Stresses in life have seen a dramatic increase in broken and fractured teeth due to grinding and clenching. At times, the problem can be so severe, that leads to headaches, neck pain and an inability to chew. This is known as TMD (temporomandibular joint disorder). The number of patients presenting to us with TMD are becoming more prevalent.
Luckily, we have a variety of treatment options, ranging from night guards to dental injectables to relieve your symptoms.
The symptoms of TMD may include one or more of the following:
- Sore jaw with pain on opening or closing
- Clicking and locked jaw
- Pain when yawning and limited opening of the jaws
- Headache/Migraine and Ear ache
- Neck pain
- Toothache
- Sinus problems
Causes of TMD can be numerous, including:
- Arthritis and physical injuries
- A bad bite due to malaligned teeth
- Grinding or clenching of teeth
Grinding and/or clenching is by far the leading cause of TMJ issues. Known as bruxism, it is often caused by physical or psychological stress or sleep disorder. It’s a subconscious para-function (bad habit). Left untreated, bruxism can lead to excessive wear on the teeth and may cause permanent damage to the teeth and jaw joints.
Treatment usually follows the following steps:
1. Repair and restore damaged and worn teeth
2. Night Guard (Occlusal splint) : A special hard-wearing guard that is custom made for your teeth and primarily worn at night times. The purpose of this splint is to keep your teeth apart and also to distribute the force of your bite. There are different types of occlusal splints for different situations. Ranging from softer ones for first time wearers to harder ones for heavy grinders. You will be assessed to see which type is more suitable.
3. Soft diet and stress management : For sufferers, it’s recommended that hard foods are temporarily removed and long-term reduced from the diet. These including, nuts, bones, jerky and chewing gum. Psychological stress will inevitably cause muscle tension. This will in turn exacerbate grinding and clenching and can even occur during the day while we are working. Stress relieving strategies such as yoga, naturopathic remedies, counselling, relaxing music and taking breaks during intense office work, may help.
4. Botox (Muscle relaxant) : Muscle relaxant, well known in the cosmetic industry, can lessen the destructive effects of grinding/clenching and reduce headaches associated with TMD.
An extremely dilute form of muscle relaxant is injected to weaken the muscle enough to reduce the effects of grinding and clenching, but not so much as to prevent proper use of the jaw muscle for eating.
The procedure takes a few minutes and you can start to feel the effects in a matter of days. The optimal dose is carefully calculated for each patient and is determined by the size and strength of the muscle. This is why you should always see someone specifically trained in the application of muscle relaxant for treatment of TMD.
Depending on the severity of TMD, the effects of Botox can last for about 3-6 months. However, over time it is usually possible to decrease the dose and/or increase the interval between treatments.
Side effects are minimal, especially when performed by a trained professional with experience in the head and neck area. Possible side effects may include but are not limited to:
Temporary discomfort, burning/stinging sensation, swelling, redness, bruising around the injection site.
5. Physiotherapy : Physiotherapists specialized in the area of massaging head and neck region may offer some muscular relief.
6. Jaw Surgery : In severe cases of TMD, Surgery may be the only option to fix the issue. However, this is last resort and only contemplated when all of the above efforts have been exhausted.
