Temporomandibular Joint Disorders (TMD, TMJ)

Your temporomandibular joint is a hinge that connects your jaw to the temporal bones of your skull, which are in front of each ear. It lets you move your jaw up and down and side to side, so you can talk, chew, and yawn.

Problems with your jaw and the muscles in your face that control it are known as temporomandibular disorders (TMD). But you may hear it wrongly called TMJ, after the joint.

What Causes TMD?

We don’t know all the causes of TMD. However, its symptoms can arise from problems with the muscles of your jaw or with the parts of the joint itself.

Injury to your jaw, the joint, or the muscles of your head and neck -- like from a heavy blow or whiplash -- can lead to TMD.

Other causes include:

• Grinding or clenching your teeth, which puts a lot of pressure on the joint
• Movement of the soft cushion or disc between the ball and socket of the joint
• Arthritis in the joint
• Stress, which can cause you to tighten facial and jaw muscles or clench teeth.
• Missing teeth
• Multiple dental restorations

Treatment options

Home Treatments for TMD

There are things you can do on your own to help relieve TMD symptoms.

• Take over-the-counter medications. Nonsteroidal anti-inflammatory drugs (NSAIDs), like naproxen or ibuprofen, can relieve muscle pain and swelling.
• Use moist heat for 5 min and massage the sore muscle area. Dr. Repscher can show you how do to this.
• Eat soft foods. Add yogurt, mashed potatoes, cottage cheese, soup, scrambled eggs, fish, cooked fruits and vegetables, beans, and grains to your menu. Cut foods into small pieces so you chew less. Skip hard, crunchy foods (like pretzels and raw carrots), chewy foods (like caramels and taffy), and thick or large bites that require you to open wide.
• Avoid extreme jaw movements. Keep yawning and chewing (especially gum or ice) to a minimum and don’t yell, sing, or do anything that forces you to open wide.
• Don't rest your chin on your hand. Don’t hold the phone between your shoulder and ear. Practice good posture to reduce neck and facial pain.
• Learn relaxation techniques to help loosen up your jaw. Ask your dentist if you need physical therapy or massage.

Doctor Directed Treatments for TMD

Medications 

• Dr. Repscher can prescribe higher doses of NSAIDs if you need them for pain and swelling. He might suggest a muscle relaxer to relax your jaw if you grind or clench your teeth. Or an anti-anxiety medication to relieve stress, which may bring on TMD. In low doses, they can also help reduce or control pain. Muscle relaxants, anti-anxiety drugs, and antidepressants are available by prescription only.

TMD Splint Therapy

These plastic mouthpieces either fit over your upper or lower teeth.  They lessen the effects of clenching or grinding and correct your bite by putting your teeth in a more correct position.

Dental work

Dr. Repscher can replace missing teeth and use crowns, bridges, or braces to balance the biting surfaces of your teeth or to correct a bite problem. He can even use a computer to balance your teeth to bite correctly.

The most effective treatment for TMD symptoms

Dr. Repscher uses two types of Splints to diagnose and treat TMD symptoms.

1. Tanner Splint

This splint is an appliance that fits on the lower teeth. It is designed to allow the TMJ, the muscle of mastication, and the teeth to work in harmony with each other.  The splint is also used to reduce TMJ inflammation. Over 90% of TMD symptoms are due to the muscle of mastication trying to balance the TMJ and the Teeth.  The Tanner Splint allows harmony to be achieved between these three systems. 

2. D-PASS

This splint is a diagnostic appliance used to reduce symptoms of clenching.  Its unique design allows a stable platform to decrease muscle contraction.  The D-PASS is an upper appliance that is retained through friction.  The easiness of wearing the appliance is comfortable and effective at decreasing muscle and TMJ soreness.