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Temporomandibular Disorders


Do you often find yourself waking up with a headache or a stiff jaw? These are often signs of bruxism, also known as teeth grinding. Some people also find themselves clenching their jaw throughout the day without even realizing it. Grinding and clenching behaviors that continue over time can cause TMD, or temporomandibular disorder. TMD can also be caused by other factors, including:

- Arthritis of the temporomandibular joint (TMJ) - Dislocation of the soft cushion between the TMJ’s ball and socket - Traumatic injury, such as a blow to the head or face, or whiplash - Stress, which often leads to clenching and grinding

Besides a headache or stiff jaw, there are many other symptoms to watch for concerning TMD. Some of these include:

- Clicking or popping of the jaw when chewing, yawning, or otherwise attempting to open the mouth wide - Swelling on the side of the face with the TMJ injury - Difficulty or pain when chewing - Pain or tenderness near the temporomandibular joint - Earaches, toothaches, and upper shoulder/neck pain due to the clenching and grinding behaviors

How is TMD diagnosed?

Dr. Kotre can examine you in her Ann Arbor office to see if your symptoms are indeed the result of a TMJ injury or strain. As TMD can also have similar symptoms to other medical and dental problems, you should be sure to have a professional examination to verify that it definitely a temporomandibular disorder.

Can TMD be treated?

There are many different treatments for temporomandibular disorder which will vary depending on the underlying cause of the condition and how severe the problem is. Treatments for TMD include:

- Moist heat or cold packs to relieve pain and swelling where indicated - Splints and night guards to keep grinding and clenching at bay - Use of anti-inflammatory medications, such as ibuprofen, to relieve swelling and inflammation - Avoidance of hard or extremely chewy foods, such as soft pretzels, bagels, or caramels - Dental treatments such as braces or bridges to correct bite area issues - Behavior modification, such as learning relaxation techniques to lower stress levels; avoiding resting your chin on your hand; and remembering to keep teeth slightly apart at all times - Physical therapy and massage

If the above therapies fail to correct the TMD, alternatives are available. However, the overall efficacy of these treatments is still controversial:

- Ultrasonic or TENS (transcutaneous electrical nerve stimulation) therapy by a physical therapist - Trigger-point injections of pain killers or anesthesia

Surgery can also be indicated if the more basic therapies are not effective. Surgery is only prescribed as a last resort to treat TMD. There are three types of surgery performed for temporomandibular disorders, depending on the underlying cause:

If you have TMJ pain, please call our office at 734-677-2156 to make an appointment to see Dr. Kotre at her Ann Arbor dental office for a TMD examination as soon as possible.


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