What are the common symptoms of TMJ disorders. How are TMJ disorders diagnosed. What home remedies can help alleviate TMJ pain. When should you consider professional treatment for TMD. What surgical options are available for severe TMJ disorders. How can you prevent TMJ disorders from developing or worsening.

What is Temporomandibular Joint Disorder (TMD)?

Temporomandibular Joint Disorder (TMD) is a condition affecting the temporomandibular joint (TMJ), which connects your jaw to the temporal bones of your skull. This complex joint allows for various jaw movements essential for everyday activities like talking, chewing, and yawning. Despite being commonly referred to as “TMJ,” the correct term for the disorder is TMD.

The temporomandibular joint functions as a sliding hinge, facilitating both up-and-down and side-to-side movements of the jaw. When this joint or the surrounding muscles experience problems, it can lead to TMD, causing pain and discomfort in the jaw area and beyond.

Who is at risk for developing TMD?

TMD can affect anyone, but certain factors may increase the risk:

• Age: Most common among people between 20 and 40 years old
• Gender: Women are more likely to develop TMD than men
• Stress levels: High stress can lead to teeth grinding and jaw clenching
• Previous jaw injuries: Trauma to the jaw area can increase TMD risk
• Certain medical conditions: Arthritis and other joint-related disorders may contribute to TMD

Common Causes of Temporomandibular Joint Disorders

The exact causes of TMD are not always clear, but several factors can contribute to its development:

• Jaw injury or trauma (e.g., heavy blow or whiplash)
• Teeth grinding (bruxism) or jaw clenching
• Dislocation of the disc between the ball and socket of the joint
• Arthritis in the TMJ
• Chronic stress leading to muscle tension
• Misalignment of the jaw or teeth

Is there a genetic component to TMD? While research is ongoing, some studies suggest that certain genetic factors may increase susceptibility to TMD. However, environmental and lifestyle factors often play a more significant role in its development.

Recognizing TMD Symptoms: What to Look Out For

TMD can manifest through various symptoms, which may affect one or both sides of the face. Common signs include:

1. Pain or tenderness in the face, jaw joint area, neck, shoulders, or around the ear
2. Difficulty opening the mouth wide
3. Jaws that get “stuck” or “lock” in open or closed positions
4. Clicking, popping, or grating sounds when moving the jaw
5. Facial fatigue
6. Difficulty chewing or sudden changes in bite alignment
7. Swelling on the side of the face

Can TMD cause symptoms beyond the jaw area? Yes, TMD can lead to seemingly unrelated symptoms such as headaches, neck aches, dizziness, earaches, hearing problems, upper shoulder pain, and tinnitus (ringing in the ears).

Diagnosing TMD: The Path to Proper Treatment

Accurately diagnosing TMD is crucial for effective treatment. Dentists and oral surgeons typically follow these steps:

1. Health history review: Understanding your overall health and previous jaw issues
2. Physical examination: Checking jaw joints for pain, tenderness, and sounds
3. Range of motion assessment: Evaluating jaw movement and function
4. Bite analysis: Examining how upper and lower teeth align
5. Facial muscle evaluation: Checking for problems with facial muscles
6. Imaging tests: X-rays, MRI, or CT scans may be necessary for a detailed view of the jaw structure

Why might you be referred to an oral surgeon? In some cases, a general dentist may refer you to an oral and maxillofacial surgeon for specialized care. These experts have additional training in diagnosing and treating complex TMJ disorders.

Home Remedies and Self-Care for TMD Relief

Many TMD symptoms can be alleviated with simple home remedies and lifestyle changes:

• Over-the-counter pain relievers (NSAIDs like ibuprofen or naproxen)
• Applying moist heat or cold packs to the affected area
• Eating soft foods and avoiding hard, chewy, or crunchy items
• Practicing jaw exercises and stretches (as recommended by a professional)
• Avoiding extreme jaw movements (wide yawning, excessive gum chewing)
• Maintaining good posture
• Stress reduction techniques (meditation, deep breathing exercises)

How can you prevent nighttime teeth grinding? Consider using a night guard prescribed by your dentist. These custom-fitted devices create a barrier between your upper and lower teeth, reducing the impact of grinding and clenching during sleep.

