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FAQs:
What is a TMJ Specialist?
TMJ specialists are dental professionals who diagnose, manage, and treat temporomandibular joint dysfunction and disorders, commonly known as TMJ and TMD. They have typically pursued extensive additional training and focused their practices to address the needs of patients struggling with jaw disorders while at the same time being skilled in identifying and treating other challenging orofacial pain problems, inclusive of persistent toothaches, nerve pain disorders, and headaches.
What Does a TMJ Specialist Do?
TMJ specialists will work closely with a primary care physician to identify the signs and symptoms of TMJ/TMD. They’ll also design a comprehensive treatment plan that addresses underlying causes or comorbid health issues that may be exacerbating the condition. A TMJ specialist has other weapons in their arsenal for the fight against TMJ. Because TMJ can be a chronic illness characterized by acute, painful flare-ups, a TMJ specialist will work closely with a patient’s primary care physician to identify triggers. In general, the progression of treatment options a TMJ specialist will employ will go from least invasive to more complicated.
What is TMJ?
The temporomandibular joints, called TMJ, are the joints and jaw muscles that make it possible to open and close your mouth. Located on each side of the head, your TMJ works together when you chew, speak, or swallow and includes muscles and ligaments as well as the jaw bone. They also control the lower jaw (mandible) as it moves forward, backward, and side to side. Each TMJ has a disc between the ball and the socket. The disc cushions the load while enabling the jaw to open widely and rotate or glide. Any problem that prevents this complex system of muscles, ligaments, discs, and bones from working properly may result in a painful TMJ disorder.
What is TMJ Disorder?
TMJ disorder is a condition resulting in jaw pain, soreness near your ear, neck discomfort, earaches radiating across your face, and headaches at the side of your head. This disorder is caused by a malfunction of your temporomandibular joint, a hinge that links your jaw to your skull, facilitating actions such as talking, chewing, and yawning. Any disruption to this joint can hinder these routine activities, leading to discomfort and pain.
Is TMJ a Medical or Dental Problem?
The cause of the disorder will usually determine if your case of TMJ disorder is a medical or a dental problem. For example, this condition can be caused by certain medical problems such as fibromyalgia, which causes widespread pain that can include the jaw, though patients will likely experience pain in other areas of the body as well. Arthritis is another medical condition that can lead to a TMJ disorder.
However, TMJ disorders can also be a dental problem by nature, especially when it is caused by an underlying problem with a person’s teeth. For example, teeth grinding, or bruxism is another cause of jaw pain, and during the consultation, the dentist can spot the signs you might be grinding your teeth (such as cracks in the enamel) and recommend a treatment plan that will also reduce the jaw pain.
What Does TMJ Pain Feel Like?
Understanding what TMJ pain feels like can help you determine what questions you might need to ask your doctor and how it could impact your diagnosis. You may notice a variety of potential symptoms. The most obvious is tenderness, pain, or swelling in the jaw joint. However, pain can also occur in the neck and shoulders, in your head, or your teeth. Most often, continuing pain in the head, neck, and shoulders stems from tension carried in the jaw that translates to those other areas: when you have tension in one area of the body, you may tense other areas in response, causing increased pain. For some patients, pain in the neck and shoulders, or chronic headaches, maybe more noticeable than TMJ pain. In some cases, that can cause misdiagnosis or make it difficult for you to get relief from your pain.
Can TMJ Go Away on its Own?
It depends. If jaw pain is caused by a distinct event, such as chewing on something hard or a minor injury, the jaw pain may go away. Many people will experience jaw pain in their lifetime. In fact, according to the U.S. Department of Health and Human Services, most TMJ discomfort will resolve on its own.
However, TMD can have a variety of causes. The TMJ, teeth, masseter muscles, and the various nerves of the face can all be potential sources of TMJ pain. Without understanding the cause of your pain, it may persist and worsen. Rather than waiting to see if it will go away on its own, see a dentist experienced with TMD to begin treatment.
