TMJ Treatment
TMJ (Temporo-Mandibular Joint, Bruxism, Teeth Grinding or Clenching) Treatment in Newport News, Virginia
The most complicated joint in the body is the Temporo-Mandibular Joint (TMJ). There are three main reasons for this. First, the TMJ is controlled by multiple muscles acting at different angles to allow for opening and closing. If any one of these muscles is not working properly, then it can throw off the entire range of movement. Secondly, the TMJ is a bilateral joint – there are two of them, and the operation of one is inseparably tide to the other. Thirdly, the TMJ is significantly affected by how the teeth come together, such that if a person’s bite is asymmetrical or lopsided, then the joint can be harmed over time. For all these reasons, it can be a real challenge to diagnose and treat TMJ problems.
Perhaps the most common causative factor in TMJ problems is a bite that is not even and symmetrical. When this is the case, one joint is made to work differently from the other. While some accommodation is possible without doing harm to the joint, severe or long-term asymmetrical TMJ stress can cause changes in the functioning of the muscles, and can eventually cause remodeling of the bone in the joint itself.
If a person’s bite is unbalanced, there are three ways to balance it: orthodontics, equilibration and splint therapy. Not all of these options are good choices for every situation, so a person’s condition must be closely evaluate prior to a treatment modality being chosen.
The most rapid way to balance a person’s bite is with equilibration. In this approach the teeth are selectively adjusted so that the contacts between them are even and symmetrical. This process should include balancing the bite when a person bites straight up and down, and also when a person grinds in various directions. The process takes great attention to detail, but it is good for dealing with bite problems that are relatively minor in nature. If, however, the bite is severely unbalanced, then equilibration is not a good idea, because so much tooth structure would have to be removed that the health of the nerves would be threatened.
A second approach to creating a balanced bite is orthodontic treatment. This option is better than equilibration when the unbalanced nature of the bite is moderate to severe. Teeth can be moved into position so that equal pressure is put on each TMJ, both during straight closing and while grinding in various directions. The degree of skill required for a dentist to accomplish this is significant, and usually some equilibration is required to complete the bite balancing after the orthodontic treatment is completed.
The third approach to balancing the bite is with an occlusal splint, which some refer to as a night guard. This is a device that can fit over the upper or lower teeth to simulate a balanced bite. Significant adjustment of the appliance is usually necessary in order to maximize the effectiveness of this approach. Perhaps the best thing about occlusal splints, as opposed to the other two methods, is that it is reversible – it doesn’t require that natural teeth be reshaped, and it doesn’t require the movement of teeth.
Not all TMJ problems can be treated with one of the three methods listed above. Sometimes changes in the joint occur over time, and these changes prevent the TMJ from functioning properly, even after the bite is balanced. Also, sometimes the TMJ discomfort can be caused by a parafunctional habit of clenching or grinding, which can be stress-induced. Finally, sometimes the problem is primarily anatomical – perhaps the structure of the TMJ or its related structures did not develop properly.
In summary, TMJ disease can be a multi-factorial disease, and proper treatment is best accomplished by a dentist who has had advanced training in this are, such as the dentists at City Center Dental Care.