Professional Treatments for Temporomandibular Joint Disorders

When home remedies aren’t sufficient, professional treatments may be necessary:

1. Physical therapy: Exercises to strengthen jaw muscles and improve flexibility
2. Medications: Prescription-strength pain relievers, anti-inflammatories, or muscle relaxants
3. Oral appliances: Custom-made splints or mouthguards to reduce teeth grinding and jaw clenching
4. Botox injections: To relax overactive jaw muscles (in some cases)
5. Cognitive behavioral therapy: To address stress and anxiety contributing to TMD
6. Acupuncture: Some patients find relief through this alternative therapy

Are corticosteroid injections effective for TMD? In some cases, corticosteroid injections into the joint can provide temporary relief from pain and inflammation. However, this treatment is typically reserved for severe cases and should be discussed thoroughly with your healthcare provider.

Surgical Interventions for Severe TMD Cases

Surgery is generally considered a last resort for TMD treatment when conservative methods have failed. Surgical options include:

• Arthrocentesis: A minimally invasive procedure to remove debris and inflammatory byproducts from the joint
• Arthroscopy: A type of keyhole surgery used to repair or reposition the joint disc
• Open-joint surgery: More extensive surgery to repair or replace the joint
• Modified condylotomy: Indirect surgery on the mandible to reduce pressure on the joint

What are the potential risks of TMJ surgery? As with any surgical procedure, TMJ surgery carries risks such as infection, nerve injury, and scarring. Additionally, there’s no guarantee that surgery will completely resolve TMD symptoms. It’s crucial to discuss the potential benefits and risks with your surgeon before proceeding.

Lifestyle Modifications and Long-Term Management of TMD

Managing TMD often requires a combination of treatments and lifestyle changes for long-term relief:

1. Stress management: Practice relaxation techniques and consider counseling if needed
2. Ergonomic adjustments: Ensure proper posture at work and during daily activities
3. Diet modifications: Opt for softer foods and avoid excessive chewing
4. Sleep hygiene: Improve sleep habits to reduce nighttime teeth grinding
5. Regular exercise: Engage in low-impact activities to improve overall health and reduce stress
6. Avoid habits that strain the jaw: Such as nail-biting, pen-chewing, or holding phones between your shoulder and ear

Can orthodontic treatment help with TMD? In some cases, misaligned teeth or jaw positioning can contribute to TMD. Orthodontic treatments like braces or clear aligners may help by improving bite alignment and reducing stress on the TMJ. However, this approach should be carefully evaluated by an orthodontist experienced in TMD management.

The Role of Interdisciplinary Care in TMD Management

Effective TMD treatment often requires a team approach, involving various healthcare professionals:

• Dentists: For initial diagnosis and conservative treatments
• Oral and maxillofacial surgeons: For advanced diagnostic imaging and surgical interventions
• Physical therapists: To provide exercises and manual therapy for jaw and neck muscles
• Pain management specialists: For comprehensive pain relief strategies
• Psychologists or psychiatrists: To address stress, anxiety, or depression related to chronic pain
• Neurologists: To rule out or treat associated headaches and facial pain

How can you ensure coordinated care among different specialists? Maintain open communication with your primary care provider or dentist, who can serve as the coordinator for your TMD treatment. Keep a record of all treatments, medications, and their effects to share with your healthcare team.

Emerging Treatments and Research in TMD Management

The field of TMD treatment is continually evolving, with new approaches being researched and developed:

1. Regenerative medicine: Stem cell therapy and platelet-rich plasma (PRP) injections show promise in repairing damaged joint tissues
2. Neurostimulation: Techniques like transcutaneous electrical nerve stimulation (TENS) may help manage pain
3. Advanced imaging: Improved diagnostic tools for more accurate treatment planning
4. Personalized medicine: Tailoring treatments based on genetic and biomechanical factors
5. Virtual reality therapy: For pain management and stress reduction

What role does artificial intelligence play in TMD diagnosis and treatment? AI-powered imaging analysis and treatment planning tools are being developed to assist healthcare providers in making more accurate diagnoses and creating personalized treatment plans for TMD patients.

The Impact of TMD on Quality of Life

Temporomandibular joint disorders can significantly affect a person’s daily life and overall well-being:

• Chronic pain can lead to decreased productivity and missed workdays
• Difficulty eating may result in nutritional deficiencies
• Sleep disturbances can cause fatigue and mood changes
• Social interactions may be affected due to pain or self-consciousness about jaw sounds
• Mental health can suffer, potentially leading to anxiety or depression

How can patients cope with the emotional impact of chronic TMD? Support groups, both online and in-person, can provide valuable emotional support and practical advice for living with TMD. Additionally, cognitive-behavioral therapy can help develop coping strategies for managing chronic pain and its associated stress.

