Temporomandibular Disorder and Occlusal Splints

             Temporomandibular Disorder or TMD is characterized by having pain either in the temporomandibular joint (TMJ) or in the muscles of the face.  There are other symptoms that can be associated with this pain including popping and clicking noises or not being able to open or close the mouth all the way.  This pain might be very acute or of a more chronic nature.  Diagnosis and treatment of TMD is very possible but can take some time with various approaches. 

            There are many different reasons that someone might have pain in the area of the TMJ.  The most important thing that needs to happen is getting the right diagnosis of the pain.  In some cases there is an underlying systemic disease.  Once that right diagnosis is found the treatment can then begin.  The most common causes for the pain are: stress, grinding your teeth, arthritis, abnormal use of muscles when not eating, etc. 

            In treating TMD, there is not fail safe treatment that guarantees the removal of pain, but various things are employed that can provide the relief.  The first step is teaching what causes the pain and eliminating some of the habits that cause and aggravate the muscles and joint.  These might include clenching or grinding and stress management.  Next, a combination of medications, including NSAID’s, like ibuprofen and opiates, to reduce the inflammation and pain, and physical therapy, to allow the muscles of the face to return to their proper uses.  In some cases an appliance that can be worn at night will be prescribed.  This is what we call an occlusal splint or a night guard.  It is a type or retainer that is worn at night to reduce the wear on the teeth if there is grinding occurring.  It also helps to reduce the pain by realigning the TMJ and can provide some relief.  In some cases changing the shape and realigning them to come together in a different way will help, but this treatment is not as recognized and usually is done as a last resort.  The final option in treating TMD is having surgery.  This is a last resort if nothing else is working and there is still intense pain. 

            In conclusion, the first step in helping to eliminate this pain is seeing your dentist or other specialist.  In reading this article it might be the start of your journey.  Make an appointment and we can help to get you out of pain and back to eating and functioning.

Dr. Mark Barry, DDS