TMJ Neuromuscular Treatment
Our Ottawa dentists diagnose and treat the common jaw joint disorder (TMD) with neuromuscular treatment options to help relieve symptoms and address its underlying causes.
What is TMJ & TMD?
TMJ (Temporomandibular Joint) is the hinge that connects your jaw to the temporal bones of your skull. TMD (Temporomandibular Joint Disorder) is the dysfunction of this joint that causes issues with your jaw and face.
Symptoms of TMD
The temporomandibular joint (TMJ) is complex and is often subjected to pressure when we bite and chew.
This makes it vulnerable to dysfunction, which can cause symptoms collectively known as TMJ Syndrome or TMJ. Common symptoms by body part include:
Teeth & Gums
If you have TMD, you may feel these symptoms in your teeth and gums:
- Sensitivity to hot, cold, or sweet stimulus
- Significant pain in one or more teeth
- Uncontrolled clenching of the jaw
- Bruxism (grinding of the teeth at night)
- Significant grinding or wear on the edges of your teeth
- Inconsistent wear on the teeth
- Unexplained shifting of teeth that create spaces or crowding
Head
If you have TMD, you may feel these symptoms in your head:
- Sharp pain in the forehead
- Pain that resembles “sinus” headaches
- Excruciating headaches with a quick onset (symptoms resembling a cluster headache)
- Recurrent migraines
- Sensitivity of the scalp to even the lightest touch
Ears
If you have TMD, you may feel these symptoms in your ears:
- Continuous buzzing or ringing in the ears
- Dizziness or problems with balance
- Pain normally associated with an ear infection (even when there is no infection present)
- Reduced hearing acuity
- The sensation that the ears are “clogged” or that sounds are muffled
Throat
If you have TMD, you may feel these symptoms in your throat:
- Pain in the tongue
- Diminished ability to vocalize
- Recurrent sore throats
- Difficulty and pain when swallowing
- General sensitivity and tightness of throat
Eyes
If you have TMD, you may feel these symptoms in your eyes:
- Overly reactive tear ducts – constant watering eyes
- Frequent episodes of blurred or fuzzy vision
- Repeated and seemingly random instances of pain in or around the eye (especially behind the eye)
- Increased sensitivity to light
- Chronically irritated or bloodshot eyes
- Recurring pressure behind the eyes
Face & Jaw
If you have TMD, you may feel these symptoms in your face and jaw:
- A sudden and substantial difference in the way that the upper and lower teeth fit together
- Facial muscles that feel tight and stiff when you wake up or after speaking for a while
- Sore cheek muscles
- Spastic and involuntary jaw movements
- Distinct popping or clicking noise when chewing or yawning
- Inability to move the jaw from side to side
- Difficulty controlling tongue movements
- Limited opening range of the jaw
- Significant lateral movement when trying to open and/or close the jaw
- Difficulty opening or closing the jaw smoothly
- Continuous pain in the jaw joint
Neck & Shoulder
If you have TMD, you may feel these symptoms in your neck and shoulder:
- Pain or stiffness of the neck or shoulders
- Reduced mobility of neck
- Throbbing aches within the shoulders
- Recurrent back pain (both upper and lower)
- Tingling or numbness in fingers or arms
What causes TMD?
Injury, stress, jaw clenching, inflammation and other factors can change our bite. This causes a ripple effect throughout the body. Your posture may change and symptoms such as pain, stiffness and reduced mobility can occur.
Benefits of TMD Treatment
Your TMD disorder symptoms can improve with treatment from our Ottawa dentists. Benefits of treatment can be broken into two categories, including functional and aesthetic.
Functional
The functional benefits stem from the creation and maintenance of an optimal occlusal relationship between the upper and lower jaws and teeth. The re-establishment of optimal occlusion (bite) effectively eliminates the Temporomandibular Joint Disorder (TMD) symptoms. Many people suffering from TMJ disorder have accepted chronic pain and discomfort as part of their lifestyle. However, we may be able to eliminate this with treatment, even if other treatment approaches have been unsuccessful in the past.
Above and beyond the elimination of the TMD symptoms, the functional benefits also extend to the actual pressure and wear that is exerted on the existing teeth and/or restorations. Having the teeth and jaw optimally aligned reduces the wear and tear that the teeth and restorations are subjected to, effectively increasing their lifespan.
