Many people suffer from Temporomandibular Disorders or TMD. There are actually numerous disease that fall under the title of TMD, including Migraine headaches, Tension headaches, bruxism (nighttime grinding), joint disorders of multiple types, and muscular disorders of multiple types. The fact is that people who have pain in their head and neck region may fall into one of those categories. It is often a waxing and waning condition, where symptoms come and go.
As part of your comprehensive examination, I always start on the outside and make note of any muscular or joint anomalies that exist. Commonly, I will find isolated muscles that are tighter than others. Some people exhibit restricted range of motion in their jaws. Others show signs of joint degeneration with popping, clicking, or grating sounds. An orthodontic class is assigned to all of our patients, shedding light ot how their teeth fit together. The occlusion, or bite, is of major concern here.
The loss of harmony between the bite, the muscles, and the joint can lead to TMD. Based upon the causative reasons, an assessment can be made of how to symptomatically manage and definitively manage the complex of disease that cause TMD. It may be a simple case or an orthodontic referral to get the teeth into proper positioning. Some people benefit highly from a “selective polishing” of their teeth to help align the bite better and reestablish harmony. Others may be past that point and require some form of a nightguard. As we place fillings, crowns, and tooth replacements in people’s mouth we strive to keep that occlusion harmonized so as to not induce a TMD. Over time, tooth loss and subsequent movements may change the bite forces. These bite forces are then load onto muscles and joints that may or may not be able to handle the load. Sometimes the forces can be such that teeth themselves are broken, chipped, or severely worn. TMD is truly a complex issue in dentistry.
At your new patient comprehensive exam, if you are having any issues, please start a dialogue and appropriate measures can be taken to help. I have a specific patient questionnaire for patient’s with TMD if they would like to be evaluated. A lot of insight can be gained from this approach. I find that many people have a single high filling or crown that is causing a problem. Other people have destructive slides that can be polished away. Others may benefit from a nightguard. Please engage me to best help you. I thorough enjoy analyzing “bites” and determining a course of action towards resolution of TMD symptoms. TMD is a true lifestyle issue and the big picture can sometimes get lost in the dental profession’s quest to rid the world of dental decay and gum disease. If you have facial pain in your muscles or joints, I would love the opportunity to see how I can help change your lifestyle for the better.