What Happens If TMJ is Left Untreated?
Neglecting jaw discomfort can result in escalated symptoms and severe health implications. The pain you’re experiencing could be a result of Temporomandibular Joint (TMJ) Disorder, a condition that can progressively deteriorate if not addressed. It’s not solely about bearing the discomfort but comprehending the potential risks you’re imposing on your health.
If your TMJ disorder intensifies, you might find it increasingly challenging to consume certain foods. This circumstance can cause nutritional deficiencies and disrupt your overall health. The movement range of your jaw may also become restricted, making even the simplest tasks such as speaking or yawning difficult. Constant discomfort could also lead to sleep disturbances that can impact your mood, cognitive function, and life quality.
How Long Does TMJ Last?
Most of the time, the pain associated with TMJ disorders will go away within a few days to a couple of weeks. Treating the affected area with ice or heat, taking over-the-counter painkillers or anti-inflammatories, and switching to a soft diet to reduce chewing effort can all help to keep the pain under control until the condition resolves. In some cases, TMJ disorder may be a more persistent problem, especially if the pain is caused by arthritis or jaw clenching/tooth grinding (bruxism). In those cases, TMJ pain can last until the underlying issue is addressed.
Is TMJ Serious?
While many people find their TMJ symptoms go away on their own after addressing the root cause, other individuals may deal with more serious symptoms that can affect their quality of life. Even when someone is dealing with a more serious case of TMJ disorder, it’s recommended to avoid aggressive treatments such as surgery whenever possible, because there is still not enough evidence to show that these irreversible methods work. There are a wide variety of treatments available for TMJ disorders. If one doesn’t work for you right away, work with your doctor to find one that does.
Is TMJ Covered by Insurance?
Insurance reimbursement for TMJ treatments can be complex and difficult to navigate. Insurance coverage varies from state to state, company to company, and policy to policy. Some policies have specific exclusion clauses for TMJ treatment and some have limitations on the dollar amount or type of coverage available (e.g., only covering surgical procedures). Insurance companies generally do not include TMJ coverage unless mandated by states or at the request of company benefit coordinators because:
1. There is much controversy about the causes and proper treatment of the problem.
2. There is little scientific evidence demonstrating the safety and effectiveness of therapies for TMJ disorders.
What are the Symptoms of TMJ?
TMD often causes severe pain and discomfort. It can be temporary or last many years. It might affect one or both sides of your face. It's most common among people between the ages of 20 and 40. Common symptoms include:
1. TMJ pain or tenderness in your face, jaw joint area, neck and shoulders, and in or around your ears when you chew, speak, or open your mouth wide.
2. Problems when you try to open your mouth wide
3. Jaws that get "stuck" or "locked" in the open- or closed-mouth position
4. Jaw clicking, popping, or grating sounds in the joint when you open or close your mouth or chew; this may or may not be painful
5. A tired feeling in your face
6. Trouble chewing or a sudden uncomfortable bite—as if the upper and lower teeth aren't fitting together properly; learn more about the pros and cons of teeth alignment surgery
7. Swelling on the side of your face
8. Toothaches
9. Earaches
10. Hearing problems or ringing in your ears (tinnitus)
11. Headaches or migraine
12. Dizziness
13. Numbness or tingling in your fingers
What Causes TMJ?
There’s no singular cause of TMD. Rather, it can be a result of many different factors or a combination of factors.
