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TMJ and Splint Therapy


The "Temporomandibular Joint," more commonly referred to as the "jaw joint," assists in the basic opening and closing movements of the jaw. Unfortunately, this joint is a common area for recurring pain. Although conventional wisdom suggests that "popping" sounds in the jaw indicates a TMJ dysfunction, this is not always true. Many times, your jaw is functioning properly even if a "popping" sound is present when chewing or talking.


We offer a TMJ exam that evaluates the joint tissue in the "hinge" of the jaw. Possible problems include swelling, deterioration of the joint tissue or damaged joint tissue (which cushions the jaw bones during the opening and closing movement of the mouth). Common pain relievers and cold compresses can provide temporary relief for most cases of TMJ. 


For more serious cases of TMJ, we will recommend alternate treatments. Often, we will suggest using a mouth guard to relieve teeth grinding. In some cases, we will instruct you to use orthodontic appliances or retainers to alleviate discomfort or redirect positioning of the TMJ joint. For the most severe cases of TMJ, we may recommend certain invasive procedures.


What is TMJ Dysfunction?

Many people suffer from dizziness, earaches, face, head, neck, shoulder and back pain, without knowing the cause of their pain. Previously, many patients seeking medical cures for these types of problems were told it was "all in their mind." They would go from "specialist" to "specialist" seeking a cure. Today, however, it is now known that a condition termed TMJ (temporomandibular joint) syndrome accounts for a large number of these previously uncured and painful ailments. Correcting the problem rather than the symptom is at the heart of TMJ treatment. With new knowledge and technology, dentists and orthodontists are able to treat and diagnose TMJ problems, which previously have been overlooked. Additionally, the medical profession is becoming more aware of dentistry's involvement and physicians are referring patients to dentists knowledgeable in TMJ treatment.


Malocclusion and the TMJ

Your jaw joint, which holds your lower jaw in place, is suspended beneath your skull by an intricate system of muscles and tendons. The jaw joints, also known as the temporomandibular joints (TMJ), are some of the most complex in the body. The jaw joint, surrounding muscles, and the fit of your teeth are closely interrelated, each affecting the other as you make everyday jaw movements such as speaking and chewing. The way your teeth fit together is called occlusion. When your teeth are not in proper relation to each other and to your jaw joints, the jaw automatically shifts to a new position in an attempt to compensate for the misalignment of your teeth-a condition known as malocclusion (teeth do not fit together properly).


Diagnosing the Problem

Before prescribing the proper treatment for your particular problem, a variety of diagnostic procedures may be necessary. A radiograph (tomography) may be taken of your jaw joint. This provides a clear picture of your own particular TMJ anatomy and position of the various structures within the jaw joint. The visual radiograph is also used as a means for detecting disease in the jaw joint.

Jaw repositioners (splint) may be used. These appliances are worn for a given period of time. The appliance is refined and adjusted until it eliminates the bite disharmony and pain. In this way, the bite need not be permanently altered until the problem is accurately diagnosed via the splint and other procedures. Permanent treatment would then be prescribed to duplicate the effects of the appliance, e.g. equilibration or occlusal adjustment, orthodontics, orthognathics, restorative procedures such as crowns or a combination of some or all of these.


In order to study the relationship of the patient’s teeth and joints, it is necessary to see how the joints guide the jaw without interference from the reflexes and muscles, which are always accommodating to the fit of the teeth. To do this a record is taken measuring the relationship of the teeth to the jaw. Once this record of the joint guidance is taken, it can be reproduced on an instrument called an articulator, which simulates your own particular jaw movements and bite relationship. Then without interferences from reflexes and muscles, the bite can be studied for disharmonies and other interferences.


The Splint Appliance

The splint Orthotic appliance is not only used in diagnosis, but is also used as a treatment device to temporarily eliminate the bite disharmony and resulting pain. The splint, when properly adjusted, will position the jaw joints in a stable position. Proper diagnosis and treatment planning can then be achieved.

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