Aesthetic
With respect to aesthetic benefits, these are traditionally associated with a reconstructive course of treatment. With other types of TMD treatments, there may be a slight aesthetic improvement that arises from the changed orientation of the teeth and jaw, but those courses of treatment are primarily designed to address the TMD symptoms, not the aesthetics.
With the reconstructive treatment approach, the end results are typically spectacular. It is commonly referred to as a “smile makeover”. The smile can be transformed to look stunning and natural, but the effects of a Gneuromuscular approach to a “smile makeover” are not limited to the teeth alone. Often, the change in the position of the teeth and jaw will have a rejuvenating effect on the eyes and rest of the face. This change is particularly apparent when a smiling. When someone suffering from TMD smiles, their eyes typically squint and it seems as though the smile is forced or painful. When the TMD is addressed, the squinting disappears, and the smiles take on a more natural and livelier feel.
Certainly, the focus with our patients is placed first and foremost on allowing them to resume a pain free life. The elimination of the chronic symptoms is always the top priority but sometimes our patients take advantage of the opportunity to create the smile that they have always dreamed of.
Treatment Options for TMD
If you are suffering from the symptoms above, fortunately, Ottawa Dentistry can help. We are proud to offer the following TMD neuromuscular treatment options for patients:
ULF-TENS Technology
ULF-TENS technology is used to relax the muscle spasms in the Temporomandibular Joint. Since the optimal occlusion (bite) occurs when the muscles are completely relaxed, the TENS unit allows us to establish the approximate optimal spatial relationship between your jaws and teeth.
K7 Evaluation System
The K7 Evaluation System measures the viability of the bite while the muscles are relaxed, and the jaw is expertly manipulated. The Myotronics K7 Evaluation System provides Dr. Nguyen with objective measurements of the mandibular path of closure, muscle activity and the amount of vibration that occurs when opening and closing.
Using a thorough analysis of the data that the system collects, he can identify with a fair degree of certainty what occlusal position is optimal.
Temporary Orthotic Device
A temporary orthotic device can be used to stabilize and "test" a bite (occlusion). This orthopedic appliance is designed to correct the old, harmful habits of jaw malposition that have developed over the years to compensate for the malocclusion (poor bite) of the teeth.
The appliance is designed to be comfortable to wear and virtually invisible. The orthotic is developed with the exact occlusal (bite) specifications that are identified with Gneuromuscular approach using the ULF-TENS and K7 Evaluation System.
In instances where a minor irregularity in the occlusion (bite) is caused by the interference of a slightly protruding or poorly shaped tooth or teeth, some enamel from the affected area(s) can be reshaped to achieve optimal occlusion. This procedure is only applicable to cases that require very minor adjustments.
Removable Overlay Partials
This device can help patients achieve an optimal bite (occlusion), minimize stress placed on affected teeth and reduce the rate of wear. The name is slightly misleading since the removable overlay partials are essentially permanent orthotics that are bonded to the back teeth.
This tool that can be used as a more permanent step after the temporary orthotic validates that the selected occlusion is in fact optimal.
Dental Services
In some cases, the Temporomandibular Joint Disorder (TMD) is the result of several severely worn or broken teeth that may have extensive decay. In those instances, fixing the bite with removable overlay partials is simply not enough and a more comprehensive treatment plan is required.
In those cases, there may be several steps involved in the overall course of treatment. First, the optimal occlusion (bite) is identified using the ULF – TENS unit in conjunction with the K7 Evaluation System. ).
Next, the recommended occlusion will be tested using a temporary orthotic.). Third, as the occlusion is established with absolute certainty, a comprehensive treatment can be created to help maintain the healthy occlusion.
This will require a combination of dental services that may include the placement of dental implants (titanium components resembling a screw that are surgically placed into the jaw bone), root canal therapy, dental bridges and/or dental crowns.
Orthodontic Approach
In some instances, Dr. Nguyen can recommend an orthodontic approach, using In-Ovation® Low-friction esthetic braces or SureSmile® braces, to achieve optimal occlusion (bite). This may be the least intrusive approach and can have the same dramatic results of simultaneously eliminating the Temporomandibular Joint Disorder (TMD) symptoms and improving the aesthetic appeal of the smile.