TREATMENT TMJ DISORDERS

For most patients, treatment is divided into two phases

Phase I Diagnostic Phase

This phase is designed to properly diagnose the patient's problem and to try to reduce the signs and symptoms of the dysfunction. The diagnosis is made using the TMJ health questionnaire, range of motion measurements, palpatation of the muscles of the head and neck, postural evaluation, psychological assessment, x-rays of the TM joints (tomograms), various other x-rays of the head and neck area, Joint Vibration Analysis to assess the severity of the TM joint noises, medical and dental history, and an examination of the teeth and the dental arches and cranial examination.

The important aim or correcting your bite is to insure optimal long-term health.

If you have any of the signs or symptoms mentioned in this section, discuss them with your dentist.

Your health is your most priceless possession.

It is worth the investment!

• TMJ Function
• The TMJ Appliance by Myofunctional research co

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If there is an improper relationship between the upper and lower jaws and/or the upper and lower teeth, the patient will be required to wear temporary oral appliances (orthotic or splint). This TMJ splint is usually worn over the lower teeth until the bite and position of the lower jaw is stabilized. The objective of the lower splint is to try and establish the correct position of the mandible to the maxilla in three dimensions; namely, transverse, sagittal and vertical. The goal is to ry and find a combrotrable position for the lower jaw so that the patient can get some relief for the pain and muscle spasms. If the patient has a denture or a partial denture, the splint may be constructed over them similar to the method with natural teeth.

TMJ TREATMENT

Since most head, neck and shoulder pain originates from muscle instability or swelling and inflammation of the joints, we may employ various physical modalities to treat and help normalize these structures. This includes such things as trans cutaneous electrical nerve stimulation (TENS), moist heat therapy, vapour coolant sprays, and infrared treatments. These joints often get very tight in people with dysfunctions and various types of mobilization or stretching techniques are employed to gain normal function of these tissues.

Sometimes it will be necessary to refer patients to other health care practitioners to help relieve some of the muscle spasms including chiropractors, massage therapists, physical therapists, cranio-sacral therapists, etc. The patient must be made aware of the fact that , although the majority of patients do improve substantially, there are still a small number of patients whose treatment is not effective. The longer the disc is out of position anteriorly, the more the posterior ligaments to reposition the disc to its correct position on the head of the condyle. Some of these patients may have suffered traumatic injuries such as a blow to the head or have been involved in a car accident which caused a whiplash injury. If the posterior ligaments which help position the disc between the condyle and the temporal bone have become stretched or torn as a result of a serious injury, then the prognosis for successful treatment is diminished. Obviously, the sooner the patient can be treated, the higher the success rate.

Near the end of Phase 1, which usually lasts six months, the clinician and the patient will evaluate the success of the treatment. The patient will take the same diagnostic tests, clinical examinations, and fill out the appropriate TMJ progress report to see what improvement there is in the signs and symptoms of TM dysfunction. If the tests including the Joint Vibration Analysis and the tomograms (TMJ x-rays) reveal that the condyle is related properly to the glenoid fossa of the temporal bone and the disc has been restored to its proper position, then we would assume there would be a reduction of the signs and symptoms. A consultation appointment is held with the patient to discuss the success of Phase I and the various options for Phase II.

Phase II Treatment Phase - Jaw Stabilization

Since the teeth, jaw joints and muscles can all be involved, treatment for this condition varies, Typically, treatment will involve several phases. The first goal is to relieve the muscle spasm and pain. Then, your dentist must correct the way the teeth fit together. Often a temporary device known as an orthotic or splint is worn over the teeth until the bite is stabilized. Permanent correction may involve selective reshaping of the teeth, building crowns on the teeth, orthodontics or a permanent appliance to lay over the teeth. If the jaw joint itself is damaged, it must be specifically treated. Though infrequent, surgery is sometimes required to correct a damaged joint. Ultimately your dentist will stabilize your bite so that the teeth, muscles and joints all work together without strain.

The important aim or correcting your bite is to insure optimal long-term health. If you have any of the signs or symptoms mentioned, discuss them with your dentist. Your health is your most priceless possession. It is worth the investment!