What Is TMJ?
TMJ stands for Temporomandibular Joint — the jaw joint. These are the small joints in front of each ear that attach the lower jaw to the skull, and happen to be the most complex joints in the entire body. The TMJ is an intricate system of bones, cartilage disc and nerves.
What causes TMJ Disorders?
TMJ disorders are also called TMD, for Temporomandibular Joint Disorders. In most cases, TMJ disorders stem from a condition called malocclusion, which means having a “bad bite”, or from accidents and trauma. Malocclusion means that your upper and lower teeth do not close together in the correct way—they are misaligned. This includes underbites and overbites.
When teeth and jaw are improperly aligned, it can cause straining of the muscles that support the face, neck and back. It is this muscle imbalance that causes much of the pain associated with TMJ disorders.
Symptoms of TMJ Disorders (TMD)
If you regularly suffer from any of the following symptoms, you may be a candidate for neuromuscular dentistry:
- Headaches that seem like migraines
- Teeth loose for no apparent reason
- Prematurely worn-down teeth
- Chips or cracks in teeth or dental restorations
- Pain in and near the jaw joints
- Tooth pain that seems to move around
- Neck, shoulder or back pain
- Facial pain
- Clicking or grating sounds when you move your jaw
- Limited jaw movement or locking
- Numbness in the arms and hands
- Congestion in the ears
As qualified neuromuscular dentists, Drs. Chris and Patrice Winterholler can follow up on any TMD diagnosis and give you customized TMD treatment. Because each TMD case is unique, each TMD treatment plan is also unique, devised for you alone. Many people have suffered from TMD for years without realizing what the cause of their pain and discomfort was, so TMD treatments are very welcome to our patients, and always reduce or eliminate their pain.
Part of the TMD diagnostic process is pain relief, using the Myo-Monitor and K-7 Evaluation System. Diagnosis involves finding your relaxed jaw position and the treatment goal is to make that position permanent.
How that will be done is what constitutes your treatment plan. Dr. Winterholler will discuss the options with you and explain how they would work. One option is to continue wearing your orthotic for a while longer to more firmly re-train the jaw muscles. If you have had TMD for years, the jaw muscles have old movement habits that are sometimes hard to change.
Dental Work for Your Bite
One way to possibly make it easier to change the old jaw habits is to recontour some of the teeth. If tooth alignment is incorrect, it can throw the jaw joints out of alignment and this can actually be a cause of TMD. Dr. Chris or Dr. Patrice can remove small amounts of tooth enamel from strategic locations without affecting any tooth structure and this can make your bite more comfortable.
Tooth bonding is another tool to improve your bite. It uses a white malleable substance to add to a tooth’s shape or size, improving the way it meets its opposing tooth. The bonding material is hardened with a curing light once it is correctly applied.
If a tooth needs more significant reshaping, a porcelain crown might be the best option. That will provide a complete set of new surfaces for the tooth and add to its shape or size wherever more volume is needed for your bite. Our CEREC system can complete your dental crown procedure in one visit, as it makes use of a dental laboratory unnecessary. We can mill your crown right here while you wait.
There are other potential components for your TMD treatment plan, such as home use of a TENS unit (Myo-Monitor) to relax recurring jaw, face, neck or shoulder tension, physical therapy for that same purpose, and orthodontic work if the teeth are more severely misaligned. Whatever seems best for your treatment plan we will provide – or refer you to another health professional who can provide it.
Both Dr. Chris and Dr. Patrice have LVI training (Las Vegas Institute for Advanced Dental Studies) in neuromuscular dentistry. LVI is a world-class center for post-graduate dentistry training and at Winterholler Dentistry you are in safe, skilled hands if you need TMD treatment.
Dentistry has been changed and modernized by advances in technology. We can now accurately diagnose a misaligned jaw and bite and give you relief from what might have been years of pain and discomfort. Our training in neuromuscular dentistry, combined with our sophisticated equipment, can pinpoint the cause of your pain and relax your jaw, possibly for the first time in years.
How do TMJ treatments Work?
In advanced restorative dentistry the decision of where to construct the bite is critical to a successful outcome.
The first goal of neuromuscular dentistry is to find the position of the jaw where the muscles are relaxed and at rest. This is a three-dimensional position in space and is often irrespective of the position of the teeth.
We utilize a number of sophisticated instruments and technology to find the position of the jaw where the joints, teeth, and muscles will operate in harmony. The first of these is a device called the Myo-Monitor.
The Myo-Monitor is a low frequency TENS (Transcutaneous Electrical Neural Stimulation) unit. This device delivers a mild electrical impulse to the muscles that move the jaw. This rhythmic pulsing relaxes the muscles and sets up ideal muscle function by increasing blood flow and flushing out toxins. We often find that after 45 minutes of stimulation, the muscles are in their ideal position.
At this point we use our K-7 Diagnostic Jaw Tracking technology to measure the muscle activity. By placing a magnet in front of your lower teeth and using a sensor we can record your jaw position in three dimensions. The resulting myograph is used to verify that there is decreased muscle activity in the new bite.
Once we have verified that the new jaw position is one of physiologic rest we can then begin to make an orthotic. The orthotic is worn to stabilize the jaw in the new position and provide relief from TMD. Many people are very happy with the results.
After Pain Relief
Our patients have several options once they are pain free:
- Continue wearing the orthotic at night
- Orthodontics to move the teeth and correct the bite
- Comprehensive restorative dentistry
- Adjusting the bite on existing teeth
Twenty-five years of research and clinical experience have shown this approach to be effective in treating patients with head and neck pain.
Who Is Affected?
TMD affects 75 million people nationwide at any one time. While women report pain more of the time, men are often found to have symptoms of wear on their teeth and bite.
How Will I Look Following Treatment?
You are likely to experience a change in your facial appearance after TMD treatment. It may be just moderate, or may be quite significant. If you had an overbite with your chin recessed, you may now have a more defined jaw line and a stronger chin.
Conversely, if you had a protruding chin because of an underbite, your face may be better aligned after treatment and your chin in better balance.
Being cosmetic dentists as well as neuromuscular dentists, we will have your smile in mind if we do any dental restorations as part of your TMD treatment. We will work to improve the attractiveness of your smile by reshaping and recontouring and giving you a bright and even result. You may emerge not only pain-free, but in possession of a pleasing smile you have always wanted.
Please contact our neuromuscular dentistry office if you would like to schedule a personal consultation. We serve the areas of Scottsdale, Phoenix and Payson in Arizona.