TMJ / TMD
What is temporomandibular joint disorder?
Temporomandibular joint disorder, also known as TMD, refers to a group of related disorders. These disorders are a result of jaw, jaw joint, or facial muscles involved in jaw movement. Patients with TMD can experience both constant and intermittent discomfort. These disorders are often incorrectly referred to as TMJ, which refers only to the temporomandibular joint itself. The temporomandibular joints are the joints that connect the jaw bone to the skull.
TMD symptoms may arise from any number of easily identifiable and treatable causes, including sinus infections, tooth decay or gum disease. Patients with TMD can experience one or more of the following on a daily basis:
- Chronic facial pain in the face, jaw, neck, and shoulders
- Chronic facial pain in or around the ear
- Limited ability to open the mouth wide
- Difficulty chewing
- Uncomfortable bite
- Swelling on one or both sides of the face
- Clicking or popping noises when opening the mouth
- Headaches and neck aches
TMD Patient Testimonial
Before treatment Cesar couldn’t open his jaw, he suffered from TMJ disorder with limited opening, migraines and headaches. Dr. Garza was able to provide a treatment plan that addressed all of his symptoms.
What causes Temporomandibular Joint Disorder?
Although there are many causes of TMD, common ones include:
- Trauma to the head or neck
- Oral habits such as clenching or grinding of the teeth
- “Bad” bite or missing teeth
- Malalignment of the upper and lower jaws
- Poor growth and development
- Retraction/amputation Orthodontics
What is bruxism?
Bruxism, or teeth-grinding, occurs when the jaws are clenched, and the teeth grind against one another. Stress and anxiety are often factors, but sleep disorders, an abnormal bite, and missing or crooked teeth may also instigate this subconscious behavior. If left untreated, bruxism can lead to headaches, a sore jaw, or painful, loose or fractured teeth.
TMJ Treatment Patient
Junel experienced severe TMJ and shares her experience working with Dr. John Garza for treatment.
how does Dr. Garza diagnose TMD?
It isn’t enough to diagnose TMD using a standard clinical exam. However, this is only the beginning. In addition to visual observation of teeth, our diagnostic process also involves cone-beam CT scan imaging, specialized x-ray imaging called cephalometrics, and innovative A Biopak technology.
Biopak is three diagnostic tools in one. Using an electrosonograph, we are able to hear the sounds made by the jaw joints. Using a three-dimensional tracking device, we can observe the path that the jaw follows when the mouth opens and closes. This enables us to see if irregular movement is occurring to compensate for an imbalanced bite. Finally, the use of electromyography shows us the true measure of how hard muscles are working to operate the jaw.
TMD Treatment Options
There are several ways in which to relieve the symptoms of TMD. Dr. Garza can also perform treatments that alleviate stress on the temporomandibular joints, thereby decreasing the physical manifestation of symptoms. Conventional approaches to treating TMJ include:
- Stress-reduction exercises
- Muscle relaxants
- Low-level-laser therapy
- Mouth protectors to prevent teeth grinding
- Consumption of softer foods to allow the jaw to rest
- Heat/ice packs
- Avoidance of extreme jaw movements
- Ozone injections
- Trigger point injections
- TP Laser application
- Cervical Realignment
Dr. Garza conducts his TMD treatment with the objective of stabilizing the physiological bite that we determine using advanced diagnostics. Orthotic devices represent an integral aspect of bite stability because these fixtures actually align the vertebrae in the neck to be in-line with the dental arches so the temporomandibular joints do not have to work so hard to align teeth when you chew. Once the appropriate orthotic device retrains the muscles, controlled arch orthodontics makes these changes permanent by restructuring the jaw and the upper and lower arches of teeth.
Neuromuscular dentistry is capable of correcting many cases of TMD. Dr. Garza believes in non-surgical physiologic rehabilitation of the stomatognathic system (TMJ, cervical spine, posture, airway, and occlusion) to eliminate pain and restore patients to a normal life. Neuromuscular/Physiologic dentistry is advanced care requiring special attention of the properly trained doctor. Dr. Garza brings all of his current skills and training into every case because it is life changing for many patients. We give pain patients their life back!
In phase I, Dr. Garza will find your Neuromuscular harmony and the physiologic rest position. This corrects TMJ dysfunction while idealizing the bite position to support the proper posture of the neck and spine. In phase I, all symptoms and function are addressed. This is done reversibly with temporary acrylic orthotics. Patients do not go to Phase 2 (restorative/permanent) unless Dr. Garza has adequately resolved your pain and dysfunction.
Phase 2 can be CA Orthodontics, Full Mouth Reconstruction (Porcelain crowns) or Coronoplasty (equilibration). The patients seen in these videos are actual patients that have been treated with phase 1 and then phase 2 (all three methods). They are living better lives and you can too!
Dr. Garza’s TMD Experience
Dr. Garza is a distinguished general dentist who has achieved LVI Fellowship, which demonstrates a strong commitment to advanced patient care. LVI Fellowship is awarded to dentists who have completed a minimum of 278 continuing education hours included in the LVI Core Curriculum. Advanced Functional Restorative Dentistry and Advanced Occlusal and Restorative Principles are an integral aspect of this training that enable Dr. Garza to efficiently address issues related to TMD disorder.
Claudia suffered from TMJ disorder with dislocated discs, Vertigo and Tinnitus, flat worn teeth and a deep bite. After Dr. John Garza placed her orthotic she felt immediate relief.
What if TMD is Left Untreated?
It is important to obtain proper treatment for TMJ dysfunction. If stress on the jaw and teeth continues, dysfunction may escalate to disruptive levels. Untreated TMD can lead to chronic headaches, including migraines. These symptoms may occur due to the constant increased amount of tension and stress that are carried in your head and neck.
In addition to head and neck pain, TMD can also lead to the degradation of natural teeth. When upper and lower teeth do not fit together, clenching and grinding may result, further exacerbating the stress on the jaw joints. Over time, grinding behaviors can wear down enamel and lead to damage such as chips, cracks, and broken teeth.
Finally, TMJ that is not treated may continue to worsen over time, leading to more intense symptoms and, eventually, to limited jaw mobility.
Results of TMD Treatment
Individuals who undergo neuromuscular treatment for TMJ disorder often experience significant resolution of symptoms related to joint stress. Teeth fit together better and, in many cases, the appearance of the face improves as a result of jaw restructuring through controlled arch orthodontics.
Eleanor suffered from neck and orofacial pain and numbness, as well as TMJ Disorder. Dr. John Garza treated this TMJ patient with a custom orthotic that helped improve her symptoms and her smile.
How much does TMD Treatment Cost?
The extensiveness of TMJ treatment dictates the final cost of restorative care. We would be happy to meet with you to discuss the particulars of your case. A consultation will enable us to provide you with comprehensive details, including costs of proposed treatment.