TMJ Treatments

What is TMJ?

Temporomandibular Joints, known as TMJs are located on both sides of the face in front of the face, connecting the jaw bone (Mandible) to the skull (Temporal bone). TMJ treatments are done to correct the Temporomandibular Joint Disorders. Temporomandibular Joint Disorders describes a group of diseases that involves the Jaw joint, Associated Muscles and spatial relation of Teeth when Jaws are closed (Bite / Occlusion). TMD can be caused by a variety of reasons ranging from Genetics, Mal-alignment of teeth to Road Traffic accidents or a heavy blow to face. Hence it presents with wide variety of symptoms also. Thus early intervention & proper diagnosis is inevitable for TMD. If TMJ treatments are not provided, it may progress into a Chronic Pain state. TMD affect the quality of life of patient. It can have an impact on everyday activites like eating. talking & sleeping. The initial visit to the TMJ dentist begin with obtaining a detailed history and special clinical examination. Few investigations like Orthopantomogram (OPG) [3 Dimensional Computerized Tomography] 3D CT or CBCT [Cone Beam Computerized Tomography) of the TMJ area along with the thorough examination is critical The goal of TMJ treatments are to achieve the most comfortable bite for the patient which is in co-ordination with healthy & related masticatory (chewing) muscles. So the treatment involves the creation of this new Therapeutic biting position.

Treatment involves applying the ULF TENS (J5 myomonitor). This TENS unit provide bilateral electrical stimulation which help in relaxing the masticatory and Cervical/Upper Shoulder Muscles. Then the TMJ specialist would register the perfect Physiological Bite of the patient. After Bite Registration, a customized ANATOMIC ORTHOTIC is delivered to the patient. This Orthotic will maintain the new Jaw Position. In certain patients, based on the chromicity of the disease, the TMJ specialist might give a same day treatment at low cost. It is easy to use and can be fabricated quickly. This is called Quicksplint. The TMJ treatments involves 2 phases. The first phase corrects the Temporomandibular Joint with the help of an Orthotic. The Orthotic delivered are of 3 main types:- ACRYLLIC ORTHOTIC, RESIN ORTHOTIC and CADCAM ORTHOTIC. Patient has to wear this Orthotic 24 hours a day for 8-10 months. TMJ treatments time varies individually which includes bimonthly visits to the TMJ specialist for adjustments (Bite Corrections). The pain & associated symptoms would reduce in 1-2 weeks time. By the end of treatment time, patients will show no symptoms or vast improvements associated with TMD. Second part of treatment consists of ORTHODONTIC or PROSTHODONTIC rehabilitation. This is to maintain the corrected BITE & JAW position in the patient permanently to avoid relapse. Hence it is mandatory for the patient to undergo the second phase treatment. Since TMD presents with a wide variety of symptoms which mimics others, diseases which are way more common to people, it is very important for the patient to get an early diagnosis and proper treatment from a TMJ specialist. It takes great skill and practice for identifying the root cause of the problem and treating it so as to avoid any relapse. BITE CORRECTION includes DIGITAL OCCLUSION CALIBRATION using Occlusense from Bausch. It is a new system which records the masticatory forces of the patient Digitally. It helps in calibrating the Occlusal Distribution & Pressure Distribution Digitally using Individual SENSORS.

TMJ PAIN TREATMENTS

Joints are the areas where two or more bones in the body connect or meet. There are almost 360 joints in the human body. The Temporomandibular Joints (known as TMJs) are one of the important joint in the human skull which allows protrusion & retraction movements & also permits elevation & depression of mandible. TMJs are located anteriorly to the ears on both sides of the face. There are around 10 million cases of Temporomandibular Joint Disorder in India every year. These disorders describes a group of diseases which affect the Joint, Associated Muscles and Dental Occlusion (Bite). TMJ Pain Treatments pertains to the correction of the Temporomandibular Joint Disorders. The TMJ system is distinctive in many ways. The joints are in a complex inter-relationship with the Associated muscles and the Body's local and Central Nervous System, Also the movements permitted by the joints are controlled by the Dental Occlusion (coming together of Teeth/Bite). Thus a healthy & functioning Temporo Mandibular Joints requires a fully functioning & healthy components such as Muscles, Nerves and Dental Bite.

The goal of TMJ pain treatments are to provide a total painless and comfortable Bite for the patient which will in turn enhance the quality of life of the patient. TMD can be caused due to Mal-aligned Teeth, Continuous Teeth Clenching or Grinding, a Tension on the Facial muscles, Missing or Decayed Teeth etc. A blow or trauma to the joint area can also result in Temporomandibular Disorder. TMDs are also seen in patients with no apparent cause. A physical discomfort in the jaw or a Jaw pain on chewing food might present as an inital symptom. In some patients, it starts with Clicking or Crackling voices in the Ear area on Opening or Closing the mouth. Unfortunately most of the patients just ignore these symptoms or rely on analgesics. Another common symptom found is frequent episodes of Severe Headache. These are often misinterpreted as Migraine and the patients take medications lifelong. These patients must take these symptoms seriously and should seek for TMJ pain treatments from a TMJ Specialist at the earliest.

The treatment for TMD is only available in very few cities in India. It is a developing science, which takes a holistic approach on the patient. The treatment includes 2 phases. In the first phase, the Patient's NEUROMUSCLAR Bite is registered with the help of J5 Myomonitor or a K7 Kinesiograph. To this New Bite, an ANATOMIC ORTHOTIC is delivered. The patient have to wear it for 4-10 months, 24 hours a day. The TMJ Specialist will correct this bite either Manually or Digitally during the bimonthly visits of the patient. By the end of the first phase, the patient will show vast improvement in the symptoms. The second phase of treatments are permanently aligning the bite of the patient to the early registered Neuromuscular bite position. Only the completion of second phase of treatment will ensure complete cure and prevent relapse.

ORTHODONTIC REHABILITATION

The patient's bite is modified to the new NEUROMUSCULAR bite position with the help of braces. The TMJ Specialist use SELF LIGATING BRACKET SYSTEM for the second phase.

PROSTHODONTIC REHABILITATION

In patients with missing teeth, sometimes, an orthodontic treatment won't be possible. Also some patients prefer a faster treatment modality compared to braces. In such cases, the teeth are brought to the new bite position with the help of CROWNS, OCCLUSAL TOPS, ONLAYS etc. In certain cases, both of these treatment approaches are combined to give the perfect occlusion. After the completion of the second phase of TMJ pain treatments, the patients will have a Better sleep pattern. Because these treatments help in improving the airway area as well by bringing the Mandible (Lower Jaw) forward. Thus it can be easily said that, these treatments aims at the emotional, physical and social well being of the patient. It can also improve the Facial Profile of the patient .