Millions of people in the U.S. suffer from the effects of the neuromuscular disorder called Temporomandibular Joint Dysfunction (TMD), also known as TMJ. Sadly, because the symptoms are similar to many other disorders, diseases, and conditions, TMD is frequently misdiagnosed. Choosing to see an experienced neuromuscular dentist for your routine cleanings and examinations is one of the best ways to ensure TMJ is properly diagnosed and treated.
If you have been struggling with jaw pain, chronic headaches, or any of the other symptoms of TMD, please call Forestream Dental at 716-656-8686 and schedule a consultation today. Dr. Larry Evola is an LVI-trained neuromuscular dentist serving Buffalo, Orchard Park, and nearby areas of New York from our office in Depew.
TMJ is a condition marked by misalignment of the jaw. During routine examinations, experienced neuromuscular dentists like Dr. Evola use hands-on evaluations to determine if misalignment is present. When detected, further diagnostic testing can be undertaken to determine if TMD is at the root of your discomfort.
Due to the intricate network of nerves and muscles in and around your jaw, symptoms of TMJ can be vast and complex – many occurring away from and seemingly unrelated to the jaw. However, relief requires swift diagnosis and intervention, making it a good idea to contact our office if you are suffering one or more of the following TMJ warning signs:
- Locking jaw or jaw with limited movement
- Unexplained loose teeth
- Worn, chipping or cracked teeth
- Chronic pain or soreness around the jaw joints
- Pain in teeth that seems to move around
- Neck, shoulder or back pain
- Generalized facial pain
- Clicking or popping sounds in the jaw joints
- Grinding noises when biting and chewing
- Numbness in fingers and arms
- Congestion, stuffiness or ringing of the ears
- Uneven bite
- Difficulty in chewing
Neuromuscular dentistry is the art and science of first discovering the relaxed position of the jaw muscles and jaw joint, and then devising treatments which will make this relaxed position permanent.
Healthy muscles work together in harmony and can rest more comfortably. When muscles rest in their natural position they can reduce many TMD symptoms, including grinding, enamel wear, and pushing of the teeth.
Understanding Your bite
When we close our mouth, that's known as our bite, and the dental term is occlusion. It can be well-aligned or misaligned. When it's misaligned, stress builds up in the jaw muscles, eventually pressuring the nerves and causing pain.
Why hasn't your jaw been in a relaxed position all along? The answer to that differs from person to person, and Dr. Evola will discover the answer to plan your treatment.
For instance, tooth grinding can be either a symptom of TMJ or one of its causes. If it's a cause, what then is the cause of the tooth grinding? It could be a psychological cause, in which case some psychotherapy might be recommended as part of your overall TMJ treatment.
If it's a symptom, it could be caused by misaligned teeth. Each time you close your mouth, the jaw muscles try to do it correctly despite teeth being in the way, bumping against each other, wearing each other down prematurely. Such repetition creates chronic stress that can find an outlet in teeth grinding.
Dr. Evola utilizes the most advanced technology to detect and diagnose TMJ. While each diagnostic evaluation is different, tools available for the purpose include:
- State-of-the-art computer technology
- Hands-on evaluations
- Mandibular scanners
Dr. Evola can record the movements and sounds of the jaw joint to help detect abnormalities. Every person has unique jaw and muscle physiology, so neuromuscular diagnosis and treatment is a custom science that involves careful study of an individual's oral and dental history, health, and habits.
Neuromuscular dentists have been trained in the diagnosis and treatment of TMJ. Some general and cosmetic dentists have undergone training in the specialty, but only a handful of dentists have completed all necessary course work to hold the title. Dr. Larry Evola is the only dentist in Western New York who is fully trained in neuromuscular dentistry.
Dr. Evola completed his graduate training in neuromuscular dentistry at the Las Vegas Institute (LVI) in Nevada, giving him the most sought-after dental training in the world.
Dr. Evola committed to this rigorous, demanding, and extensive post-doctorate training to learn the skills and obtain the knowledge and experience necessary to provide men and women lasting relief from the painful symptoms of TMJ.
