How a TMJ Dentist Treats Jaw Pain and How The OPPERA Findings Relate

As a TMJ dentist, we are asked on a frequent basis what causes TMJ.  In our experience, patients that are going through a stressful situation are more likely to experience the condition as are those that regularly eat things that are difficult to chew.  In the case of high stress, people tend to clench their jaw and grind their teeth while sleeping.  This puts enormous amounts of pressure on the temporomandibular joint, resulting in irritation or pain in the morning.  In its most basic instances, this may cause a headache or sore jaw but as the condition worsens some people are not able to open their mouth in the morning.  Since TMJ doesn’t happen overnight, there are clear warning signs so if you are aware of basic discomfort, we recommend visiting our office for early treatment.

Medical science has been unable to identify all of the causes of TMJ and, as a result, a study is ongoing titled OPPERA.  The study was launched in 2006 by Dr. William Maixner and Dr. Gary Slade and has followed 2,737 healthy men and women between the ages of 18 and 44.  In this study, they have followed up with participants to monitor how many have since experienced the condition.  The results have found an average of four percent of participants start experiencing TMJ on an annual basis.  This ranges from mild to severe cases, and they have found that those with mild TMJ don’t necessary go on to experience acute levels.   As a TMJ dentist, we prefer to treat the condition immediately because we have seen how clearly it works in preventing escalation.

Researchers are still looking into what all of the causes of TMJ are and one interesting finding is that those with heightened somatic awareness are more likely to suffer from the condition.  Somatic awareness is what scientist have labeled as an awareness of both internal and external factors.  For example, those that are more aware of smells, hot, cold, wind, etc. may have a heightened somatic awareness. This also applies to people that are more aware of internal irritations like a stomach ache or joint pain, in general.  Dr. Slade stated that it "is probably capturing some basic survival sensations.”  As a TMJ dentist, this was intriguing to us because it provides some information that our patients can take action on.  If, for example, you are more sensitive to environmental factors or find that a regular headache is more intense for you than a family member – you should visit us on the first onset of jaw pain.  Since those with heightened somatic awareness appear to be more aware of everything, failing to treat TMJ early may result in unnecessary discomfort.

If you do have TMJ, we will treat it by making an impression of your mouth and having a removable oral appliance created in a dental lab.  This device will surround both the upper and lower teeth, connecting them and preventing grinding and clenching at night.  This provides relief from pressure that can in turn reduce or eliminate your symptoms.

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A TMJ Dentist Can Treat Your Jaw Pain Using These Procedures

As a TMJ dentist, there are several procedures we can recommend to help alleviate any pain or discomfort you feel in your jaw.  TMJ will affect somewhere between twenty and thirty percent of the entire population of the United States. While there have not been any comprehensive nationwide studies done, smaller studies show that only chronic back pain causes more distress on a national scale. As a matter of fact, tooth pain is the only condition that causes more facial distress than TMJ. Over 15% of all TMJ cases that go untreated and will become chronic, which often requires surgical intervention to correct. Considering that only about two-thirds of all people who have TMJ seek out the medical attention they need, this is a large gap in education that must be provided to the general public about this condition. 

Understanding TMJ is a little bit harder than understanding a single condition diseases. This is because TMJ is a symptom complex, meaning that it is a series or group of symptoms that may have multiple causes and unfortunately multiple ways of treating those causes. All of this has lead to a level of confusion about the condition and how to best treat it. What is not in dispute is the importance of treating TMJ before it escalates and becomes chronic, a condition that could affect a person’s jaw movement and hence hinder chewing, yawning, and talking. 

As a TMJ dentist, we prefer to treat the condition right away using a non-surgical, non-invasive method.  One of the main causes of TMJ is grinding and clenching teeth at night.  We make it impossible for teeth to touch so that they cannot clench.  This is done by wearing a removable oral appliance that looks like a full retainer.  It is connected and prevents the teeth from clenching.  It is a simple step to take because you only need to wear it before going to bed and take it out again in the morning.  While easy to do, this should alleviate many of your symptoms and soreness.  Once chronic TMJ sets in, there are three main options for treatment. 

Arthrocentesis is the most minor of the procedures that a TMJ dentist can use to clean the damaged tissue and treat TMJ. Usually, this treatment is recommended when a patient has no prior history of TMJ and is suffering from locked jaw as a result of the condition. The needle can be inserted into the joint to flush or clean out the joint. Any damaged tissue can then be removed with a special tool, and ultimately unstick the joint. All of this is done under general anesthesia, but the procedure has minimal recovery time and no risk of scarring or nerve damage. 

Arthroscopic surgery is a little more complex and involves making a small incision under the ear of the patient. Arthroscopic surgery relies on specialized tools, with a camera and flashlight attached that are inserted into the patient and give the orthodontist a clear view of the jaw. Seeing the areas of damage magnified on a video screen, allows the surgeon to remove any damaged tissue and align the disc as necessary. This surgery is also performed under general anesthesia and is considered to be minimally invasive. The risk of infection, scarring, and nerve damage are also greatly reduced as is the amount of time recommended for recovery. 

If you are currently experiencing jaw or joint pain, call and schedule an appointment with a TMJ dentist.