The temporomandibular joints (TMJs) are arguably the hardest-working joints in the body. They connect the jaw to the skull and slide like a hinge to give a person’s jaw an impressive range of motion. That includes side-to-side, back-and-forward, and up-and-down movements—all of which are essential for chewing and speaking.
But for some patients, overuse, trauma, or even genetic factors can beget TMJ disorders (TMDs), which cause facial pain, inflammation, dysfunction, and a host of other unpleasant symptoms.
You can help them by brushing up on devices from a dental lab and some at-home best practices for noticeable TMJ relief.
TMJ = the name of the joint
TMD = disorders with the joint
What causes TMJ discomfort?
Today, approximately 10 million Americans are affected by a TMD. For the vast majority of these people, the problem is relatively minor, with discomfort typically being fleeting and cyclical.
More painful TMJ disorders tend to occur if there is damage to or around the site of the temporomandibular joint. According to the Mayo Clinic, the most common causes of TMDs include:
- The disk eroding
- The disk moving out of its proper alignment
- Arthritis damaging the joint’s cartilage
- A blow or impact damaging the joint
Additionally, various risk factors can cause a patient to develop TMJ problems, including a traumatic injury, chronic teeth grinding or clenching, connective tissue diseases, or certain types of arthritis.
Dental applications for TMJ relief
If a patient complains of TMJ pain, your first step will be to determine the root causes of jaw discomfort and inflammation by performing a complete dental and medical evaluation. Although the exact reasons may not always be readily apparent, the diagnostic knowledge gathered during this exam can help inform the dentist as to the optimal bruxism and TMJ treatment.
For mild to moderate cases of TMD, the most common, non-invasive treatment option involves stabilization splints to prevent jaw movement. Also known as bite plates or bite guards, these are removable dental intraoral appliances that cover all or some of the upper and lower teeth.
The specific type of splint your patient may benefit from the most, such as a TMJ splint or night guard, can vary depending on the case. Common types include:
- Stabilization splints – Flat plane splints cover a patient’s upper teeth to reduce tooth grinding and relax jaw muscles.
- Anterior bite plane – Also known as a night guard, this fits on the patient’s upper jaw, contacting only the six lower front teeth. This prevents the molars from clenching and grinding during sleep.
- Repositioning splint – This is a temporary dental implant meant to move or lower the jaw backward or forward.
- Nociceptive Trigeminal Inhibition Tension Suppression System (NTI-TSS) – An NTI dental appliance is a daytime splint that fits on the upper front teeth to prevent tooth clenching and grinding.
In more severe TMJ disorders, surgery may be necessary to fix the underlying problems.
Why Dental Appliances Need to Go Digital
Regardless of what type of stabilization splint the dentist recommends, it’s paramount that the dental appliance is precisely molded to perfectly fit the patient’s mouth. Whether the wrong device is recommended or the right device is improperly sized, either result could exacerbate the existing condition.
This is why dentists are increasingly moving toward digital dental technologies and workflows, such as:
- Intraoral scanners – These dental devices enable dentists to instantly capture dental impressions to automatically register the size and shape of each tooth.
- CAD/CAM technology – CAD/CAM technology enables dentists to send digital scans instantly. Once the digital laboratory receives the scans, the team can instantly review them to confirm that they’re accurate or request a retake. If the scan is usable, the design team can make slight adjustments to ensure proper spacing and alignment.
- 3D Milling – After the 3D image is ready, a milling machine shapes the dental appliance from a single ceramic block. Once it’s created, it will be washed, dried, cured, and prepared for shipment.
Digital technologies enhance the entire dental appliance manufacturing process, making it faster, less expensive, and more accurate. Aided by Dandy digital workflows, a dentist can ensure that the stabilization splint is a perfect fit the first time around.
At-home ministrations for TMJ disorders
In addition to seeing a dentist and receiving a dental appliance, there are several at-home supplemental measures a patient can implement into their daily routine for TMJ relief, such as:
- Performing jaw exercises – For patients struggling with a minor TMJ disorder, jaw strengthening, stretching, and relaxing exercises can increase mobility, reduce pain, and help guide the jaw back into its proper position. Common exercises are:
- Goldfish (partial and full opening)
- Chin tucks
- Resisted opening and closing of the mouth
- Tongue-ups
- Side-to-side jaw movements
- Forward jaw movements
- Reducing stress levels – A natural response to stress and anger is to clench the jaw. Therefore, patients are encouraged to practice stress-relieving activities that can help prevent the behaviors that contribute to jaw tension. Stress-relieving practices may include:
- Meditation
- Prayer
- Yoga
- Getting more sleep
- Exercising
- Focused breathing
- Spending time outside
- A change in sleeping positions – If your patient’s problem involves nighttime grinding, advise them not to sleep on their stomach or side with a hand under the jaw. Instead, TMJ patients should sleep on their backs with a pillow that provides adequate neck support.
- Cut out bad habits – Certain poor habits can contribute to TMJ pain, including:
- Chewing on cheeks
- Biting nails
- Grinding teeth
- Clenching teeth
- Leaning on your hand with your jaw
- Avoid certain foods – Some foods can be difficult for the jaw to handle, including:
- Gum
- Chewy candies
- Baguettes
- Nuts
- Chewy or tough meat
- Ice
- Hard fruits and veggies
Provide modern dental care with Dandy
TMJ disorders cause dysfunction of the jaw bone, which typically manifests in jaw pain, difficulty chewing, clicking, locking, and a host of other symptoms. Fortunately, the vast majority of cases are not severe and can be treated with a stabilization splint and supplemented with at-home habits and exercises. But there are ways you can ensure your patient’s TMD care is top-notch and up to today’s standards.
At Dandy, our digital dental workflows empower dentists to fabricate high-quality dental appliances that fit perfectly and cost less. The average Dandy partners experience $30,000 in upfront savings, 76% faster delivery of prosthodontics, and an 89% reduction in remakes.
If you want to provide TMJ pain relief for your patients, try our demo today to see the difference Dandy can make.
Sources:
1. Mayo Clinic. TMJ Disorders. https://www.mayoclinic.org/diseases-conditions/tmj/symptoms-causes/syc-20350941
2. NIH. TMJ Disorders. https://www.nidcr.nih.gov/sites/default/files/2017-12/tmj-disorders.pdf
3. Mayo Clinic. TMJ Disorders. https://www.mayoclinic.org/diseases-conditions/tmj/symptoms-causes/syc-20350941
4-6. NIH. TMJ Disorders. https://www.nidcr.nih.gov/sites/default/files/2017-12/tmj-disorders.pdf
7. Penn Medicine. TMJ Pain Relief: 8 Best Practices to Help Manage Temporomandibular Joint Disorders. www.pennmedicine.org/updates/blogs/health-and-wellness/2020/september/tmj-pain-relief-8-best-practices-to-help-manage-tmd
