Headaches & Treatment of TMJ disorder

Temporomandibular joint disorder or ‘TMJ disorder’ for short, neuromuscular dentistry, chirodontics, gnathology, temporomandibular joint or TMJ therapy, malocclusion, occlusal disease, occlusal splint therapy, equilibration; these terms alone could give you a headache! So I will attempt to simplify the concept.

As someone who used to have headaches it was news to me that they might have been caused by the way my teeth met. My bite was ‘wonky’. As there are no straight lines in nature, neither are there any perfectly straight teeth. We all have to adapt to ‘wonkiness‚’ to some extent and we are very good at it. Indeed we are designed to tolerate some degree of imperfection.

Some imperfection is normal

As our teeth meet together imperfectly our muscles move our jaw to compensate. One side of our bite will move a little more than the other. As we bite together our jaw joints will shift a little to compensate. This is all normal and generally does not cause a problem; we have flexible parts in our joints, and our muscles are controlled in a coordinated way to make movements smooth and stop teeth clashing together.

So we have a very sophisticated system with our teeth used frequently for chewing, speaking and smiling. The muscles are involved in coordinating all of these movements which hinge around the two joints on either side of our face, just in front of our ears.

However there is a limit to how much we can adapt to our imperfect bites. We can pass this limit in a number of ways; we can over work our imperfect bites by chewing too much, or grinding teeth together. Stress can also make our muscles more active. As jaw muscles are highly active anyway, too much stress can lead to tooth grinding or clenching, often at night.

Certain factors combine to cause problems

If we have imbalanced bites beyond a comfortable threshold then this alone can cause a problem. Imbalanced bites can be caused by: poor dentistry, having teeth moved with braces, teeth movement after extractions, inheriting poor teeth and trauma.

Problems can develop when you add stress into the mix with already poor fitting teeth. The muscles have to work too hard to coordinate movements and the jaw joints get worn out. This is called TMJ disorder. Sometimes the joint can dislocate and cause lock jaw. Joints get painful, muscles get painful and teeth get painful. The pain resulting from these areas can get quite confusing and is often misdiagnosed and treated inappropriately.

Symptoms of TMJ disorder

Symptoms include; pain behind the eye, jaw ache, neck ache and stiffness, headache, hypersensitive teeth, clicking or grinding in the joints, stiffness or pain in the shoulders, ringing in the ears, ear ache and sinus congestion. The symptoms can manifest themselves in a pattern that specifically relates to the patients bite imbalance and / or grinding habit.

Treatment Approach

The first treatment approach is to assess whether the problem is temporary. If you are under some temporary stress then the symptoms may go with the stress. So stress management is one approach.

If the problem has more to do with particularly ill fitting teeth then an appliance to balance the bite would be a good idea. A mouth guard can be made to balance the bite.

Some massage techniques and physiotherapy is also a good idea. We may refer to a chiropractor for adjustments and advice on exercises too.

If a patient can’t tolerate a mouth guard, then the bite can be corrected by braces moving teeth to a better position. Another approach may be more suitable for some patients, where we permanently alter the biting surfaces of the teeth with slight trimming (occlusal adjustments or equillibration) or restorations.

At Shelly Manor Dental we believe that a combined approach would be optimal because the problem itself is caused by several contributing factors.


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