Preventive Measures for TMD

While not all cases of TMD can be prevented, certain measures may reduce the risk or severity of symptoms:

1. Practice good posture to reduce strain on the jaw and neck muscles
2. Avoid excessive gum chewing or chewing on non-food items
3. Use proper technique when yawning to prevent overextending the jaw
4. Manage stress through regular exercise, meditation, or other relaxation techniques
5. Wear a mouthguard during contact sports to protect against jaw injuries
6. Address teeth grinding or clenching early with the help of a dentist
7. Maintain regular dental check-ups to catch potential issues early

Can dietary changes help prevent TMD? While diet alone may not prevent TMD, avoiding excessive consumption of hard or chewy foods can reduce strain on the jaw joint. Additionally, ensuring adequate intake of vitamins and minerals that support joint health, such as vitamin D and calcium, may be beneficial.

The Economic Impact of TMD

Temporomandibular joint disorders not only affect individuals but also have broader economic implications:

• Healthcare costs: Diagnosis, treatment, and ongoing management can be expensive
• Lost productivity: Chronic pain and associated symptoms may lead to reduced work efficiency or absenteeism
• Disability claims: Severe cases may result in short-term or long-term disability
• Research funding: Ongoing studies to improve understanding and treatment of TMD require significant investment

How does TMD impact the healthcare system? The complex nature of TMD often requires multiple healthcare visits and interdisciplinary care, placing additional demands on healthcare resources. Improving early diagnosis and effective management strategies could help reduce the overall economic burden of TMD.

TMD in Special Populations

While TMD can affect anyone, certain groups may have unique considerations:

1. Children and adolescents: Early intervention is crucial to prevent long-term complications
2. Elderly patients: May have comorbidities that complicate TMD management
3. Pregnant women: Hormonal changes may exacerbate TMD symptoms
4. Athletes: Higher risk of TMJ injuries in contact sports
5. Musicians: Wind and brass players may experience increased jaw strain

How should TMD be managed in pediatric patients? Treatment for children and adolescents with TMD typically focuses on conservative approaches, including behavioral modifications, physical therapy, and orthodontic interventions when necessary. Surgical options are generally reserved for severe cases that don’t respond to other treatments.

The Future of TMD Research and Treatment

As our understanding of temporomandibular joint disorders continues to grow, several areas of research hold promise for improved diagnosis and treatment:

• Genetic studies to identify risk factors and potential therapeutic targets
• Advanced imaging techniques for more precise diagnosis and treatment planning
• Development of biomarkers for early detection and monitoring of TMD progression
• Innovative materials for joint replacement and tissue engineering
• Integration of artificial intelligence in diagnostic and treatment decision-making processes

What role might telemedicine play in future TMD management? Telemedicine could potentially improve access to TMD specialists, particularly for patients in rural areas. Virtual consultations, remote monitoring of symptoms, and AI-assisted diagnostic tools may become increasingly important in the comprehensive care of TMD patients.

Temporomandibular Joint Disorders (TMJ & TMD): Overview

Written by WebMD Editorial Contributors

Medically Reviewed by Evan Frisbee, DMD on October 31, 2021

• What Causes TMD?
• What Are the Symptoms?
• How Is TMD Diagnosed?
• Home Treatments for TMD
• Traditional Treatments
• Other Treatments
• Surgery for TMD
• More

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.

We don’t know what causes TMD. Dentists believe symptoms 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 the teeth

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. More women than men have it, and it’s most common among people between the ages of 20 and 40.

Common symptoms include:

• Pain or tenderness in your face, jaw joint area, neck and shoulders, and in or around the ear when you chew, speak, or open your mouth wide
• Problems when you try to open your mouth wide
• Jaws that get “stuck” or “lock” in the open- or closed-mouth position
• Clicking, popping, or grating sounds in the jaw joint when you open or close your mouth or chew. This may or may not be painful.
• A tired feeling in your face
• Trouble chewing or a sudden uncomfortable bite — as if the upper and lower teeth are not fitting together properly. Learn more about the pros and cons of teeth alignment surgery.
• Swelling on the side of your face

You may also have toothaches, headaches, neck aches, dizziness, earaches, hearing problems, upper shoulder pain, and ringing in the ears (tinnitus).

