Temporomandibular Joint Disorder or TMD (also frequently referred to as just "TMJ")is characterized by problems of the jaw, jaw joints, and/or surrounding facial muscles. Symptoms might include pain, locking, clicking, or popping of the jaw joints, recurrent headaches, sinus pressure, and even earaches. The exact cause of TMD is often difficult to determine, but common culprits are genetics, arthritis, or injury. In most cases, the disc between a person's jaw bone and cheek bone is slipping out of place due to soft tissue damage, inflammation, or misaligned anatomy. People who have TMD might also clench or grind their teeth, though it is important to note that many people who habitually clench or grind their teeth never develop TMD.
Treatment for TMD might range from anti-inflammatory medication to injections to open joint surgery. However, Dr. Davis prefers to treat TMD with an oral appliance (or splint) because it is far less invasive and carries with it fewer risks. A TMJ appliance works to stabilize damaged soft tissue and simultaneously repositions the jaw to prevent the disc from slipping. During the first few weeks of treatment, a person will need to wear a TMJ appliance constantly, but once the area begins to heal, wearing time can be often be decreased to just at night.
What do TMJ appliances do?
Decrease pain or tenderness in your jaw joints
Improve range of motion
Help with recurrent headaches or earaches
Reduce clicking and/or popping noises
What can I expect?
If you are experiencing TMD symptoms, you may schedule a consultation with Dr. Davis with or without a referral from another practitioner. Usually, your first appointment will simply consist of a discussion about your symptoms, their onset, their severity, etc., followed by an examination and range of motion measurements. On rare occasions, a person's jaw may be locked in the closed position, which would require physical manipulation to unlock it.
Should Dr. Davis determine that a TMJ appliance might be helpful for you, the next step would be to call both your dental and medical insurance carriers to find out which one (if either) has a TMD benefit. Depending on what we find out, we may need to pre-authorize your treatment. Once we have received the necessary approvals, we would begin by taking highly accurate impressions of your upper and lower teeth so that a custom appliance can be fabricated. The type of appliance Dr. Davis recommends is called a LOGIC appliance. A LOGIC appliance is made of hard acrylic that fits over your lower teeth with flanges that your upper teeth can lock into. To determine the best relationship between your upper and lower arches, Dr. Davis will take x-rays, called tomograms, of your jaw joints. After your LOGIC appliance has been fabricated (typically after a week or so), you will come back to our office for a longer appointment. We will first use a TENS (transcutaneous electrical neurostimulation) unit to relax your jaw muscles and allow them to settle into your most natural occlusion (closed position). Then we will insert and adjust your appliance. Some people begin to experience relief from their TMD symptoms right away, while others do require additional appointments to change the fit and feel of their appliance.
We recommend that you clean your appliance the same way you clean your teeth (i.e., with a toothbrush and toothpaste) and that you store it in a clean, dry place. (Please note: dogs love the taste of acrylic, so keep your appliance well out of reach or you may lose it to your canine friend!) We also recommend that you bring your appliance with you to your 6 month cleaning appointments so that we can give it a deep clean and check the way it fits you.