What Causes TMJ (Temporo-mandibular-joint) Pain?
The cause of TMJ is not known. Doctor DiGiulio, a Bend dentist believes that symptoms arise from disorders within the muscles of the jaw or the bony parts of the joint. There is no ADA officially recognized TMJ specialist. So don’t be fooled, that claim should raise your interest for more information.
Trauma to the jaw, or muscles of the head and neck like from a heavy blow (..think car accident etc.) can cause TMJ. Others include:
- Grinding and clenching the teeth, which puts a tremendous force on the TMJ
- Subluxation of the soft cushion between the ball and socket
- Presence of osteo or rheumatoid arthritis in the TMJ
- Emotional stress can cause a patient to tighten facial and jaw muscles causing clenching the teeth.
What Are the Symptoms of TMJ?
People with TMJ can experience severe discomfort,which usually prompts them to seek the help of a TMJ specialist. The discomfort like headache, jaw popping or jaw pain, can be intermittent or last for years. More women than men experience TMj and this disorder is seen most commonly in people between the ages of 20 and 40. If you are experiencing pain and would like to consult with Doctor Di Giulio in her Bend dental office, please call 541.389.2885.
Common Symptoms of TMj:
- Pain in the face, jaw joint, neck, shoulders, and around the ear when you chew, speak or open your mouth wide. Many patients are often convinced that there is something wrong with their ear.
- Limited ability to open the mouth wide
- A Jaw that sticks or locks in the open or closed position
- Clicking and/or popping sounds in the jaw joint when opening or closing
- A fatigued feeling in the face, jaw, or neck region
- Problems chewing almost as if the upper and lower teeth are not fitting together properly
- Intermittent swelling on the side of the face
Other common symptoms include toothaches, headaches, neck aches, vertigo/dizziness, earaches and hearing problems. If you are experiencing pain and would like to consult with Dr DiGiulio, a bend family dentist, please call 541.389.2885
How Does Dr DiGiulio Diagnose TMJ?
Because many other medical and dental issues can cause similar and often confusing symptoms including tooth pain, sinus problems, arthritis, or gingivitis, Dr DiGiulio will conduct a careful patient history and clinical head and neck examination to determine the exact cause of your symptoms.
Dr DiGiulio will examine your TMJ for pain or tenderness; listen for clicking and popping sounds during jaw articulation; identify limited motion of the jaw while opening or closing the mouth; and examine the facial muscle function. Sometimes Dr DiGiulio wiil take panoramic X-rays. These X-rays allow her to view the entire jaw, TMJ, and teeth to make sure that other dental issues aren’t causing your symptoms. Sometimes other imaging tests, such as an MRI or a CAT-SCAN (CT), are needed.
Dr DiGiulio may decide to send you to an oral surgeon for further evaluation and treatment recommendations. Oral surgeons are professionals specializing in surgical procedures around the face, mouth and jaw. I f you are experiencing pain and would like to consult with Dr DiGiulio in her Bend dental office, please call 541.389.2885
What Treatments Does Dr DiGiulio Recommend for TMJ?
Treatment options range from at-home self-care, conservative in-office treatments to injections of cortico-steriods and surgery. Experts agree that treatment should begin with conservative non-surgical treatment first, with surgery as the last resort. Many of the treatments listed below work best when used in combination. To learn more check out the AUTHORITY.
- Apply cold packs or moist heat. Apply an ice pack to the side of your face and temple area for about 10 minutes. Do a few simple stretching exercises for your jaw (as instructed by Dr DiGiulio or a physical therapist). Perform this routine a few times each day.
- Eat soft foods. Eat foods like yogurt, mashed potatoes, cottage cheese, soup, scrambled eggs, fish, and cooked fruits and vegetables. Also, slice foods into small pieces in order to decrease the amount of chewing required. Avoid crunchy foods (hard rolls and pretzels or raw carrots), and chewy foods, like caramels, and large foods that need your mouth to open wide.
To relieve muscle discomfort, swelling, and inflammation use non-steroidal anti-inflammatory drugs such as ibuprofen which can be bought over-the-counter at your grocery or pharmacy. Muscle relaxers, especially for people who grind can help relax tightened jaw muscles. If you are experiencing pain and would like to consult with Dr DiGiulio in her Bend dental office , please call 541.389.2885
Wear a night guard. Night guards are soft plastic mouthpieces that fit over the upper and lower teeth. They prevent the upper and lower teeth from coming together, lessening the effects of clenching and reducing the force on your teeth. They also help correct the bite by positioning the teeth in the correct position.
- Undergo corrective or restorative dental treatments. Replace missing teeth; utilize crowns, bridges or braces to balance the biting surfaces of your teeth.
- Avoid extreme jaw motions. Try to avoid excessive yawning and chewing (Gum and Ice)
- Don’t rest your chin on your hand or hold the telephone between your shoulder and ear.
- Keep your teeth a little apart as often as you can to relieve pressure on the jaw.
- Learn relaxation and or meditation techniques to help control muscle and emotional tension in the jaw. Ask Dr DiGiulio about the need for physical therapy.
Surgery for TMJ
Surgery should only be considered after all other treatment options have been tried and you are still experiencing severe, persistent pain. There are three types of surgery for TMJ: arthrocentesis, arthroscopy, and open-joint surgery. The type of surgery needed depends on the exact nature of the TMJ problem. If you are experiencing pain and would like to consult with Dr DiGiulio, a Bend dentist, please call 541.389.2885
- Arthrocentesis. This is a minor procedure performed in the office under general anesthesia. The surgery involves inserting needles inside the affected joint and washing out the joint with sterile fluids. Occasionally, the procedure may involve inserting a blunt instrument inside of the joint. The instrument is used in a sweeping motion to remove tissue adhesion bands and to dislodge a disc that is stuck in front of the condyle (the part of your TMJ consisting of the “ball” portion of the “ball and socket”)
- Arthroscopy. Patients undergoing arthroscopic surgery first are given general anesthesia. The surgeon then makes a small incision in front of the ear and inserts a small, thin instrument that contains a lens and light. This instrument is hooked up to a video screen, allowing the surgeon to examine the TMJ and surrounding area. Depending on the cause of the TMD, the surgeon may remove inflamed tissue or realign the disc or condyle. Compared with open surgery, this surgery is less invasive, leaves less scarring, and is associated with minimal complications and a shorter recovery time. Depending on the cause of the TMJ, arthroscopy may not be possible, and open-joint surgery will need to be considered.
- Open-joint surgery. Patients undergoing open-joint surgery also are first given a general anesthesia. Unlike arthroscopy, the entire area around the TMJ is opened so that the surgeon can get a full view and better access. There are many types of open-joint surgeries. This approach is used if:
- The bony structures that comprise the jaw joint are deteriorating
- There are tumors in or around your TMJ
- There is severe scarring or chips of bone in the joint
- Compared with arthroscopy, open-joint surgery results in a longer healing time and there is a greater chance of scarring and nerve injury.
Sometimes Dr DiGiulio will recommend other solutions including a full mouth restoration with particular attention paid to the articulation of your teeth to ensure a proper bite.
1470 SW Knoll Avenue
Bend, Oregon 97702
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