Modalities we incorporate in treatment when necessary include:

• Custom orthotic (splint)
• Laser therapy
• MRI's & CT scans
• TENS - Trancutaneous Electrical Neuro Stimulation
• TekScan - a computerized occlusion analysis apparatus that allows us to accurately measure how your teeth come together and adjust your "bite" if needed. It is a simple procedure where you tap and grind on special paper and it shows on the computer screen where your teeth are hitting unevenly and/or where your TMJ splint needs to be adjusted.

Once the proper bite position is established, sometimes other services are needed such as building crowns, orthodontics or a permanent appliance (known as Phase II TMJ treatment).