TMJ Diagnosis and Treatment

DIAGNOSIS & TREATMENT OF TMJ DISORDERS

"TMJ Disorders" and "TMD" are generic terms which like any other joint in the anatomy, encompasses a whole spectrum of diseases, derangements of the articulating elements in the Joint, and injured or damaged tissues affecting the function of the Joint. Obviously, in order to treat a patient effectively, it is necessary to first find out EXACTLY what the specific problems are.

There are two elements to diagnosis. The first is a comprehensive history and clinical examination. The second is a series of diagnostic studies. Each practitioner has his or her own favorites which they rely on, and which may be used either singly or in any combination. In general, the diagnostic studies available for TM Joint diagnosis and evaluation are:

X-rays of the TM Joints & Skull

MRI (Magnetic Resonance Imaging)

Electromyography (studies of muscle function)

Motion Performance Studies

Joint Vibration Analysis (a form of ultra-sound sonography)

Diagnostic Study Casts of the Mandible & Maxilla

X-rays of the Dentition

TREATMENT

The diseases which affect the TM Joints are no different, really, than the diseases which affect other joints in the human anatomy. Rheumatoid, and Osteoarthritis; Inflammation of the Joint capsule; inflammation of the Synovium; torn Ligaments; perforation, or tears in the Articular Disks; internal derangement of the Condyle Head, and or Disk, in the Joint space, and etc.

There are two basic types of treatment for TM Joint disorders: surgical and non-surgical, but it is generally agreed that in most cases the non-surgical approach should be taken first in an effort to restore comfort, and improve jaw function to an acceptable level.

NON-SURGICAL TREATMENT MAY INCLUDE THE FOLLOWING IN ANY COMBINATION DEPENDING ON THE CASE:

Fabrication and insertion of an Intra-oral Orthotic (sometimes referred to as a Splint)

The purpose of these Orthotics, which may be fitted to either the upper or lower jaws, and in some cases to both, is to re-position the Condyle Head in the Joint space to a more normal position, thereby relieving the stresses, and pressures, being placed on the tissues of the Joints, and their related supporting structures allowing them to heal.

Physical Therapy Treatments.

These treatments might include Ultra-sound, and an exercise rehabilitation program.

Adjuntive Medication.

These would include anti-inflammatory, and muscle relaxants, and such other prescription medications as may be applicable to the case.

Stress Management.

The treating TMJ practitioner may refer the patient for stress management which can include any number of modalities from bio-feedback training to counseling.

FREQUENTLY ASKED QUESTIONS

How long, on average, does treatment take?

Again, it depends on the case. Remember that in those cases where the onset of symptoms was not as a result of a traumatic injury, the TMJ condition develops slowly over time. That which takes years to develop, does not necessarily take only weeks to resolve. This is not to say that treatment takes years, but it probably will require weekly visits to your treating Dentist for some number of weeks - perhaps as long as six months. Again, this is a very specific issue relating to each individual case, and to the way individual patients respond to the treatment modalities.

I have some TMJ symptoms, but I just don't want to take the time, or spend the money for treatment right now. What will happen if I put it off?

It depends on how serious your symptoms are. The odds are that without treatment your condition will progress, because your TM Joints are in almost constant use, when you talk, when you chew, and even when you think they're not being used. For example:

EVERY TIME YOU SWALLOW YOUR TEETH COME IN CONTACT

EACH CONTACT DURING THE SWALLOW PLACES ABOUT 25 POUNDS OF PRESSURE ON THE TEETH

EACH TIME YOUR TEETH COME INTO CONTACT YOUR TM JOINTS BECOME FUNCTIONAL, AND SOME OF THAT 25 POUNDS OF PRESSURE IS TRANSFERRED TO THE JOINTS

Will a TMJ condition ever go away by itself
Sure. No one is suggesting that you rush off for treatment the first time one of your Joints click. Minor muscle sprains frequently self resolve. You'll know when you need treatment. You'll know when you WANT treatment, and you'll certainly know when you MUST HAVE treatment.