Many other conditions cause similar symptoms — like tooth decay, sinus problems, arthritis, or gum disease. To figure out what’s causing yours, the dentist will ask about your health history and conduct a physical exam.

They’ll check your jaw joints for pain or tenderness and listen for clicks, pops, or grating sounds when you move them. They’ll also make sure your jaw works like it should and doesn’t lock when you open or close your mouth. Plus they’ll test your bite and check for problems with your facial muscles.

Your dentist may take full face X-rays so they can view your jaws, temporomandibular joints, and teeth to rule out other problems. They may need to do other tests, like Magnetic resonance imaging (MRI) or computer tomography (CT). The MRI can show if the TMJ disc is in the proper position as your jaw moves. A CT scan shows the bony detail of the joint.

You may get referred to an oral surgeon (also called an oral and maxillofacial surgeon) for further care and treatment. This doctor specializes in surgery in and around the entire face, mouth, and jaw area. You may also see an orthodontist to ensure your teeth, muscles, and joints work like they should.

There are things you can do on your own to help relieve TMD symptoms. Your doctor may suggest you try some of these remedies together.

Take over-the-counter medications. Nonsteroidal anti-inflammatory drugs (NSAIDs), like naproxen or ibuprofen, can relieve muscle pain and swelling.

Use moist heat or cold packs. Apply an ice pack to the side of your face and temple area for about 10 minutes. Do a few simple jaw stretches (if your dentist or physical therapist OKs them). When you’re done, hold a warm towel or washcloth to the side of your face for about 5 minutes. Perform this routine a few times each day.

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.

Keep your teeth slightly apart as often as you can. This will relieve pressure on your jaw. Put your tongue between your teeth to control clenching or grinding during the day.

Learn relaxation techniques to help loosen up your jaw. Ask your dentist if you need physical therapy or massage. Consider stress reduction therapy as well as biofeedback.

Talk to your dentist about these tried-and-true treatments for TMD:

Medications. Your dentist can prescribe higher doses of NSAIDs if you need them for pain and swelling. They 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.

A splint or night guard. These plastic mouthpieces fit over your upper and lower teeth so they don’t touch. They lessen the effects of clenching or grinding and correct your bite by putting your teeth in a more correct position. What’s the difference between them? You wear night guards while you sleep. You use a splint all the time. Your dentist will tell you which type you need.

Dental work. Your dentist can replace missing teeth and use crowns, bridges, or braces to balance the biting surfaces of your teeth or to correct a bite problem. Learn more about what causes an overbite, as well as when an overbite is considered normal.

If the treatments listed above don’t help, your dentist may suggest one or more of the following:

Transcutaneous electrical nerve stimulation (TENS). This therapy uses low-level electrical currents to provide pain relief by relaxing your jaw joint and facial muscles. It can be done at the dentist’s office or at home.

Ultrasound. Deep heat applied to the joint can relieve soreness or improve mobility.

Trigger-point injections. Pain medication or anesthesia is injected into tender facial muscles called “trigger points” to give relief.

Radio wave therapy. Radio waves stimulate the joint, which increases blood flow and eases pain.

Low-level laser therapy. This lowers pain and inflammation and helps you move your neck more freely and open your mouth wider.

If other treatments can’t help you, surgery is an option. Once it’s done, it can’t be undone, so get a second or even third opinion from other dentists.

There are three types of surgery for TMD. The type you need depends on the problem.

Arthrocentesis is used if you have no major history of TMJ but your jaws are locked. It’s a minor procedure that your dentist can do in their office. They’ll give you general anesthesia, then insert needles into the joint and wash it out. They may use a special tool to get rid of damaged tissue or dislodge a disc stuck in the joint, or to unstick the joint itself.

Arthroscopyis surgery done with an arthroscope. This special tool has a lens and a light on it. It lets your doctor see inside your joint. You’ll get general anesthesia, then the doctor will make a small cut in front of your ear and insert the tool. It’ll be hooked up to a video screen, so they can examine your joint and the area around it. They may remove inflamed tissue or realign the disc or joint. This type of surgery, known as minimally invasive, leaves a smaller scar, has fewer complications, and requires a shorter recovery time than a major operation.

