Diagnosis & Treatment of Jaw Problems (TMD)

Dr. Jay Lopez, in Tucson, AZ, has advanced training in diagnosing and treating jaw joint problems. Although the temporomandibular joint (TMJ) system is highly flexible, its muscles, ligaments, and jaw joints are influenced by your occlusion (the way your teeth come together when you bite and chew). “Temporomandibular Joint Disorder (TMD)” is a term used to refer to problems relating to the temporomandibular joints.

Many patients come to Dr. Lopez with tender facial, jaw and neck muscles, and they also exhibit occlusal wear consistent with malocclusion and bruxism. They sometimes suffer from multiple TMD complaints, including:

  • Soreness or pain in the cheek area (jaw muscle tenderness)
  • Clicking, popping and grating noise in the jaw joints
  • A limited ability to open the mouth wide or move it side-to-side with associated difficulty in chewing
  • Occasional inability to find a comfortable bite position
  • Occasional inability to move the jaw (often described by patients as having a locked jaw)
  • Deep pain in the jaw joint itself
  • Frequent headaches, often around the temple area
  • Earaches, buzzing, or ringing noises in the ears

Causes of TMD

Dysfunction of the jaw joint and the muscles that control lower jaw movement can be caused by:

  • Trauma to the jaw
  • An unbalanced bite (malocclusion)
  • Bruxism (habitual teeth grinding)
  • Being double jointed
  • Arthritis of joints in general
  • Over use of the temporomandibular joints
  • Habitual chewing on ice or other hard objects

The most common cause is an unbalanced bite. When you open your mouth, the rounded ends of the lower jaw (condyles) glide along the joint socket of the temporal bone. The condyles slide back to their original position when you close your mouth. To keep this motion smooth, a soft disc of cartilage lies between the condyle and the temporal bone. This disc absorbs shock to the temporomandibular joint during chewing and other movements. When the upper and lower teeth come together, the cusps can interfere with each other as you chew. The components of the jaw system are then forced to stretch and flex to move around the occlusal interferences. The protective disc in the joint that cushions the condyles may move forward or back depending on how the TMJ ligaments are stretched, allowing the jaw to pop out of the joint socket. Frequent overstretching of the muscles and ligaments results in painful inflammation. Without treatment, repeated condyle displacement puts you at risk for growing discomfort, chronic pain, wear on the condyles, and permanent damage to the jaw joints.

“Many people with TMD are not aware of what a correct bite feels like,” says Dr. Lopez. “They are also not aware that they are wearing down their teeth, weakening their dental restorations, and doing permanent injury to their joint system, due to their dysfunctional bite. Once, I show them close-up images of the wear on their teeth and demonstrate to them where teeth are interfering with one another, the light goes on, and they nod their heads, understanding the dynamics of what is causing their inflammation, head and neck tension, and limited jaw function. Because there are other factors that can cause TMD symptoms, a comprehensive examination and medical history may uncover why an individual has the symptoms, even though they have an optimal bite. Proper diagnosis will lead to understanding the cause or causes and the most appropriate treatment.”

Treatment of TMD

Dr. Jay Lopez can diagnose the occlusal problems that are causing the TMD symptoms, treat the inflammation, and correct the bite. Wearing a custom orthotic appliance (bite splint) during the night provides almost immediate relaxation of overworked muscles and tendons so the body can heal. As inflammation goes down, the jaw works more easily, and then, Dr. Lopez can provide orthodontic treatment, restore teeth, and/or make occlusal adjustments on the occlusal surfaces (tops) of teeth to create a lasting balanced bite.

Depending on the nature and severity your condition, Dr. Lopez will recommend treatment. This treatment may include:

  • Resting of the joints, switching to a soft diet and prescribed medication to relax tight muscles and alleviate inflammation
  • An intra-oral orthotic (therapeutic bite splint) specially designed to fit on the top of upper teeth and optimally position the lower jaw to redistribute stresses on the TMJs and keep the jaw system relaxed
  • Therapeutic massage in combination with an orthotic
  • Orthodontics to properly align teeth and modification of teeth to create an optimal bite

Additional treatment may be recommended to treat bruxism or obstructive sleep apnea, two common co-morbidities of TMD. Although migraines may be triggered by TMD, diagnosis and treatment will require the combined efforts of a dentist like Dr. Lopez and a physician with expertise in migraines.

Don’t suffer from TMD. Help is available. If you live in the Tucson area, give Jay Lopez, D.D.S. a call to schedule your initial TMD consultation.


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