TMJ Disorders | Oral & Facial Surgery in Auburn and Sumner, WA

TMJ (temporomandibular joint) disorders are a family of problems related to your complex jaw joint. TMJ stands for Temporomandibular Joint, which is the name for each joint (right and left) that connects your jaw to your skull. Since some types of TMJ problems can lead to more serious conditions, early detection and treatment are important. If you have symptoms like pain with chewing or "locking" of the jaw joints, you may have a TMJ disorder. These symptoms occur when the joints of the jaw and the chewing muscles do not work together correctly. Occasional painless clicking and popping of the jaw joints can be a normal finding and does not usually require intervention.

What causes TMJ disorders?

TMJ disorders develop for many reasons. You might clench or grind your teeth, tightening your jaw muscles and stressing your joints. You may have a damaged jaw joint due to injury or disease. Injuries and arthritis can damage the joint directly or stretch or tear the muscle ligaments. As a result, the disk, which is made of cartilage and functions as the “cushion” of the jaw joint, can slip out of position. Whatever the cause, the results may include a misaligned bite, pain, clicking or grating noises when you open your mouth, or trouble opening your mouth wide.

Treatment

There are various treatment options that can be utilized to improved the harmony and function of your jaws. Once an evaluation confirms a diagnosis of TMJ disorder, Dr. Molen will determine the proper course of treatment. It is important to note that treatment always works best with a team approach of self-care joined with professional care.

The initial goals are to relieve the muscle spasm and joint pain. This is usually accomplished with a pain reliever, anti-inflammatory or muscle relaxant. Steroids can be injected directly into the joints to reduce pain and inflammation. Self-care treatments can often be effective as well and include:

Resting your jaw
Keeping your teeth apart when you are not swallowing or eating
Eating soft foods
Over-the-counter anti-inflammatories
Applying ice and heat as directed
Stretching your chewing muscles as directed
Practicing good posture

Stress management techniques such as biofeedback or physical therapy may also be recommended, as well as a temporary, clear plastic appliance known as a splint. A splint or nightguard fits over your top or bottom teeth and helps keep your teeth apart, thereby relaxing the muscles and reducing pain. There are different types of appliances used for different purposes. A nightguard helps you stop clenching or grinding your teeth and reduces muscle tension at night and helps to protect the cartilage and joint surfaces. Appliances also help to protect from tooth wear. These appliances are usually constructed by an oral medicine or facial pain specialist who can perform adjustments as needed.

No one treatment can resolve TMJ disorders completely and treatment takes time to become effective. Surgery is usually a treatment of last resort, if at all, for patients with chronic pain. Dr. Molen will usually refer patients with chronic TMJ disorders to a specialist in oral medicine and facial pain who can provide non-surgical treatment to help you have a healthier and more comfortable jaw.

What About Surgery?

If your TMJ disorder has caused problems with how your teeth fit together, you may need treatment such as bite adjustment orthodontics with or without jaw reconstruction, or restorative dental work. Surgical options such as arthroscopy or joint reconstruction are sometimes needed but are reserved for severe cases. Dr. Molen does not consider TMJ surgery unless the jaw can’t open, is dislocated, has severe degeneration, or the patient has undergone appliance treatment unsuccessfully and meets certain criteria of joint disease.