TMJ and TMD Treatment     

How do you know if you have a problem with your TMJ? (This is commonly known as TMD, or Temporo-Mandibular Dysfunction)

Symptoms could include:

• Jaw pain
• Headaches
• Noises coming from the joint, including clicking or popping
• Pain in the ear
• Pain in the face
• Ringing in the ears (tinnitus)
• Pain or spasm in the neck or shoulder muscles
• Shortened teeth from grinding
• Inability to open very wide
• A change in your bite

Drug-induced TMD:

In the last few years, research has shown that Selective Serotonin Reuptake Inhibitor (SSRI) medications such as Prozac, Paxil, Zoloft, and Celexa may cause clenching and grinding of the teeth in patients who have never done this before and will increase these behaviors (both frequency and intensity) in those known to clench or grind their teeth. This side effect is relatively unknown to physicians, although we continue to educate them when we can. If your jaw pain / headache symptoms started a few weeks to a month or two after you started taking one of these medications, we would suggest you alert your physician to this, as the symptoms could well be related to the drugs.

Treatment in our office could include:

• Splint therapy
• Iontophoresis (supplying medication through the skin at the area of pain)
• TENS therapy (transcutaneous electrical nerve stimulation)
• Orthotic
• Acupuncture

How could you be treated at 21st Century Dental?

When a diagnosis of TMD has been made, the first step in therapy might be to relax and medicate the muscles which are in a state of hyperactivity, fatigue or in spasm. This is done with TENS, acupuncture and/or iontophoresis.

TENS uses a minute electrical current to massage and relax the facial muscles. Feeling a series of rhythmic taps on the cheeks, patients can read, watch TV, listen to music on headphones or take a nap during the therapy.

An Orthotic is often used after TENS treatment to hold the relaxed jaw in the most natural and unstrained position. This can be worn for 3 months to a year, depending on whether it is a removable orthotic or one that is fixed to the lower teeth. Once it is established that your bite would best be permanently positioned in the new location, a decision is made whether or not orthodontics, restorative dentistry or simply coronoplasty is used.

Acupuncture uses the same electrical current as TENS, but employs the use of tiny, painless needles at strategic points. It proves beneficial when the spasm is deeper in origin.

Iontophoresis also uses electricity, but it incorporates the use of medications (epinephrine, xylocaine and most importantly, the anti-inflammatory drug dexamethasone). Iontophoresis is based on the principle that like charges repel. With a direct current, an electrical charge can be applied to an ion of a drug with the same charge and the drug ion will be pushed away through the skin.

Splint therapy can be used after the musculature is in a more relaxed state using one of the above techniques, or as a first line treatment. This can be the final answer, and in some cases, a realignment of teeth or jaws is needed, depending on the patient.