Posts for tag: tmj disorders
Chronic jaw pain can be an unnerving experience that drains the joy out of life. And because of the difficulty in controlling it patients desperate for relief may tread into less-tested treatment waters.
Temporomandibular disorders (TMDs) are a group of conditions affecting the joints connecting the lower jaw to the skull and their associated muscles and tendons. The exact causes are difficult to pinpoint, but stress, hormones or teeth grinding habits all seem to be critical factors for TMD.
The most common way to treat TMD is with therapies used for other joint-related problems, like exercise, thermal (hot and cold) applications, physical therapy or medication. Patients can also make diet changes to ease jaw function or, if appropriate, wear a night guard to reduce teeth grinding.
These conservative, non-invasive therapies seem to provide the widest relief for the most people. But this approach may have limited success with some patients, causing them to consider a more radical treatment path like jaw surgery. Unfortunately, surgical results haven't been as impressive as the traditional approach.
In recent years, another treatment candidate has emerged outside of traditional physical therapy, but also not as invasive as surgery: Botox injections. Botox is a drug containing botulinum toxin type A, which can cause muscle paralysis. Mostly used in tiny doses to cosmetically soften wrinkles, Botox injections have been proposed to paralyze certain jaw muscles to ease TMD symptoms.
Although this sounds like a plausible approach, Botox injections have some issues that should give prospective patients pause. First, Botox can only relieve symptoms temporarily, requiring repeated injections with increasingly stronger doses. Injection sites can become painful, bruised or swollen, and patients can suffer headaches. At worst, muscles that are repeatedly paralyzed may atrophy, causing among other things facial deformity.
The most troubling issue, though, is a lack of strong evidence (outside of a few anecdotal accounts) that Botox injections can effectively relieve TMD symptoms. As such, the federal Food and Drug Administration (FDA) has yet to approve its use for TMD treatment.
The treatment route most promising for managing TMD remains traditional physical and drug therapies, coupled with diet and lifestyle changes. It can be a long process of trial and error, but your chances for true jaw pain relief are most likely down this well-attested road.
If you would like more information on treating jaw disorders, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “Botox Treatment for TMJ Pain.”
Chronic pain affects the quality of life for an estimated 50 million adults in the U.S. alone. The American Chronic Pain Association designates September as “Pain Awareness Month” to highlight the many conditions that cause chronic pain and strategies to manage them. Among these are conditions that can involve your oral or facial health. Here are two painful mouth and face disorders and what you can do about them.
Temporomandibular Joint Disorder (TMD). TMD is a common condition often seen in the dental office. The temporomandibular joints connect the lower jaw to the skull and facilitate activities like eating or speaking that require jaw movement. If they and their associated muscles become inflamed, this can trigger debilitating chronic pain. If you suffer from TMD symptoms, make sure we know about it so we can make your dental visits as comfortable as possible.
When possible, avoid irreversible and invasive treatments for TMD that may permanently change your bite, such as surgery or having teeth ground down. Instead, most healthcare professionals recommend a more conservative approach. Try the following tips to alleviate TMD pain:
- Eat soft foods so you do not aggravate the jaw joint.
- Avoid extreme jaw movements like suddenly opening your mouth very wide.
- Use ice packs and moist heat to relieve discomfort.
- Ask us about jaw exercises to stretch and relax the jaw.
- Practice stress-reduction techniques, such as meditation, yoga, tai chi or taking short walks to clear your mind.
Burning Mouth Syndrome. The sensation that the mouth has been burned or scalded without an obvious cause is most common among women during menopause. While researchers can’t yet pinpoint clear causes for it, the list of suspects includes hormonal changes, neurological or rare autoimmune disorders or medication-induced dry mouth.
The first step to treatment is an oral exam along with a complete medical history to identify any possible contributing factors. Depending on the results, we can offer recommendations to manage your symptoms. The following tips often help:
- Keep your mouth moist. We can recommend an artificial saliva product or medication to increase saliva flow if needed.
- Change your toothpaste if it contains irritating ingredients.
- Identify and avoid foods and beverages that seem to precede an episode. These may include spicy foods, coffee and alcoholic beverages.
- Quit smoking, as this is often linked to burning mouth episodes.
The pain and discomfort caused by these and other oral conditions can put a dent in your life. A visit to your dentist, though, could be the first step to finding relief.
If you would like more information about oral conditions that produce chronic pain, please contact us or schedule a consultation. To learn more, read the Dear Doctor magazine articles “Seeking Relief From TMD” and “Burning Mouth Syndrome.”
If you have chronic jaw pain, you may be one of an estimated 10 million Americans suffering from temporomandibular joint disorders (TMD). If so, it's quite possible you're also coping with other health conditions.
TMD is an umbrella term for disorders affecting the temporomandibular (jaw) joints, muscles and adjoining tissues. The most common symptoms are limited jaw function and severe pain. Determining the causes for these disorders can be difficult, but trauma, bite or dental problems, stress and teeth clenching habits seem to be the top factors. Women of childbearing age are most susceptible to these disorders.