A. TMJ causes may include:
1. Jaw injury (like a broken or dislocated jaw).
2. Teeth grinding or clenching (bruxism).
3. Arthritis in your jaw joint.
4. Malocclusion (when your teeth don’t fit together exactly as they should).
5. Stress.
B. Things that make TMJ dysfunction worse
You can’t always control factors that cause TMJ dysfunction. But certain habits can make TMD worse, including:
1. Using your teeth as tools (like tearing off clothing tags).
2. Poor posture. (This can place excess pressure on your neck, shoulder, and facial muscles.)
3. Chewing on pens, pencils, or other items (a common “nervous habit” behavior).
4. Chewing on ice or excessively chewing gum.
5. Taking big bites of food. (This can overwork your jaw muscles.)
6. Daytime teeth clenching or grinding.
7. Sleeping on your stomach.
How to Diagnose TMJ
Your doctor or dentist will discuss your symptoms and examine your jaw. He or she will probably:
1. Listen to and feel your jaw when you open and close your mouth
2. Observe the range of motion in your jaw
3. Press on areas around your jaw to identify sites of pain or discomfort
If your doctor or dentist suspects a problem, you may need:
1. Dental X-rays to examine your teeth and jaw
2. CT scan to provide detailed images of the bones involved in the joint
3. MRI to reveal problems with the joint's disk or surrounding soft tissue
TMJ arthroscopy is sometimes used in the diagnosis of a TMJ disorder. During TMJ arthroscopy, your doctor inserts a small thin tube (cannula) into the joint space, and a small camera (arthroscope) is then inserted to view the area and to help determine a diagnosis.
How to Treat TMJ
In some cases, the symptoms of TMJ disorders may go away without treatment. If your symptoms persist, your doctor may recommend a variety of treatment options, often more than one to be done at the same time.
A. Medications
Along with other nonsurgical treatments, these medication options may help relieve the pain associated with TMJ disorders:
1. Pain relievers and anti-inflammatories. If over-the-counter pain medications aren't enough to relieve TMJ pain, your doctor or dentist may prescribe stronger pain relievers for a limited time, such as prescription strength ibuprofen.
2. Tricyclic antidepressants. These medications, such as amitriptyline, are used mostly for depression, but in low doses, they're sometimes used for pain relief, bruxism control, and sleeplessness.
3. Muscle relaxants. These types of drugs are sometimes used for a few days or weeks to help relieve pain caused by TMJ disorders created by muscle spasms.
B. Therapies
Nondrug therapies for TMJ disorders include:
1. Oral splints or mouth guards (occlusal appliances). Often, people with jaw pain will benefit from wearing a soft or firm device inserted over their teeth, but the reasons why these devices are beneficial are not well understood.
2. Physical therapy. Along with exercises to stretch and strengthen jaw muscles, treatments might include ultrasound, moist heat, and ice.
3. Counseling. Education and counseling can help you understand the factors and behaviors that may aggravate your pain, so you can avoid them. Examples include teeth clenching or grinding, leaning on your chin, or biting fingernails.
B. Surgical or other procedures
When other methods don't help, your doctor might suggest procedures such as:
1. Arthrocentesis. Arthrocentesis (ahr-throe-sen-TEE-sis) is a minimally invasive procedure that involves the insertion of small needles into the joint so that fluid can be irrigated through the joint to remove debris and inflammatory byproducts.
2. Injections. In some people, corticosteroid injections into the joint may be helpful. Infrequently, injecting botulinum toxin type A (Botox, others) into the jaw muscles used for chewing may relieve pain associated with TMJ disorders.
3. TMJ arthroscopy. In some cases, arthroscopic surgery can be as effective for treating various types of TMJ disorders as open-joint surgery. A small thin tube (cannula) is placed into the joint space, an arthroscope is then inserted and small surgical instruments are used for surgery. TMJ arthroscopy has fewer risks and complications than open-joint surgery, but it has some limitations as well.
3. Modified condylotomy. Modified condylotomy (kon-dih-LOT-uh-mee) addresses the TMJ indirectly, with surgery on the mandible, but not in the joint itself. It may be helpful for the treatment of pain and if locking is experienced.
4. Open-joint surgery. If your jaw pain does not resolve with more conservative treatments and it appears to be caused by a structural problem in the joint, your doctor or dentist may suggest open-joint surgery (arthrotomy) to repair or replace the joint. However, open-joint surgery involves more risks than other procedures do and should be considered very carefully, after discussing the pros and cons.
