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The temporomandibular joint is right in front of the ears. You can feel it with your fingertips. It allows your lower jaw to open and close, and move forward and side to side. Like any joint, it can undergo wear and tear changes. The bony part of the joint can degenerate. The cartilage disc can become misshapen or lose its normal position. The blood vessels and nerves behind the joint can become inflamed and irritated. All of this can occur with or without pain and alteration of joint function.
During an examination, we perform orthopedic types of tests on the TMJ such as palpation (pressing various areas), auscultation (listening while the jaw moves), range of motion tests, and loading or joint compression tests. These allow us to assess the current status of joint form and function. If you have joint pain, we will determine exactly which structure(s) are involved in order to make a diagnosis. We will also palpate the muscles of the head and neck area to determine if they may be a source of pain. The causative factor(s) of the TMJ or muscle pain must be determined. The causes can be multiple, such as trauma, habits such a bruxism (grinding the teeth), sleep disorders, psychological factors and medical conditions.
The bite of the teeth (occlusion) has a direct effect on TMJ structure and muscle function. If the bite is incorrect, it can cause undue stress and force on the TMJ structure and cause the muscle to overwork. Both undue stress and force can be a source of pain and/or dysfunction. If we determine that there is a cause/effect relationship between the incorrect bite of the teeth and TMJ/muscle symptoms, a bite splint could be recommended. A bite splint (which can fit on your upper or lower teeth) creates an artificial physiologic biting surface that alleviates undue stress and force, providing for better joint and muscle function and comfort. We then carefully and precisely fit and adjust this bite splint. As you wear the splint, your bite on it will change, requiring additional adjustments to the splint. The goal is to alleviate the signs and symptoms of TMJ disorders, as well as stabilize your bite on the splint. We may prescribe medication and/or refer you to a physical therapist or psychologist if contributing factors seem to warrant this type of treatment.
Once the goal of splint therapy is met, we will re-evaluate your TMJs and reassess your bite using models of your teeth attached to an articulator (jaw simulator). Then your bite is carefully studied to determine what corrections can be made to optimize your oral comfort, function, health and esthetics.
