TMJ Disorders

Dr. Colgan has extensive experience with the management of facial pain and will tailor each treatment to the individual patient. Again, surgery on the joint is often not required. In rare instances TMJ replacement surgery (not unlike hip replacement surgery) is required.

TMJ (temporomandibular joint) disorders are a family of problems related to your complex jaw joint. If you have had symptoms like pain or a "clicking" sound, you'll be glad to know that these problems are more easily diagnosed and treated than they were in the past. Since some types of TMJ problems can lead to more serious conditions, early detection and treatment are important.

No one treatment can resolve TMJ disorders completely and treatment takes time to be effective. Dr. Colgan can help you have a healthier and more comfortable jaw.

Trouble with Your Jaw?

TMJ disorders develop for many reasons. You might clench or grind your teeth, tightening your jaw muscles and stressing your TM joint. Or, you may have a damaged jaw joint due to injury or disease. Whatever the cause, the results may include a misaligned bite, pain, clicking or grating noises when you open your mouth, or trouble opening your mouth wide.

Do You Have a TMJ Disorder?

• Are you aware of grinding or clenching your teeth?
  
• Do you wake up with sore, stiff muscles around your jaws?
  
• Do you have frequent headaches or neck aches?
  
• Does the pain get worse when you clench your teeth?
  
• Does stress make your clenching and pain worse?
  
• Does your jaw click, pop, grate, catch, or lock when you open your mouth?
  
• Is it difficult or painful to open your mouth, eat or yawn?
  
• Have you ever injured your neck, head or jaws?
  
• Have you had problems (such as arthritis) with other joints?
  
• Do you have teeth that no longer touch when you bite?
  
• Do your teeth meet differently from time to time?
  
• Is it hard to use your front teeth to bite or tear food?
  
• Are your teeth sensitive, loose, broken or worn?
  

The more times you answered "yes," the more likely it is that you have a TMJ disorder. Understanding TMJ disorders will also help you understand how they're treated.

Treatment

There are various treatment options that Dr. Colgan can utilize to improve the harmony and function of your jaw. Once an evaluation confirms a diagnosis of TMJ disorder, Dr. Colgan will determine the proper course of treatment. It is important to note that treatment always works best with a team approach of self-care as well as professional care.

THE TEMPOROMANDIBULAR JOINT, or (TMJ) is a small joint located in front of the ear where the skull and the lower jaw meet. This joint allows the lower jaw (mandible) to move and function, and is the most constantly used joint in the body. The TMJ is a "ball and socket" joint, and the round end, or "ball" portion, is called the condyle; the socket is called the articular fossa. Between the condyle and the fossa is a disc made of cartilage that acts as a cushion to absorb stress and allows the condyle to easily move when the mouth opens and closes.

At the back of the joint, the disc attaches to tissue that contains nerves and blood vessels and can be quite sensitive. Ligaments hold the disc and condyle in place, and muscles surrounding the TMJ also help stabilize the joint as well as move the lower jaw during chewing, speaking, and other functions.

The teeth themselves are also important for proper TMJ function, because if they don't fit together properly, stresses can be generated that can displace the condyle and damage the disc, ligaments and muscles. Trauma can also damage the TMJ and inhibit proper function.

When all of the elements of the TMJ are in harmony and working properly, the joint operates smoothly and without problems. However, TMJ disorders can develop if these elements are not functioning as they should, or if stresses, trauma or other factors generate TMJ problems.

TMJ DISORDERS can be relatively minor, or they can be extremely painful and potentially debilitating. Emotional stress, with attendant habits such as grinding or clenching the teeth, can trigger TMJ symptoms as well as muscle spasms around the joint and jaws. Malpositioned jaws also may trigger TMJ problems and, in some cases, arthritis may be the cause of TMJ disorders. Injury, such as a blow to the chin or jaw, can displace the condyle or disc, thus causing problems. In some cases of TMJ disorder, the disc is displaced, which interferes with its ability to properly interface between the "ball" and "socket." The sensitive layer of tissue behind the disc becomes the cushion, and the result is tenderness and pain in the joint. In some cases the disc may move so far forward that the mouth cannot be widely opened. This condition can cause degenerative joint disease, a form of arthritis involving the bones of the joint.

TMJ SUFFERERS CAN DISPLAY A VARIETY OF SYMPTOMS, and certain signs may indicate the potential for TMJ disorders to develop. Following are signs and symptoms that are possible in patients with TMJ problems:

• painful clicks or pops in the joint when opening or closing the mouth
  
• a habit of tooth grinding or clenching
  
• sore jaw muscles when awakening
  
• difficulty in opening the mouth fully
  
• frequent headaches or neck aches
  
• pain in TMJ area
  
• locking of the jaw

Presence of some of these signs and symptoms could also indicate a specific type of disorder known as myofacial pain dysfunction syndrome or MPD. This disorder is accompanied by muscle pain and tenderness, limitation in range of jaw motion, and local pain usually limited to one side of the face. Dr. Colgan can diagnose this disorder when evaluating your need for TMJ treatment.

IN THE TREATMENT OF TMJ DISORDERS you will be working in partnership with Dr. Colgan and in some cases an orthodontist or restorative dentist. It is important to know that most types of TMJ disorders can be treated, in whole or at least in part, by "self-care" and specific changes in lifestyle on your part. Other problems, in addition to self-care techniques, require more extensive therapy, sometimes including surgery.

THE TMJ is the most constantly used joint in the body, and if a TMJ disorder exists it can make the simplest acts of eating, talking or even yawning extremely painful. If you suspect a TMJ disorder or have any of the above signs or symptoms associated with your TMJ, please call Vero Beach Surgical Arts to set up a consultation appointment to discuss your problem.

From "A Patients Guide to TMJ Disorders,"1994, American Association of Oral and Maxillofacial Surgeons