How to Stop TMJ Dizziness
TMJ dysfunction (TMJD) can lead to dizziness, which may be either temporary or chronic. Regardless of its duration, TMJ-related dizziness can significantly impact daily life, making activities uncomfortable and heightening the fear of falling. Treatment options vary and include self-care practices, lifestyle changes, and professional interventions. Addressing the TMJ directly is crucial to minimizing dizziness and improving quality of life.
Here are five ways to treat TMJ dizziness:
1. Hot and cold compresses — One of the most effective ways to alleviate TMJD pain at home is by switching between hot and cold compresses on the area for 20 minutes at a time. The cold will help to reduce the pain while the heat helps to relax your jaw muscles.
2. Habit changes — Several habits can contribute to TMJD pain, including grinding your teeth, biting your nails, and chewing on your lips or cheeks. By trying to quit these habits, you can help reduce your TMJD symptoms, including TMJ dizziness.
3. Reduce stress — TMJD symptoms often flare up when you tighten your jaw muscles, which is usually a stress response. By learning stress management techniques, such as meditation or yoga, you can reduce the tension in your TMJ.
4. Adjust your posture — Poor posture can contribute to your TMJD. Make sure that you’re using a desk chair with back support and sitting upright while driving or sitting on the couch. A physical therapist can help you make postural and gait adjustments.
5. Jaw exercises — One of the most effective ways to alleviate your TMJ pain is through exercises that will increase your jaw’s mobility. A physical therapist can walk you through stretching and strengthening techniques to increase your range of motion and function.
How to Sleep with TMJ
In addition to adopting the right sleeping position, consider these tips to improve your sleep quality while managing TMJ pain:
1. TMJ Treatment: Consult a TMJ specialist for a thorough evaluation and personalized treatment plan. Addressing the underlying cause of your TMJ can lead to significant pain reduction.
2. Heat and Ice Therapy: Apply a warm compress to the jaw before bedtime to relax tense muscles. Alternatively, you can use an ice pack to reduce inflammation. Be sure to wrap it in a cloth to avoid direct contact with your skin.
3. Dietary Modifications: Avoid hard and chewy foods that can aggravate TMJ symptoms. Opt for a soft diet, including foods like yogurt, soup, and mashed potatoes, to reduce jaw strain.
4. Stress Reduction: Practice relaxation techniques such as deep breathing, meditation, or yoga to manage stress. High stress levels can contribute to TMJ pain and disrupt sleep.
5. Limit Caffeine and Alcohol: Both caffeine and alcohol can interfere with sleep patterns. Try to limit their consumption, especially in the hours leading up to bedtime.
6. Oral Appliances: Dr. Nojan Bakhtiari may recommend the use of oral appliances, such as splints or mouthguards, to help alleviate TMJ-related pain during sleep.
7. Sleep Hygiene: Maintain a consistent sleep schedule, create a comfortable sleep environment, and avoid stimulating activities before bedtime to improve sleep quality.
When to See a TMJ Specialist
Outlined below are five warning signs that indicate that you may need to see a TMJ specialist. It is a good idea to review these signs if treatment is needed as putting it off can be detrimental to one's health.
1. Jaw Pain and Surrounding Discomfort
TMJ disorder often presents as pain or soreness in the jaw due to dysfunction in the temporomandibular joint. This can extend to surrounding areas, including the face, neck, and upper back.
2. Pain While Chewing
Discomfort during chewing or even while opening the mouth can signal TMJ issues, indicating the need for a TMJ evaluation.
3. Jaw Clicking or Locking
Dysfunction in the temporomandibular joint may lead to clicking or locking in the jaw, causing discomfort and restricted movement.
4. Dental Wear and Tear
TMJ disorder often leads to teeth grinding and clenching, which can result in worn-down molars, sensitivity, and even decay.