The goal of your TMJ treatment will be a permanently relaxed jaw. So before any treatment can be planned, Dr. Evola will use a TENS unit to find where that relaxed position is in your case. The TENS unit has electrodes that are affixed to certain places on the head, neck, and shoulders, and they transmit a mild electrical impulse that painlessly relaxes muscles – often producing instantiations relief.
Between 30 and 60 minutes will be all that's needed for this gentle stimulation to relax your jaw muscles. Once completed, your lower jaw will be in its natural position, perhaps for the first time in many years! And as for the pain - headaches, earaches, facial, neck, and shoulder pain - it's all gone when your jaw is relaxed!
Once Dr. Evola has recorded and measured your relaxed jaw position, your natural bite, he will determine the best ways to make it permanent. That could include several treatments and strategies:
- Assigning a custom orthotic, a mouthpiece or splint that can be worn to retrain the jaw muscles. It fits over your back teeth, but stays invisibly behind the front teeth. It's not uncomfortable, but gently nudges your bite towards a relaxed position
- Reshaping teeth, moving them, or sometimes extracting one or two to make space (many people with TMJ have small mouths)
- If your TMJ was caused by an injury to the jaw joint, surgery is sometimes appropriate
- Sometimes anti-inflammatory drugs are used, at least for a while
- Physical therapy might be used in retraining the jaw muscles
- Hard foods might be avoided for a while, to give the jaw muscles a better chance of resting and relearning
- Psychotherapy might be used to help you let go of tension or anxiety
- Lifestyle changes such as meditation and relaxation techniques
In general, treatment is at first conservative. If simpler neuromuscular dentistry strategies don't work, more vigorous options can be used.
Most people have a customized combination of treatments that focus on their specific causes and symptoms. Dr. Evola takes all necessary steps in preparing, planning, and implementing TMD treatments that are fully customized to meet the exact needs of the patient. Send us an email or call us today to schedule a consultation and learn more.
What is the temporomandibular joint and where is it?
The temporomandibular joint is the ball and socket joint that connects the jawbone to the skull and is located right in front of each ear. TMJ disorder occurs when the joint is misaligned or not operating properly. Symptoms range from mild (a dull ache) to severe (migraines and chronic pain).
What causes TMJ?
While in some cases the cause of TMJ is unknown, there are quite a few common causes including the following:
- Mental and emotional stress
- Physical trauma or acciden
- Bad habits, such a nail-biting, chewing gum, clenching or grinding of teeth
- Dental work that doesn't fit properly
- Arthritis or other types of inflammation
- Poor posture
- Hereditary conditions
How do I know if I have TMJ?
If you have any of the following TMJ symptoms consistently, it is worth an appointment with a neuromuscular dentist to be evaluated.
- Dull or sharp jaw pain
- Clicking or popping of the jaw
- Difficulty eating or chewing
- Depression, in some cases
- Neck and shoulder pain
- Locking jaw
- Chipped or worn teeth
- Teeth that are loose for no apparent reason
- Tingling in the fingers
Can TMJ go away on its own?
TMJ may self-correct if conditions, emotional or physical, change substantially. However, under most circumstances, jaw misalignment will require the attention of an experienced neuromuscular dentist.
What happens if TMJ is left untreated?
Untreated TMJ can result in lasting and chronic facial pain, headaches, ear ringing and pain, sinus pressure, pain behind the eyes, and neck shoulder and back pain. It can cause a gradual sloping of the jaw, which can impact neck angle, which can impact posture, which can impact digestion and cause a host of issues as well.
Our bodies have networks of complex systems. Misalignment in one part can have far-reaching and unexpected consequences on all of the other. Choosing to ignore the symptoms of TMJ will likely result in larger and more serious concerns.
Are there effective treatments for TMJ?
Fortunately, yes, there are effective treatments. For some people, the treatment may be as simple as breaking a chronic gum-chewing habit. For others, the treatment may be more technical including bite therapy, mouth guards, jaw exercises and stretching, anti-inflammatory medications, corrective dental treatment and sometimes surgery.
If you've endured popping jaws or chronic jaw or neck pain long enough and you suspect that you have TMJ, call 716-656-8686 to schedule your consultation with neuromuscular dentist Dr. Evola today. Located in Depew, Forestream Dental welcomes patients living in Buffalo, Amherst, Lancaster, or Williamsville, New York. Relief is closer than you think! Call today to learn more!