Dental Health Articles
Problems with the TMJ?
By Nick K. Nguyen, DDS, APC
Bruxism, the clenching and grinding of teeth, is a very common problem many people unknowingly face. Bruxing usually happens at night during sleep but may also occur any part of the day. Bruxing can lead to restless sleep, head and neck muscle soreness, and certain headaches. It can also cause fractured and excessive wear of teeth, limited opening of the mouth, clicking and popping of the jaw, and lock jaw. Often times, these symptoms are ignored and passed off as something not serious, especially when there is little pain. Ignoring one or more of these symptoms may lead to irreversible and long-term problems in the jaw joint, known as the temporomandibular joint (TMJ).
The TMJ is a very delicate joint resembling a ball and socket. When a person opens his mouth halfway, there is a hinge movement in the TMJ similar to a door hinge. As the mouth continues to fully open, the lower jaw and the ball portion of the TMJ moves in a down and forward motion. At rest, the TMJ is in harmony. The muscles, tendons, and ligaments are relaxed and the ball is seated intimately within the socket whether or not the teeth are touching.
One of the main reasons why someone may brux is by having an abnormal and unbalanced bite, leading to one or more of the above symptoms. This bite may have occurred as the result of missing and/or shifting of teeth. When teeth are in balance and harmony with the TMJ, muscles of the head and neck are generally relaxed. An abnormal and unbalanced bite causes tension and firing of muscles in the head and neck contributing to bruxism. Bruxing can lead to arthritis, scar tissue and degeneration of the TMJ.
If bruxism is determined to have resulted because of an abnormal bite, a dentist must decide how to relax the muscles of the head and neck to ensure that the TMJ is in its most relaxed position. This is generally accomplished with a splint orthotic (not to be confused with a nightguard, which helps prevent wearing of the teeth due to bruxism, but may not do much in regards to relaxing a misaligned TMJ). The dentist can then proceed to adjust the person's bite to match this correct TMJ position. This may mean removing high spots on the teeth, altering the surfaces of teeth with crowns or onlays, performing orthodontic treatments, filling in missing spaces with bridges or implants, or a combination of these. It is important to fully discuss this with your dentist if you feel that you are possibly experiencing problems from a bad bite.