Open-joint surgery. Depending on the cause of the TMD, arthroscopy may not be possible. You may need this type of surgery if:

• The bony structures in your jaw joint are wearing down
• You have tumors in or around the joint
• Your joint is scarred or full of bone chips

You’ll get general anesthesia, then the doctor will open up the entire area around the joint so they can get a full view and better access. You’ll need longer to heal after open-joint surgery, and there is a greater chance of scarring and nerve injury.

Top Picks

Temporomandibular Joint Disorders (TMJ & TMD): Overview

Written by WebMD Editorial Contributors

Medically Reviewed by Evan Frisbee, DMD on October 31, 2021

• What Causes TMD?
• What Are the Symptoms?
• How Is TMD Diagnosed?
• Home Treatments for TMD
• Traditional Treatments
• Other Treatments
• Surgery for TMD
• More

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.

We don’t know what causes TMD. Dentists believe symptoms 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 the teeth

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. More women than men have it, and it’s most common among people between the ages of 20 and 40.

Common symptoms include:

• Pain or tenderness in your face, jaw joint area, neck and shoulders, and in or around the ear when you chew, speak, or open your mouth wide
• Problems when you try to open your mouth wide
• Jaws that get “stuck” or “lock” in the open- or closed-mouth position
• Clicking, popping, or grating sounds in the jaw joint when you open or close your mouth or chew. This may or may not be painful.
• A tired feeling in your face
• Trouble chewing or a sudden uncomfortable bite — as if the upper and lower teeth are not fitting together properly. Learn more about the pros and cons of teeth alignment surgery.
• Swelling on the side of your face

You may also have toothaches, headaches, neck aches, dizziness, earaches, hearing problems, upper shoulder pain, and ringing in the ears (tinnitus).

Many other conditions cause similar symptoms — like tooth decay, sinus problems, arthritis, or gum disease. To figure out what’s causing yours, the dentist will ask about your health history and conduct a physical exam.

They’ll check your jaw joints for pain or tenderness and listen for clicks, pops, or grating sounds when you move them. They’ll also make sure your jaw works like it should and doesn’t lock when you open or close your mouth. Plus they’ll test your bite and check for problems with your facial muscles.

Your dentist may take full face X-rays so they can view your jaws, temporomandibular joints, and teeth to rule out other problems. They may need to do other tests, like Magnetic resonance imaging (MRI) or computer tomography (CT). The MRI can show if the TMJ disc is in the proper position as your jaw moves. A CT scan shows the bony detail of the joint.

You may get referred to an oral surgeon (also called an oral and maxillofacial surgeon) for further care and treatment. This doctor specializes in surgery in and around the entire face, mouth, and jaw area. You may also see an orthodontist to ensure your teeth, muscles, and joints work like they should.

There are things you can do on your own to help relieve TMD symptoms. Your doctor may suggest you try some of these remedies together.

Take over-the-counter medications. Nonsteroidal anti-inflammatory drugs (NSAIDs), like naproxen or ibuprofen, can relieve muscle pain and swelling.

Use moist heat or cold packs. Apply an ice pack to the side of your face and temple area for about 10 minutes. Do a few simple jaw stretches (if your dentist or physical therapist OKs them). When you’re done, hold a warm towel or washcloth to the side of your face for about 5 minutes. Perform this routine a few times each day.

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.

Keep your teeth slightly apart as often as you can. This will relieve pressure on your jaw. Put your tongue between your teeth to control clenching or grinding during the day.

Learn relaxation techniques to help loosen up your jaw. Ask your dentist if you need physical therapy or massage. Consider stress reduction therapy as well as biofeedback.

Talk to your dentist about these tried-and-true treatments for TMD:

Medications. Your dentist can prescribe higher doses of NSAIDs if you need them for pain and swelling. They 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.

A splint or night guard. These plastic mouthpieces fit over your upper and lower teeth so they don’t touch. They lessen the effects of clenching or grinding and correct your bite by putting your teeth in a more correct position. What’s the difference between them? You wear night guards while you sleep. You use a splint all the time. Your dentist will tell you which type you need.

Dental work. Your dentist can replace missing teeth and use crowns, bridges, or braces to balance the biting surfaces of your teeth or to correct a bite problem. Learn more about what causes an overbite, as well as when an overbite is considered normal.

If the treatments listed above don’t help, your dentist may suggest one or more of the following:

Transcutaneous electrical nerve stimulation (TENS). This therapy uses low-level electrical currents to provide pain relief by relaxing your jaw joint and facial muscles. It can be done at the dentist’s office or at home.

