Have you been told by a healthcare professional, whether it be a dentist or medical provider that you have “TMJ”? Actually we all have it, we actually have 2, a right and a left! “TMJ” stands for temporomandibular joint. When there is dysfunction in this joint system it is referred to as “TMD” or Tempromandibular Disorder/Dysfunction. There are a variety of disorders when it comes to this joint as well as a variety of causes. A dentist trained in this area of treatment can diagnose and treat these disorders.

A physical examination is typically the most effective way for your doctor to diagnose you with TMJ. Your physician will observe your jaw’s range of motion and feel your jaw as it opens and closes. By pressing gently on your temporomandibular joint and the surrounding areas, your doctor can identify areas of particular tenderness or pain. Digital imaging such a CT scan, x-ray, or MRI may be required to confirm your diagnosis or to further assess the severity of your condition. A dental x-ray can examine your jaw and teeth, while a CT scan can provide a more detailed picture of the bones and an MRI can reveal issues that may be present in the soft tissue.

The jaw joint or TMJ is unlike any other joint in your body. Not only does it hinge like your knee but it also translates down the boney eminence of you skull as you open wide. In between the skull bone and your lower jaw bone there is a cartilaginous disc that is held in place by ligaments and muscles. As you open this disc should stay in between the two bones but sometimes it can “click” out of place and back into place which is usually the noise one might hear or feel. Like other joints in the body it can also break down and experience degenerative disorders. These degenerative disorders can sound like crunch noises or sand like noises. It is important to seek a dentist with advanced training in the diagnosis and treatment of TMJ disorders to get the proper diagnosis.

Typically you should seek treatment when the disorder is painful, disrupting the function of it such as chewing or speaking and when it is interfering with the quality of your life. Dentists trained in the diagnosis and treatment of TMD call this “PDQ”-pain, disfunction and quality of life. If you suspect your have a jaw joint disorder and are concerned it may get worse and cause “PDQ” then you should seek an evaluation by a dentist who has had additional training in TMJ disorders to make sure there are not other causes contributing to it. Other causes may be cervical spine issues, sleep apnea, certain medications that cause bruxism, or stress.

First, it is important to seek out a dentist who has had additional training and focus in the diagnosis and treatment of jaw joint disorders. In general, dental school does not prepare graduates well in this area. For those doctors who have completed additional training, most start with conservative treatment. It is important to determine the proper diagnosis and then treat based on the diagnosis. The use of splint therapy along with physical or message therapy would be one form of conservative treatment. The splint, or orthotic, allows the jaw joints to rest in a neutral position, providing biofeedback for muscle relaxation. Depending on the issue your doctor will see you every few weeks to adjust the orthotic as your joint heals. The use of physical therapy or message therapy modalities allow for the release of tense muscles, strengthening of supporting muscles and additional biofeedback. Together the orthotic and therapy provide the best conservative approach to treatment of TMD. Surgery should be reserved as a last course of treatment.

Yes! If your jaw joint use to click and pop but then it “catches” and either you can’t open or can’t close all the way this can be alarming and if not evaluated and treated can cause long term issues. A dentist trained in TMD treatments can often time work to “unlock” the jaw joint with use of splint therapy and or injections of the jaw joint. The earlier the “lock” is evaluated and treated the better the long-term prognosis for it to remain “unlocked” for the future.

If TMD is left untreated, it can lead to chronic issues that will persist throughout your life. If your TMJ disorder causes you to clench or grind your teeth, it can lead to tooth erosion and chronic migraines. You may also develop worsening issues inside the joint that could cause permanent difficulty opening and closing your mouth. By finding an experienced TMJ doctor, you will ensure that anatomic anomalies are corrected, and you can enjoy the benefits of a healthier jaw alignment and appropriate movement when talking and eating.

The answer is unfortunately no. Dental insurance routinely does not cover TMJ treatments. It may cover a traditional night guard, but these flat night guards do very little to support a temporomandibular joint disorder. Sometimes medical insurance will cover such things as exams, imaging and referrals for physical therapy. Again, a dentist trained in this area will be able to work with your medical insurance so that out of pocket costs are minimized as much as possible. For treatments not covered by insurance most doctors offer affordable payment options to assist you in getting the treatment you need to get out of pain.