TMJ Pain Treatment & Therapy

Unveiling the Mystery of TMJ Dysfunction

The temporomandibular joint, commonly referred to as TMJ, is a complex structure in the intricate web of bones within your jaw. This joint interacts harmoniously with various parts of your body, and when it's not functioning correctly, it can cause a range of symptoms. 

TMD, or temporomandibular joint dysfunction, is the term used to describe symptoms such as migraines, facial pain, jaw discomfort, clicking or popping of the jaw, limited jaw movement, and more.

Interestingly, the impact of TMD isn't limited to your jaw area alone. It can affect your teeth, leading to worn, broken, or chipped teeth. 

Furthermore, TMD can trigger neck, shoulder, and back pain and unexpected symptoms like ear ringing (tinnitus) and restricted airway.

Understanding Your TMJ: The Key to a Pain-Free Smile

Your TMJ is more than just a joint; it's like a sliding hinge that lets your jaw do all its important jobs—like opening and closing or moving side-to-side.

Now, what makes your TMJ work so smoothly? A few things:

1. Soft Cushioning: The bones in your TMJ are wrapped in cartilage, a kind of flexible tissue.
2. Shock-Absorber: A special disc, also made from cartilage, sits between these bones to absorb any shocks.
3. Smooth Operator: The joint has a thick fluid called synovial fluid that keeps everything gliding smoothly.

All these elements work in harmony thanks to the muscles in your face and head. Together, they allow you to do everyday things like:

• Chew your food
• Suck on a straw
• Swallow
• Talk
• Show your emotions through facial expressions
• Even breathe!

So, when your TMJ is functioning well, life just feels better. And if it isn't, we're here to help you get back to living comfortably.

Unveiling the Root Cause: Malocclusion

Surprisingly, many cases of TMD are rooted in a condition called malocclusion. This term refers to a misalignment of your teeth, which don't fit together correctly. 

Malocclusion encompasses underbites, overbites, crowding, spacing, and even missing teeth that cause surrounding teeth to shift. Even if your teeth are straight, they might not be positioned in a way that supports comfortable muscles and joints, leading to TMD symptoms.

Traditional Dentistry is based on mechanical concepts that assume that your present bite is best for you and does not recognize the critical role that muscles and joints play in dentistry.

The Power of Physiologic Dentistry

Enter TMJ and Physiologic dentistry—a specialized branch of general dentistry that delves into the intricate system of teeth, muscles, and jaw joints. 

This approach seeks to understand how these components combine in your bite (occlusion) and how imbalances can trigger various issues. We aim to bring your muscles and joints into harmony by addressing the underlying misalignment, preventing discomfort and damage.

• Headaches or migraines
• TMJ pain
• TMJ popping or clicking
• Broken, worn, or chipped teeth
• Limited mouth opening or jaw locking
• Ear congestion
• Dizziness
• Ringing or pain in the ears
• Hard to swallow
• Loose Teeth
• Clenching or grinding
• Facial, Neck, Shoulder or Back Pain
• Sensitive teeth
• Hard to chew
• Postural problems, vertigo, dizziness
• Tingling of the fingertips
• Hot & cold sensitivity of teeth
• Nervousness or insomnia

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Non-surgical physiologic jaw re-education to relieve TMJ pain and dysfunction

Phases of TMJ Treatment

Phase I: Initial Evaluation and Reversible TMD Therapy

Orthotic Therapy

In the first phase of TMJ treatment, we comprehensively assess your teeth, jaw joints, neck muscles, and airway. Once we confirm that your symptoms are dental-related, we initiate the first phase of treatment. Our focus is achieving a comfortable muscle position through reversible therapy before considering any definitive procedures when test-driving a new position for your bite.

We use an ultra-low frequency transcutaneous electrical nerve stimulation (ULF TENS) device to relax your face and neck muscles. This device counters the previous muscle programming caused by functioning in an improper position. After muscle relaxation, we record your comfortable jaw position and create a custom orthotic, removable TMJ appliance, that you'll typically wear for 3-6 months or however long it takes for you and Dr. Green to be happy with symptom relief.

In all TMJ cases, we utilize bite and jaw-tracking devices and electromyography to monitor muscle activity (EMGs) at every visit during Phase 1 to ensure optimal results.

Phase 1 TMJ Treatment

Phase 1 TMD/TMJ Treatment Includes

• 3D X-ray (CBCT)
• CBCT radiology report
• Detailed digital bite analysis
• Digital models
• Ongoing measurement of EMGs
• Daytime orthotic
• Night time TMJ appliance
  
• Posture correction device
• Jaw decompression exercises
• Ultrasound therapy
• Low-level red light therapy
• Stretching routines
• Referrals as needed
• All visits included

Phase II: Bite Correction and Lasting Symptom Relief

Once finding relief for TMD symptoms, we proceed to the second phase of treatment. In this phase, we adjust your bite to align with the comfortable muscle position achieved in Phase I. Treatment options may include creating records for a long term removable device (orthotic), moving the teeth orthodontically, or slightly changing your natural tooth structure. 

For more substantial realignments, physiologic orthodontics, Invisalign and specialized appliances can move teeth to a desired position. If aesthetic improvements are an end goal, alongside bite correction, custom-made porcelain restorations in the form of porcelain crowns, veneers, or full mouth reconstruction can help rehabilitate your bite.

What are other common TMD treatment options Dr. Green's patients pursue before discovering relief from TMJ symptoms?