Ultrasound. Deep heat applied to the joint can relieve soreness or improve mobility.

Trigger-point injections. Pain medication or anesthesia is injected into tender facial muscles called “trigger points” to give relief.

Radio wave therapy. Radio waves stimulate the joint, which increases blood flow and eases pain.

Low-level laser therapy. This lowers pain and inflammation and helps you move your neck more freely and open your mouth wider.

If other treatments can’t help you, surgery is an option. Once it’s done, it can’t be undone, so get a second or even third opinion from other dentists.

There are three types of surgery for TMD. The type you need depends on the problem.

Arthrocentesis is used if you have no major history of TMJ but your jaws are locked. It’s a minor procedure that your dentist can do in their office. They’ll give you general anesthesia, then insert needles into the joint and wash it out. They may use a special tool to get rid of damaged tissue or dislodge a disc stuck in the joint, or to unstick the joint itself.

Arthroscopyis surgery done with an arthroscope. This special tool has a lens and a light on it. It lets your doctor see inside your joint. You’ll get general anesthesia, then the doctor will make a small cut in front of your ear and insert the tool. It’ll be hooked up to a video screen, so they can examine your joint and the area around it. They may remove inflamed tissue or realign the disc or joint. This type of surgery, known as minimally invasive, leaves a smaller scar, has fewer complications, and requires a shorter recovery time than a major operation.

Open-joint surgery. Depending on the cause of the TMD, arthroscopy may not be possible. You may need this type of surgery if:

• The bony structures in your jaw joint are wearing down
• You have tumors in or around the joint
• Your joint is scarred or full of bone chips

You’ll get general anesthesia, then the doctor will open up the entire area around the joint so they can get a full view and better access. You’ll need longer to heal after open-joint surgery, and there is a greater chance of scarring and nerve injury.

Top Picks

Distal occlusion – why it appears and features of treatment in children and adults

Distal occlusion is an anomaly of occlusion associated with the sagittal plane, it is a type of occlusion when the lower jaw is in a posterior position.

There are many possible nuances here. This can be, for example, a true distal bite, when the reason is precisely in the underdevelopment of the lower jaw, when the problem is in the joint and, again, the lower jaw occupies a posterior position.

If the patient does not have underdevelopment of the lower jaw:

• it could be genetics,
• this may be a short frenum of the tongue, which prevents the development of the lower jaw,
• this may be a narrowing of the upper jaw,

that is, there are a lot of reasons, but the result is the same – the development of a distal occlusion.

How does it happen

• There is a retroposition of the lower jaw – its posterior position, but the dimensions are normal. Here it is quite simple to push the lower jaw forward on special devices, put it in the correct position and restore the correct closing of the teeth.

• And there is another reason when the patient has an overdevelopment of the upper jaw, that is, a large upper jaw, the lower jaw is of normal size.

• And again, a combination of two anomalies: a large upper jaw, a small lower one.

Therefore, the features of the distal occlusion are individual, each patient has his own problems. And, accordingly, each problem of the distal occlusion has its own treatment.

What can provoke the development of distal occlusion?

Let’s start here

• with our favorite pacifier:
• with thumb sucking:
• it is adenoids and mouth breathing, often rhinitis, allergic especially when parents do not maintain in constant remission.

There is also such a habit as biting the lower lip :

but this is more as a consequence of the fact that when a child sucks his finger, he deforms his upper jaw, pulling it forward, the lower jaw has a flattened appearance, that is, we push the lower jaw with a finger, and what do we get? Our upper teeth move forward and it is naturally very convenient for us to bite our lower lip. As a result, pressure of the lip muscles appears, that is, the circular muscle of the mouth begins to act on the upper teeth and pushes them even more, that is, it acts as a kind of lever. There is an attachment to the distal occlusion, as in the situation with the tongue – the patient “receives” open bite :

and then he “finishes” the development of pathology with his tongue.

Be sure to draw the attention of parents to the adenoids and bad habits of the child, that is, these are the most important points.

Overbite: causes, how to fix it

Any anomaly of bite (occlusion) is determined by the position of the antagonist dentition when closing. The distal bite is also called prognathic. This disorder is common and can be mild or severe. Amenable to correction and treatment at any age.

