“TMJ” is a popular term used to describe a disorder of the jaw joints, chewing muscles and bite. Symptoms masquerade as a multitude of other problems such as sinus headaches, migraines, neck and shoulder stiffness, earaches and tooth problems. These symptoms are caused by an instability in your jaw joint and can be successfully treated by a dentist who has specialized training in managing these disorders.
TMD (TMJ dysfunction) is the dental term describing a collection of symptoms, which result when the chewing muscles, bite and jaw joints do not work together correctly. TMJ stands for the temporomandibular joints. These are the two joints that connect your jaw to your skull. When these joints are not functioning as designed, they can cause many problems, such as:
Clicking or popping noises
Pain to opening or closing the jaw
Locking or limited opening of your mouth
Muscle spasm goes hand-in-hand with displaced jaw joints. Because the nerves and muscles are so complex in this area, when these muscles are in spasm the problems can be far-reaching. People suffer from symptoms they would never think to associate with their bite, such as:
Pain behind the eyes
Earaches or ringing of the ears
Clenching or grinding of the teeth
Worn, broken loose and chipped teeth
Neck, shoulder, or back pain
Numbness, or tingling of the fingers
The primary problem can be in the joints themselves; the muscles of the face and jaw; the bite (how the teeth fit and work for chewing) or a combination of these. Because the symptoms masquerade as so many other conditions, many people travel from doctor to doctor in search of relief. It is estimated that as many as 10-15% of Americans suffer from one or more of these symptoms. Many never think to seek a dentist trained in TMD for help.
The structures that make it possible to open and close your mouth include the jawbones, jaw joints, and chewing muscles. These are very specialized and must work together whenever you chew, speak, or swallow. Your teeth are also inserted in your jaw bone. At the other end of your jaw bone are the temporomandibular joints. These joints attach your jaw to your skull. Muscles attach both the bones and joints and allow them to move. Any problem which prevents the complex system of teeth, muscles, bones, and joints from working together in harmony may result in TMD.
A “Bad Bite”
There are various ways this system can be disrupted, such as accidents involving a blow to the face or a whiplash. Yet the most common cause of TMD relates to your teeth and your bite. If your bite isn’t right, it can affect both the muscles and the joints. What do we mean by a “bad bite”? We mean that your upper and lower teeth do not come together in a way that provides the proper bracing support for your jaw against your skull. This might result from a missing tooth, misaligned teeth, or bite that has drifted due to tooth wear or teeth grinding.
Your upper and lower teeth must come together firmly each time you swallow. This happens over 1000 times each day and night! When your bite is unstable your muscles must work extra hard. This extra work makes them shortened and stiff. Eventually this strain makes them feel painful. A vicious cycle begins of increased tissue damage, muscle tenderness, and pain. The pain makes you feel tense and uptight. This worsens the muscle spasm, which in turn increases the pain.
Jaw Joint Displacement
The position of your teeth can also affect the position of your jaw joints. Each jaw joint is a ball and socket joint. When functioning properly, the ball and socket do not actually touch because a thin disc of cartilage rides between them. The disc acts as a cushion and allows the joint to move smoothly. Each disc is held in place and guided by muscle. If your bite is not right, the disc is pulled forward by hyperactivity of the muscle. Since the disc no longer serves as a cushion, the joint itself now rubs against the boney socket and presses on pain fibers. Mild displacements cause a clicking or popping sound in the jaw joint; more severe displacements can be very painful and eventually can cause permanent damage to the joint. An unstable bite can cause both jaw joint displacement and muscle strain and pain. When this condition is prolonged, the body begins to compensate and adapt by involving muscles in the neck, back, and shoulders.
DIAGNOSIS AND TREATMENT
Diagnosis of TMD involves a thorough history; an examination of the jaw joint and chewing muscles; evaluating joint noises; and checking the teeth and bite for wear and proper alignment. Additional records may include study models for detailed bite analysis and imaging such as Cone Beam Computed Tomography (CBCT).
Since the teeth, jaw joints, and muscles can all be involved, treatment for this condition can vary and will usually involve several phases. The first phase is to relieve the muscle spasm and pain and stabilize the jaw joint in the jaw socket. Often a temporary device known as a “bite splint” is worn over the teeth until the muscles relax and the pain is relieved. Once your jaw joint is stabilized, the second phase is to evaluate your bite for corrective options so you are not dependent on the “bite splint” for comfort and stability. Permanent correction involves refitting your bite and teeth with minimally invasive bonding materials – in some cases, building crowns on the teeth and/or orthodontics are needed. Rarely, if the jaw joint itself is damaged, it may need surgical care. Ultimately, Dr. Korolewski can stabilize your bite so that the teeth, muscles, and joints all work together naturally for optimal long-term health and comfort.
TMJ Treatment Testimonial by Renae Grahn: Dr. Korolewski truly has a passion for treating patients with TMJ. He is someone that will listen to you, care for you, and validate your concerns with his extensive knowledge of treating complex TMJ cases. I was referred to Dr. Korolewski by another Dentist. I had the same splint for 25 years and in December 2014, I went to see Dr. Korolewski and he agreed it was time to get a new one. He built me a custom splint that I am very happy with today. The splint changes he made for me over 6-months in 2015 were not minor adjustments. It was weekly visits for 6-months and they worked diligently until he got it right. My issues are very complex and the time he and Mary spent with me over a course of 6-months was way over the top of what a patient would expect. My TMJ symptoms were debilitating including headaches, inability to chew properly and eat certain foods, and daily chronic pain. I feel like Dr. Korolewski has given me quality of life back. Mary, his dental assistant is fabulous, gentle, and a very caring person with a “can do” attitude. The staff always make me feel comfortable and valued. If you have been suffering with TMJ pain, please don’t suffer any longer, go see Dr. Korolewski. He will tow the line and stay on the journey with you. He is a trusted partner no matter how complicated you think your situation may be.
TMJ Treatment Testimonial by Linda Bertram: Dr. Korolewski is a great Dentist and a very caring man. I refer everyone I know to his office because I have the utmost trust in him and his dental staff. I was referred to Dr. Korolewski by another TMJ Dentist. I was in excruciating pain and he was able to create a mouth piece for me to help take the edge off the pain. He knew exactly what to do, his treatment plan was straight forward and he explained every step of the process. Dr. Korolewski takes a genuine interest in his patients. He treats you like a human being with a high level of care and understanding. I also really like his sense of humor. The staff make you feel like a family member when you arrive, they are all very nice and sweet and extend a warm greeting.