What is TMD/TMJ?

Problems with your jaw and the muscles in your face that control it are known as temporomandibular disorders (TMD). Referring to the specific temporomandibular joint (TMJ), is the hinge joint that connects the lower jaw to the bone of the skull. This joint is located immediately in front of the ear on each side of the head.

The muscles attached to the jaw allow the jaw an incredible amount of movement, such as side to side and up and down. This flexibility allows us to chew, talk, and yawn. Each TMJ has a disc between the ball and socket. The disc cushions the load while enabling the jaw to open widely and rotate or glide. Any problem that prevents this complex system of muscles, ligaments, discs and bones from working properly may result in a painful TMJ disorder.

What are the chronic symptoms of TMD/TMJ?

• Pain or tenderness in the face, jaw joint area, neck and shoulders, and in or around the ear when you chew, speak, or yawn
• Limited ability to open the mouth wide
• Jaws that get “stuck” or “locked” in the open or closed mouth position
• Clicking, popping, or grating sounds in the joint when the mouth is opened or closed
• Tired feeling in the face or neck
• Difficulty chewing
• Sudden uncomfortable feeling when biting
• Swelling on the side of the face
• Toothaches
• Consistent headaches or neck aches
• Dizziness
• Earaches
• Hearing problems
• Upper shoulder pain
• Ringing in the ears
• More women experience TMD/TMJ pain than men and is most often seen in people between 20 to 40 years of age.

What are potential causes of TMD/TMJ?

• Trauma or injury such as whiplash
• Bruxism, or teeth grinding
• Clenching
• Osteoarthritis
• Rheumatoid Arthritis
• Dislocation
• Tooth and jaw alignment

How is TMD/TMJ diagnosed?

At present, there is no widely accepted, standard test to correctly identify TMD/TMJ. Because the exact causes and symptoms are not clear, diagnosing temporomandibular disorders can be confusing especially because other dental conditions, such as a toothache or sinus problems, can cause similar symptoms. In about 90 percent of the cases, says the Delta Dental Plans Association, your description of symptoms, combined with a simple physical examination of face and jaw by Dr. Hylton provides useful information for diagnosing temporomandibular disorders. 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.

Dr. Hylton may also take x-rays and make a cast of your teeth to see how your bite fits together, or may request specialized x-rays for the TM joints.
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What treatment options do I have?

Keep in mind that for most people, discomfort from TMD/TMJ will eventually go away whether treated or not and our office encourages simple self-care non-invasive practices. If more treatment is needed, it should be conservative and reversible. Dr. Hylton avoids, if at all possible, treatments that cause permanent changes in the bite or jaw. If irreversible treatments are recommended, we encourage you to gather all the information you need to make an informed best decision and even to get a second opinion. Pain clinics in hospitals and universities are a good source of advice and second opinions for temporomandibular disorders.
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Non-Invasive treatment options include:

• Using a dental articulator, Dr. Hylton will analyze your bite on an instrument that simulates the way your jaw works
• Bite correction with T-Scan computer-bite sensors which digitally map your bite so we know precisely how your teeth bite, from the high spots to the low spots
• Bite Splint Therapy-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 hard acrylic therapeutic device is fabricated to fit snugly over either your upper or lower teeth creating an artificial biting surface that alleviates undue stress and force, providing for better joint and muscle function and comfort. 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.
• Inflamyar – a compound of various natural plant based products for Treatment of Inflammation, Arthritis, Muscle Pain, Bursitis, Sprains, Bruises and Sports Injuries. We use this with low level laser therapy to help with sore temporomandibular joints and muscles
• Eating soft foods
• Try to avoid extreme jaw movements, like yawning and gum chewing
• Avoid biting your nails
• Applying warm compresses to the area of pain
• Muscle stretching and relaxation exercises to perform at home
• If you have the habit of teeth grinding, Dr. Hylton can fit you with an therapeutic splint that fits over your upper and lower teeth like a mouth sports guard. The splint is designed to ease muscle tension by reducing clenching or teeth grinding at night More invasive treatment options include:
• A bite adjustment to correctly engineer your bite. It is a precise procedure that is always done first on models of your mouth. And before that procedure is done, a bite splint may be prescribed to relax the muscles and allow the joints to stabilize first.
• Cortisone shots can help relieve inflammation and pain
• Fixing an uneven bite by adjusting or reshaping some teeth
• Orthodontic treatment may also be recommended
• Jaw joint replacement surgery to replace the jaw joint with an artificial implant After a personal consultation and exam, Dr. Hylton can suggest the most appropriate therapy based on the suspected cause of your TMD/TMJ pain.