5. Ear Pain
Due to the proximity of the temporomandibular joint to the ear canal, TMJ dysfunction can also cause ear pain or pressure, particularly if triggered by jaw injury.
What to Expect from Your First Appointment with a TMJ Specialist
Before your appointment, take some time to gather any information that may be important to your diagnosis and treatment. This includes your health records, any imaging done recently lists of medications (including vitamins and supplements) you’re taking regularly, and any mouth/jaw-related procedures you’ve had in the past. Your TMJ specialist will ask several questions during your first appointment and it can’t hurt to be over-prepared.
Your first appointment is full of questions, examinations, and possibly impressions. Here are some things you can expect from your first appointment with your TMJ specialist:
1. Comprehensive Health Questions: Your specialist will ask detailed questions about your health history, TMJ pain, and any other symptoms that might be related, as these can aid in diagnosis.
2. Physical Examination: The specialist will closely examine your jaw, head, and neck, focusing on alignment and movement to assess how your temporomandibular joint (TMJ) functions and determine effective treatments.
3. Imaging Tests: Special X-rays or tomographic imaging may be used to provide a clearer view of the joint.
4. Teeth Impressions: If necessary, the specialist may take impressions of your teeth to analyze your bite and chewing patterns.
By the end of the appointment, the specialist will have a clearer understanding of your TMJ pain, leading to a tailored treatment plan.
How to Choose the Best TMJ Specialist Near Me
When choosing your TMJ specialist, take these steps to ensure you're working with a highly trained professional with long-term experience treating TMJ disorders:
1. Check certifications. Beyond a dental degree, your TMJ specialist may have specialized training in orofacial pain.
2. Consider experience. You should determine how long your specialist has been practicing and if they frequently treat similar cases.
3. Seek patient reviews. Patients who take the time to provide positive reviews and details about their treatment can be excellent resources for new patients.
4. Determine your exact location radius. For example, if you are in the center of Houston, Texas, how far would you be comfortable traveling from there to see a specialist: 10 miles, 20 miles, 50 miles, or more?
5. Identify preferences. Identify any preferences you have related to the specialist's gender, hospital affiliation, and primary language.
6. Gather your medical records. Any documents you have relating to attempts to resolve your TMD would help find a resolution.
7. Make your first appointment. Call the office and ask the medical secretary if you need to provide any other information before the visit.
8. Get a second opinion. After your visit, feel free to seek a second opinion if you are uncomfortable with the results or feel you would get better care elsewhere. Your health is essential, so you should feel at ease advocating for yourself and the respect you deserve.
How to Find The Right TMJ Specialist Near You
As there are several treatment options, it's about finding specialists who will best address your concerns and provide the most comfortable approach. Here are some ways to expedite your search.
1. Ask Around
Word of mouth is one of the most tried-and-true ways to receive a recommendation about anything, especially when trying to find a specialist. If any of your friends or family is familiar with a specialist, ask them their opinions and what they liked about the provider. See if their comments align with what you're looking for in a provider.
2. Online
It's quite likely that friends and family may not have the best recommendations if they're not experiencing TMJ themselves; in this case, going on the websites of local dentists will give you a better insight into what they offer. Read up on their credentials and, most importantly, how they would approach TMJ treatment. Assess their ideas of therapy and see if these are interesting to you. Most major search engines also allow you to read reviews about people’s experiences there. In addition, you can ask for people’s opinions or recommendations in a local Facebook Group or something similar.
3. Insurance
A factor that may come into play is if the dentist carries your dental insurance. Treatments for TMJ vary, as do their prices. When evaluating which specialist is right for you, also inquire about your dental insurance to make sure they're in a contract with them.
4. Reviews
While on these sites, read what other patients have shared about their experiences. These reviews can help give a unique insight unbiased from friends and family and help decide if you're on the fence.
Sources:
Apple
Google (online)
Office 365 (online)
Outlook
Outlook.com (online)
Yahoo! (online)