TMJ Treatments

TMJ is a commone phrase.  TMJ actually is an abbreviation for the temporomandibular joint. Temporal, represents the temple area of the skull; mandibular represents the mandible, or lower jaw; the joint is where the head and jaw meet. Problems in this joint may be caused by a misalignment of the teeth, trauma, excessive muscle tension or a combination of all of the above. Between these two bones, a disc acts as a buffer, and five muscles on each side are involved in the movement of the lower jaw.

Problems in this area can cause:
• Headaches
• Earaches
• Trouble/soreness in opening and closing the mouth
• Clicking or popping of the jaw
• Pain in the jaw muscles
• Soreness in the area, sometimes extending to the face

Treatment of temporomandibular joint disorders, or TMD, is done in phases in this practice. Phase I is the most imporatnt, which is the DIAGNOSIS of the pain problem.  Successful treatment can not be obtained without a proper diagnosis first.  We use High Tech diagnostics and xrays to help in that process. 

Phase II is used to establish where the lower jaw wants to be in space so that the joint and the muscles are comfortable. This usually includes an appliance called an orthotic, which is used to stabilize the bite in a position that decreases the stress on the joint. This appliance is typically worn during the day, including when eating.  During this phase, specific treatment options such as iontophoresis, ultrasound and stretching of the muscles may be implemented.  Nutritional supplementation is also utilized so that your body has the proper building blocks to do the repair process with.  

The goal of Phase III is to restore the mouth to the position that eliminates the need to wear the orthotic during the day to keep the joint stable. Sometimes it is as simple as weaning off of the orthotic. Other options include fabrication of new dentures, crown, onlays, direct bonded restorations, or even orthodontics. There is no one solution that is right for all cases. If untreated and the condition progresses to extremes, surgery may be required to repair a badly damaged joint, but this is reserved as a last resort, not primary treatment.

Nighttime stability of the joint is usually maintained with the use of an appliance that is different from the day appliance. The appliance most often used for pure clenching and grinding is a NTI-tss. This treatment appliance is designed to minimize the damage to the teeth and joint that occurs during the night from the forces generated during nighttime clenching and grinding, also known as bruxism. It is a small appliance, about the size of your thumb’s first digit, that fits over your front teeth. Your opposing front teeth will contact a flat area on the appliance that allows the lower jaw to rest in a neutral position. It will allow you to move from side to side when you are sleeping, but it will not allow anything from the eye teeth back to touch.

If your diagnostic portion reveals a compromised airway, yout night appliance will address it as well.  Patients who have a PSG confirmed obstructive sleep apnea component to their health concerns can have an FDA approved appliance fabricated to both protect their joint position and health and open your airway.

If your diagnostic portion reveals a compromised airway, but it not severe enough to be considered obstructive sleep apnea, and appliance will be made to protect your joint and teeth from clenching and grinding, and also hold the chin in a more forward position, increasing the probability of helping to keep the airway open while you sleep.

If you are interested in meeting with Dr. Wiggins to see if can potentially be helped, please complete the link that completes a comprehensive medical history review form.  That will get the process started.  This information is loaded through a secure server to our office, which can then be reviewed by Dr. Wiggins. Once this hasa been completed, please contact our office for an appointment.