Signs and diagnosis

Such a pathology is a type of improper closing of the teeth, when the lower jaw is shifted back, the chin looks miniature, and the large upper jaw protrudes forward. The phenomenon is common, according to statistics – this is every third malocclusion.

Correction of the distal occlusion by various methods is possible in children or adults and will allow you to restore the physiologically justified mechanisms of chewing, rhythmic breathing, and the purity of pronunciation of sounds. Criteria for the severity of the anomaly:

• A slight violation is considered if the opposite “sixes” are in contact when the dentition is closed.
• An urgent correction is needed when the upper sixth tooth, when the jaws are compressed, is between the fifth and sixth lower.

A distorted sagittal plane is a clear sign of an overbite pathology. The gap between the dental units, when the anterior teeth protrude, is a symptom of prognathism, which is noticeable even to patients.

The greater the distance, the more serious the problem. Slot, mm:

• less than 3 – mild degree is diagnosed.
• 3 to 6 medium.
• over 6 heavy.

The location of the teeth and the presence of a gap between them are clear signs of a violation of occlusion.

Symptoms of underbite

In addition to the signs that only the dentist knows about, distal bite is accompanied by a pronounced bright symptoms :

• Facial disproportions – an imaginary line that can be drawn from the tip of the nose to the middle of the chin does not touch the lips. “Bird” profile is noticeable – beveled with narrow lips sinking:
• Chin wrinkle due to the fact that the lower jaw moves back and the lip sinks under the upper incisors:

When smiling, it is noticeable that the upper front teeth are pushed forward. A double chin is often formed, even in those who are not overweight. When the degree is severe, the lips do not close, and the mouth seems ajar. Diction is broken, the pronunciation of hissing, whistling sounds is distorted.

Causes of underbite

Such a bite has several causes, more often a combination of different factors. This:

• Genetic predisposition.
• Rickets suffered in childhood, respiratory diseases not treated in time. The habit in childhood of holding an object between the teeth.
• Early removal (loss) of several units – especially canines.
• Thickened short bridle.

It is possible that malnutrition during the formation of the jaw apparatus led to the violation – the lack of a sufficient amount of trace elements and vitamins.

Distal occlusion: treatment

The pathological position of the dentition causes uneven distribution of the load on the jaw apparatus. It provokes diseases of periodontal tissues, is the cause of pathologies of the jaw joints, damage to tooth enamel, mobility of the root system of units.

Diagnostics

The doctor draws conclusions after a visual examination and analysis of CT scans or X-rays, which allow to clarify the structure of the jaw and see the position of the roots.

Examples of work

A 15 year old child: four canines in deocclusion created a second row of teeth. Braces Damon Clear

Pathology

lack of space in the dentition, narrowing of the dentition, crowding of teeth, disocclusion of the canines, distal position of the mandible

Bite Correction System

Damon Clear Brackets

See work

Patient 14 years old – Damon Clear Brackets and posterior occlusion

Pathology

Distal occlusion, center line shift, narrowing of dentition, bore value, deviation

Bite Correction System

Damon Clear braces

View artwork

Do you want to correct your or your child’s overbite?

Make an appointment now!

How is overbite treated and at what age?

You need to start treatment the sooner the better. In the early stages from 2 to 5-6 years there are more preventive procedures – this is the wearing of a myofunctional apparatus – a trainer.

More complex procedures follow – you need to push the lower jaw, you need to rebuild the muscles, you need to rebuild the joint, and here the twin block device helps very well. This is a difficult construction – laminar devices for the upper and lower jaws, which include such occlusal linings, they push the lower jaw and prevent it from standing in the rear position. this way:

• teething occurs in a certain position,
• joint realignment
• and the muscles begin to work in a new way.

Such treatment can be started at 7-8 years old, if severe cases, the optimal age is somewhere around 8-9 years old and most often, of course, we use it at 12-13 years old in children before orthodontic treatment, or in conjunction with a bracket system , everything is individual here.

If it is possible to stretch the lower jaw to the braces and generally try to avoid treatment on the bracket system, why not, in this way:

• future treatment with braces can be avoided,
• if a child was brought to the orthodontist, you can put this apparatus on him, undergo a course of treatment on it and finish it,
• if any further adjustments are needed – they are applied on non-removable equipment.

Treatment of distal occlusion in adults is carried out both on braces and with the help of aligners.

