What is TMJ?
TMJ a type of oral facial pain stands for the temporomandibular joint, which is made up of a disk separating the lower jaw from the fixed upper jaw. It is also a complex area a few millimeters in front of the ear canal and a passageway for many of the nerves and blood vessels to the head and neck. When this joint is injured, inflamed or when the disk is not staying between the jaws, headaches, muscle spasms, ringing in the ears, and difficulty eating are a few of the problems that can result.
WHAT CAN YOU THE PATIENT DO?
As we begin to treat your temporomandibular joint muscle dysfunction, our success will depend in large part upon the way you treat these injured areas. By following these guidelines, even without drugs or appliances, some significant relief can occur.
- Keep your teeth apart. During times of occupational, marital, or academic stress, and also while waiting to fall asleep at night, say to yourself, “Lips together, teeth apart.” over and over.
- Avoid opening your mouth any wider than the thickness of your thumb (1/2-inch) for the next few weeks. Therefore, cut your food into small bite size pieces. When yawning, catch your jaw with your hand as in covering your mouth to limit the opening.
- Give your mouth a rest. No gum chewing, biting yours lips or cheeks, clenching teeth, chewing peanuts, ice cubes or any other substance that is repeatedly milled between your back teeth such as a hard crust of bread.
- Sleep on your back or side. Do not sleep on your stomach.
- Do not lift anything more than 10 lbs. or do any strenuous work. Get rid of heavy shoulder bags or briefcases. Your jaw does not work as a separate unit. Your neck and upper back affect this area.
- Avoid or cut down on caffeine, fats, and sugars. The chemicals and acids produced in the digestion of these products can aggravate your situation.
- For temporary relief of pain, as a general rule, use heat for a muscle problem and ice for a joint problem. For a “TMJ” problem, if the pain is right in front of your ear, that is probably joint related. If the pain is in the cheek area, it is probably muscular. The procedure would be 15 minutes on and 15 minutes off as often as you can or you can alternate the heat and ice.
Treating TMJ problems is like peeling an onion, i.e.; you must eliminate many different layers of the problem before coming to a definite solution or solutions. Even with sophisticated radiographic techniques, CAT scans, and even MRI’s, there is no way a completely accurate picture of the TMJ can be obtained. Therefore, the doctor must use all the modern diagnostic techniques available, consultation with other doctors, and his clinical skill to solve the problem.
We may refer you back to your physician to rule out any other physical and/or organic problems. Sometimes treatment may be as simple as how you sleep, sit, or work. If drugs are used, it is generally for a short period of time. Only reversible techniques are utilized to diagnose and treat the problem before any final decision is made.
Generally, one or more intraoral appliances similar to a mouth guard are constructed to obtain and maintain the correct relationship between the disk and jaws. Once the symptoms are relieved, and the patient is comfortable, final treatment decisions must be made. Treatment for many may be just staying in the appliances at night and modifying daily activities. Rarely are irreversible procedures such as braces, crown and bridge work or shaping of the teeth needed. Surgery is a last resort.
Treatment for this type of oral facial pain, as well as the decisions as to what type treatment, requires the teamwork of patient, physician and the dentist.
Sylvan S. Mintz, DDS, MScD