In recent years we've also learned that many people with TMD also experience other conditions. In a recent survey of TMD patients, two-thirds reported having three or more other health conditions, the most frequent being fibromyalgia, chronic fatigue syndrome, rheumatoid arthritis or chronic headaches. Researchers are actively exploring if any systemic connections exist between TMD and these other conditions, and how these connections might affect treatment changes and advances for all of them including TMD.
In the meantime, there remain two basic approaches for treating TMD symptoms. The most aggressive and invasive approach is to surgically correct perceived defects in the jaw structure. Unfortunately, the results from this approach have been mixed in their effectiveness, with some patients even reporting worse symptoms afterward.
The more conservative approach is to treat TMD orthopedically, like other joint problems. These less invasive techniques include the use of moist heat or ice to reduce swelling, physical therapy and medication to relieve pain or reduce muscle spasming. Patients are also encouraged to adopt softer diets with foods that are easier to chew. And dentists can also provide custom-fitted bite guards to help ease the stress on the joints and muscles as well as reduce any teeth grinding habits.
As we learn more about TMD and its relationship to other health conditions, we hope to improve diagnosis and treatment. Until then, most dentists and physicians recommend TMD patients try the more conservative treatments first, and only consider surgery if this proves unsatisfactory. It may take some trial and error, but there are ways now to ease the discomfort of TMD.
If you would like more information on the causes and treatments of TMD, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “Chronic Jaw Pain and Associated Conditions.”
If you suffer from a temporomandibular (“jaw joint”) pain disorder (TMD), you know any activity involving jaw movement can be uncomfortable. That includes eating.
But avoiding eating isn’t an option—which means you may be attempting to minimize discomfort during flare-ups by choosing soft, processed foods that don’t require a lot of jaw force. While this may certainly ease your TMD symptoms, you might also be cheating your health by eating foods not optimally nutritious.
It doesn’t have to be a trade-off: with a few simple techniques you can still eat whole, natural foods while minimizing jaw joint pain. Here are 3 tips for making mealtime less stressful during TMD flare-ups.
Cut food into manageable bite sizes. Preparing your food beforehand will make a big difference in how much effort your jaws exert as you eat. Make sure all your food portions of vegetables, fruits or meats are cut or prepared into small, manageable bite sizes. It also helps to remove the tough outer skin of some fruits and vegetables or to mash other foods like potatoes or beans.
Use cooking liquids to soften food. For foods that aren’t naturally moist, you can add liquids to soften them and make them easier to chew. Incorporate gravies, sauces or marinating liquids into your meal preparation to help soften tougher foods like poultry, meats or some vegetables.
Go easy with your chewing and biting motion. The strategy here is to minimize jaw movement and force as much as possible. While preparing your food as mentioned before will help a lot, how you bite and chew will also make a big difference. Limit your jaw opening to a comfortable degree, take small bites and chew slowly.
Managing a jaw joint disorder is an ongoing process. When practiced together with other treatments like therapy or medication, eating deliberately can help make life with TMD easier.
If you would like more information on coping with jaw joint disorder, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “What to Eat When TMJ Pain Flares Up.”
After ruling out other possibilities for your constant jaw joint pain, your doctor has diagnosed you with a temporomandibular disorder (TMD). Now that you know what you have, what can you do about it?
Unfortunately, it's not always an easy answer. Ideas about treatment are almost as numerous as theories on the causes of TMD. By and large, though, we can classify treatment into two broad categories: conservative and aggressive.
The conservative approach is the result of many years of experimentation and application; it's also much less invasive than aggressive treatments. For most patients, though, these treatments can offer significant relief from pain and dysfunction.
Conservative treatments are based primarily on the philosophy that the temporomandibular joint is like any other joint, and should be treated that way. Treatments include thermal therapies like ice or heat packs applied to the jaw, physical therapy (gentle stretching, jaw exercise, and massage) and pain and muscle relaxant medication. In cases where teeth grinding may be a contributing factor, we might recommend a bite guard worn in the mouth to reduce biting pressure.
On the other end of the spectrum are treatments like altering the bite or the position of the jaw. The purpose of bite alteration is to change the dynamic when the jaws are in contact during chewing or clenching, and reduce pressure on the joints. This is often done by reshaping the teeth's biting surfaces, moving the teeth with orthodontics or performing crown and bridgework. Another possibility, actually modifying the lower jaw location, requires surgery. All of these aggressive treatments are done in order of less to more invasiveness.
These more aggressive treatments, especially jaw surgery, are irreversible. Furthermore, studies on results have not been encouraging — there's no guarantee you'll receive relief from your symptoms. You should consider the aggressive approach only as a last resort, after you've tried more conservative measures. Even then, you should get a second opinion before undergoing more invasive procedures.
Hopefully, you'll see relief from therapies that have made a significant difference for most TMD sufferers. And that's our goal: to reduce your pain and dysfunction and help you regain your quality of life.
If you would like more information on TMD causes and treatments, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “Seeking Relief from TMD.”