Total TMJ Joint Surgery

Total TMJ Joint Surgery is an invasive approach that directly treats the disorder but comes with risks like limited jaw movement, possible infection, and a long healing period. More orthodontic (braces) treatment before and after surgery may also be required.

We do not offer jaw surgery, and for most guests, help them avoid it.

Dental Night guards

Night guards can help decrease force on teeth but can increase the frequency and force of clenching or grinding and worsen sleep quality. When night guards wear down fast, it usually means your muscles aren't optimal, pulling your teeth to grind even more. When technology is not used to pinpoint optimal relief, worsening symptoms happen often.

We design custom night appliances for obstructive sleep apnea and TMJ sufferers; the two often go hand-in-hand. Dr. Green and her team will help you find your optimal biting position by using sophisticated measurements of muscle health and jaw-tracking technology to prove it scientifically before making the appliance. Wearing a sleep and snore device has helped many lower their AHI (apnea-hypopnea index score).

Botox for TMJ

Botox injections offer quick relief from symptoms but only provide temporary fixes that need to be repeated regularly without addressing the root cause of the issue and can add up over the lifetime of injections to be costly.

Botox simply deadens the muscles so that your brain can't feel the pain. The pain will come back, and it's only a guessing game for when TMJ flares plague your well-being.

Watch Dr. Green explain why she doesn't offer Botox injections for TMJ pain.

TMJ/TMD Splints and Orthodontics

TMJ/TMD splints and mouth guards are typically made to the existing biting position. Sometimes they might work, and for many they don't and can make TMJ symptoms worse. Traditional orthodontics can aim to improve jaw positioning and teeth alignment but don't always examine the TMJs, bite relationship, soft tissue (tongue-tie,) and sleep disordered breathing issues.

Dr. Green takes meticulous measurements of muscles throughout treatment to track progress and TMJ symptom relief. She offers specific types of orthodontia that consider jaws (bite), teeth, muscles, and Airway to move teeth into their optimal biting position slowly.

Depending on how far the teeth have to move, this can take time but is a conservative choice when faced with jaw surgery. She screens patients for obstructive sleep apnea, connecting the dots for TMJ relief and better sleep.

"I just assumed a splint was a splint no matter which dentist made it. I wish I had known about Dr. Randi Green before I spent so much money on mouth guards! I’m excited to fix my jaw problems without surgery"

Are You Experiencing TMD Symptoms?

If any of the following questions resonate with you, your symptoms could be linked to TMJ issues:

• Do you grind your teeth during sleep, as reported by your sleep partner?
• Does chronic or severe facial pain plague you?
• Do migraines frequently disrupt your life?
• Does neck and shoulder pain accompany your headaches?
• Is eating, drinking, yawning, or mouth movement painful?
• Have you noticed unexplained ringing in your ears?
• Do you wake up with facial pain or sore jaw tissues?
• Does your jaw make clicking or popping sounds?

Choosing the Right Provider for Your TMJ Care

If any of these TMJ symptoms sound familiar, there's hope for relief. While various approaches exist for treating TMD, our emphasis is on physiologic dentistry, which has relieved countless individuals suffering from this condition. 

By addressing the root cause and focusing on reversible methods, we strive to offer symptom relief before considering extensive jaw surgeries or costly recurring injection treatments.

If you're grappling with TMD symptoms, seeking a provider who stays up-to-date with the latest advancements is crucial. I am proud to share that I am an LVI Fellow and have undergone extensive advanced training at the Las Vegas Institute for Advanced Dental Studies—a world-renowned center for dental education in aesthetics and TMD treatment.

Through rigorous training and a commitment to excellence, Dr. Green has assisted patients from patients who travel many hours to manage their TMJ pain symptoms.

She is passionate about incorporating knowledge into patient care and helping her patients regain comfort and well-being.

Remember, you don't have to endure TMD symptoms—help is available, and a brighter, more comfortable future awaits.

Understanding TMJ and TMD

What's the difference between TMJ and TMD?

TMJ is the short name for the joint that links your lower jaw to your skull. TMD stands for a disorder that affects this joint.

Is TMD a serious condition?

Yes, TMD can cause ongoing pain, discomfort, and swelling around your jaw joint causing dysfunction in the craniofacial complex including, popping and clicking, migraine headaches, and many other painful signs and symptoms.

What causes TMD?

TMD occurs when your TMJ is compromised, which can happen for various reasons. This dysfunction could be from overworking your chewing muscles, having a bite that's out of alignment like an underbite or overbite, or even due to injury.

Sometimes, natural wear and tear or conditions like arthritis can also be culprits.

At other times, the issue might be with the internal disc in your TMJ or could be something you were born with.

Whatever the cause, we're here to help you find the best treatment to live your pain-free life.

Who should I talk to if I think I have TMD?

If you're having jaw issues, it's important to consult with your dentist or primary care doctor. There are various treatments that can help you feel better. Dr. Green has helped many patients navigate TMJ treatment options.

Top 5 Benefits of Working with a TMJ Dentist

For those seeking expert care in TMJ dentistry, Dr. Randi Green comes highly recommended. Her commitment to her patients' jaw health and function is evident in every aspect of her work. It's essential to conduct comprehensive research, read reviews, and perhaps even schedule an initial consultation to ensure that any TMJ dentist—regardless of their accolades—is the right fit for you and your specific needs.

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