Treatment and Diagnosis of TMJ Disorders
TMJ disorder is a misalignment of the joint that connects the jaw to the head. The temporomandibular joint, or TMJ, acts like a sliding hinge where it joins your jaw with your skull. The joint bones are cushioned with a little disk that helps the jaw move smoothly, and it is a system that works well until it doesn't. At least 10-15% of the adult population suffers from TMJ. The pain and discomfort can cause missed work and increased levels of depression and anxiety, in addition to being debilitating.
Anything can irritate the joint and prevent your jaw from moving properly. If you find you are having trouble chewing, talking, or yawning, or begin experiencing muscle pain, tightness, or headache that starts in your jaw, you might have dysfunction of your temporomandibular joint. Seeing your doctor, dentist, or chiropractor is the first step to treatment, which involves realigning the position of the jaw. Keep reading to learn more about the diagnosis and treatment of TMJ problems, and what to expect from your first appointment.
Getting a diagnosis of TMJ can be difficult; it is often one of those diagnoses that come after other possible reasons have been ruled out. Because the symptoms of TMJ tend to mimic those of headaches, accessed teeth, and more, it is imperative that you see a health professional. Jumping to the immediate conclusion that your discomfort is TMJ could miss a serious medical issue.
Any chiropractic care for TMJ is usually done in consultation with a doctor or dentist. Whoever is treating you will take a complete medical history and do a physical exam, including:
Listening for pops, clicks, or grinding when opening and closing your jaw
Observing your range of motion in your jaw
Touching the areas surrounding your jaw to identify where and how much it hurts
Examining the joint for pain and tenderness
Testing your bite and jaw joint alignments
Examining your teeth for structural problems like displaced teeth, uneven fillings, and cavities
Checking whether you grind or clench your teeth
Checking the muscles in your face, neck, and shoulders
Once other conditions like infection, ear problems, nerve issues, or headaches are ruled out, your doctor or dentist may order dental x-rays, a CT scan, and/or an MRI. All of these scans are used to get a better look at the teeth, jaw bone, and soft tissue around the joint.
Treatments and Therapies
Once you have a TMJ diagnosis, your chiropractor will discuss treatment options based on their findings. Treatment for TMJ disorder can include a combination of appropriate
therapies and lifestyle changes depending on your particular condition. For instance, if your TMJ is caused by myofascial pain syndrome, fibromyalgia, or degenerative disk disease, then chiropractic adjustments may help with pain and mobility. Early diagnosis and treatment of temporomandibular disorders prevent them from becoming chronic issues. The most common non-surgical treatments can include, but are not limited to:
▪ Correcting your bite
Do you grind your teeth or wake up in the morning with pain from clenching your teeth? Talk to your dentist about the possibility of getting a bite guard. Depending on your diagnosis, you may need a TMJ mouthguard, a guard specific to bruxism, or tooth grinding.
The TMJ mouthguard is made of hard plastic and is used to realign the jaw. This takes the pressure off the jaw and will help reduce TMJ symptoms. The bruxism guard depends on whether you severely grind your teeth or are just minimally clenching or grinding. Most bruxism guards are made from a soft, pliable plastic that will cushion your bite to reduce the pain from clenching your teeth. If you are a hardcore tooth grinder, your guard might be made of a harder, more durable plastic.
Two kinds of injections can help relieve TMJ pain: corticosteroids or Botox®. The steroids reduce pain and inflammation in the TMJ as well as treat chronic jaw pain. Botox®, being a neurotoxin, works by paralyzing the muscles in your jaw, thus preventing the clenching that causes symptoms. If you require medical interventions, injections are a good place to start. They are minimally invasive and have no real recovery time. Injections are only a temporary fix, however.
▪ Chiropractic care
The goal of chiropractic care for TMJ disorder is to realign the position of the jaw. Chiropractic care can be used along with dental treatment of bite problems to help alleviate pain and symptoms.
Using traditional and alternative medical techniques in complement with each other can decrease the severity of chronic pain. Besides chiropractic care, other popular methods to treat the pain of TMJ include acupuncture, acupressure, manual therapy, ultrasound therapy, and myofascial release.
Another TMJ treatment called Arthroscopy is more intensive but also a non-invasive medical treatment. Arthroscopy involves inserting a tiny fiber-optic camera into the temporomandibular joint. This lets an orthopedic surgeon see what is going on with the joint that may be causing symptoms. The camera can see issues that x-rays and scans might not. Arthrocentesis uses a small needle and syringe to drain fluid from the joint. They can then check the fluid for infection or something else that might be the cause of the joint swelling.
Surgical options are always a last resort. Always consult a doctor if you have a degenerative bone or disk problem. If the cause is structural, parts of your TMJ can be either repaired, repositioned, or in very severe cases removed and replaced. Get a second opinion if someone recommends surgery right away; the chances are good that you can alleviate many of your pain and symptoms by using other methods.
Tips to Reduce Symptoms of TMJ Disorder
Making a few simple changes in your daily life can help you manage TMJ without medical treatment. After all, up to 75% of adults experience TMJ pain at some point in their lives, and most of the time, pain and symptoms resolve without further treatment. There are two main purposes of at-home treatments. The first is to manage or relieve the pain, and the second is to deal with the rest of your symptoms, such as impeded movement, difficulty chewing, or the annoying and painful popping and clicking.
So, about that pain. Tooth and jaw pain is the worst. It can seem like there is no escape from it. Pain management begins with over-the-counter pain medication and anti-inflammatories, but it doesn't end there. Alternating heat and ice can reduce inflammation and increase beneficial blood flow in addition to taking an edge off the pain. Gentle stretching exercises and massages can help increase range of motion, making activities like eating a little less painful.
Dealing with the other symptoms of TMJ is as much about future prevention as it is managing current issues. Use the following ideas to do both:
Jaw exercises recommended by your dentist can strengthen muscles and restore motion.
Reduce stress by practicing mindfulness, meditation, and deep breathing; biofeedback can also help with this.
Don't over-work your jaw muscles; avoid sticky, chewy, or crunchy foods, don't bite your nails or chew on pens or pencils, and don't chew gum.
Avoid the same neck or jaw positions; changing up sleeping positions or where you watch tv can prevent over-taxation of one side of your jaw.
What to Expect in Your Appointment
You'll probably first talk about your TMJ symptoms with your family doctor or dentist. If suggested treatments don't provide enough relief, they may refer you to a doctor specializing in TMJ disorders. They will take a complete medical history to rule out chronic or acute illness or injury. Some questions to expect are:
When you first experienced the onset of symptoms
Whether you've experienced similar problems before
If your pain is constant or transient
Whether you have headaches or pain and stiffness in your neck or upper back
If any specific activity triggers the pain or makes it worse
Whether your jaw clicks or pops when you move it, and if movement causes pain
Your provider may do a manual exam to check your range of motion. If you choose chiropractic care with Natural Care Chiropractic, we will conduct imaging to ensure precise treatment. We use the Atlas Orthogonal method to treat TMJ; this method seeks to treat misalignment of the atlas (the C1 vertebra) with mild percussive waves, and the machines are targeted and calibrated specifically for individual patients.
The Atlas Orthogonal method does not use twisting, cracking, or popping; rather, it gently puts the atlas back into place, which realigns the spinal vertebrae and allows the muscles of the neck, shoulders, and back to return to normal.