What is TMJ/Facial Pain Syndrome?

In recent years the news media has exploded with articles and interviews about TMJ Syndrome. Much of this information is either inaccurate or incomplete. TMJ (temporomandibular joint) Syndrome or myofacial pain dysfunction syndrome is neither new nor is it rare in occurrence.

Most people have a disharmony in the way their teeth fit. The majority of these people experience one or more of the following, due to uneven pressures form the bite: loose teeth, sore and sensitive teeth, broken and worn teeth. In approximately 20-30% of the population, bite disharmony results in the TMJ Syndrome. This is a condition affecting the structures of the temporomandibular joint. These structures consist of muscles, ligaments, bones and discs.

When bite disharmony is present, the muscles of the jaws are constantly at work to help the lower jaw move into a position that will allow the teeth to fit evenly. This constant contracting of the muscles without rest can cause the muscles to go into spasm. Resulting in numerous symptoms like facial pain

and numbness, headaches, joint sounds such as popping and clicking and locking of the jaw. These symptoms may be a result of muscle disharmony or internal derangement within the joint. Muscle spasm due to bite disharmony can be a causative factor in the TMJ Syndrome. There are also other important contributing factors which must be considered in TMJ Syndrome. Among these factors are:

·         Emotional distress

·         Nutritional deficiency

·         Hormonal imbalances

·         Bio-Chemical imbalances

·         Arthritic conditions

·         Trauma to head and neck

 

Diagnosis of TMJ/Facial Pain Syndrome

Our usual diagnostic examination consists of a four step procedure:

1.       Position the jaw in a pain-free position. If we can manually place the lower jaw in a position that allows the pain to leave, this is our most important diagnostic test. If the pain is markedly reduced with a precise guidance, this identifies the spastic muscles as the cause of the pain.

2.       Careful gathering of all history and facts relating to the problem.

3.       Muscle examination and palpation.

4.       Complete series x-rays of the mouth, x-rays of the temporomandibular joints, impressions of the teeth for models and bite records.

 

Treatment Protocol

Treatment may consist of the following:

1. Orthopedic repositioning appliance or splint – This is an upper or lower custom made plastic mouthpiece to be worn as indicated or until symptoms have reduced.

2. Equilibration of the teeth—This consist of shaping very small areas on the biting surfaces of the upper and lower teeth. Usually the spastic muscles then relax.

3. Restorative dentistry—Very often, restorative treatment may be necessary in order to stabilize the bite after equilibration of the teeth. Missing, broken teeth or large filling may also indicate the need for restorative dentistry.

4. Orthodontics—Orthodontics treatment, like braces, may be necessary if major discrepancies exist in the bite.

 

Our desire is to do the most conservative treatment possible in order to achieve a predictable result. Please ask any questions you may have concerning your treatment in order that we may help you understand your problem.