More about the treatment of distal occlusion

Distal occlusion in children is easier to correct. Toddlers from 2 years old are recommended to use orthodontic plates. In younger adolescence, trainers and mouthguards are used. Ideally, the correction should begin before the change of milk teeth to molars. Approximately 90,005 by age 10 chewing teeth and fangs erupt, which may not have enough space and it is important to regulate the process in time.

Correction of an overbite during the period of growth / replacement of teeth is carried out using a partial system of braces on the first molars plus permanent incisors. Surgical intervention is possible when the asymmetry of the face, chin dysplasia is strongly pronounced, it is necessary to trim the frenulum.

Overbite in adults will require long-term treatment – it may take 2-3 years or more. The main task of the orthodontist is to stimulate the growth of the lower jaw and contain the upper. That is why the procedures are more effective when the jaw system has not yet formed.

Braces are considered a common way to correct an overbite in adult patients. The metal arc is fixed on the teeth with locks of various designs. She seeks to regain shape by returning teeth and bone to their natural position. Aligners will help to overcome the distal bite – caps made according to individual casts or based on 3D scanning. You can remove aligners, unlike braces, but only during meals.

With distal occlusion, the operation is performed only in case of severe degree and inability to use other means. Removing some teeth can speed up the correction process.

If there is a problem, then you need to visit the dentist, the orthodontist will tell you how to correct the distal bite in your case and how long it will take.

What is bite and its main types read in our article

Want to correct an overbite for yourself or your child?

Orthodontist-center “Ortodontika” has been successfully treating patients since 1999 . The specialization of the clinic in the field of orthodontics allows us to provide an exceptionally high level of correction of the distal occlusion.

The head doctor of the clinic is the most experienced specialist, the doctor of the highest category – Polunova Oksana Vasilievna, experience in orthodontics more than 27 years . All her assistants and assistants are certified orthodontists, incl. candidates of medical sciences.

Polunova Oksana Vasilievna already in 2007 received the Incognito Master Class certificate, having completed an internship in Germany at Dr. Wichmann’s clinic in Bad Essen, and since 2016, the manufacturer of this system, 3M Unitec, has awarded her the title of Expert Incognito and WIN .

Oksana Vasilievna has more than 22 years of experience with lingual braces. This is the BIGGEST expert experience in Moscow.

We are the best in correcting the bite in adults and children.

Make an appointment now!

Appointment at the orthodontist center Orthodontics regarding the correction of distal occlusion. We will call you back!

Fill out the form and you will be contacted to make an appointment at a convenient time for you.

Why does the lower jaw hurt? Do not be surprised if in the first days it brings discomfort, including pain in the lower jaw. Usually, discomfort disappears within a week as the body adapts – if they persist, it is likely that the orthodontist made a mistake when calculating the load.

But pain in the lower jaw can have other causes, not related to the correction of the bite. In addition, it is not always possible for a person to determine exactly where its source is located. Therefore, Star Smile experts talk about all the possible roots of the problem.

Pain in the jaw

Pain in the teeth

Pain in the teeth of the lower jaw varies in intensity, respectively, and the perception of its localization changes, for example:

1. It is easy to determine which unit is affected.
2. Suspicion is a group of teeth, especially if caries has occurred on the contact surface (where one tooth borders another).
3. The pain “spreads” over the entire area of ​​the jaw.

The latter is observed with deep or multiple pulpitis, the development of which is unlikely during orthodontic treatment. The nerve does not become inflamed instantly: it is always a complication of advanced caries, and before the bite is corrected, a thorough diagnosis is carried out, after which the identified carious cavities are eliminated.

Another possible reason why the lower jaw teeth hurt is periodontitis. Inflammation develops in the area of ​​the ligamentous apparatus of the teeth. It can just appear during orthodontic treatment if the roots are under excessive load.

Gums hurt

In severe pain, a person does not understand whether the pain is limited to soft tissues or reaches the bone. This gives the impression that the jaw is splitting. This is possible in the following situations:

1. Wisdom teeth eruption. It always happens suddenly: it is impossible to predict when it will surface (if at all). Painful sensations are usually intense, spilling far beyond the source.
2. Periodontitis. Inflammation of the gums, affecting the ligaments, usually becomes a contraindication for correcting the bite. However, it may appear already during treatment – a similar phenomenon is not excluded.
3. Trauma. Soft tissue injury can cause intense spilling sensations in people with a low pain threshold.

You can immediately exclude a cyst. A benign neoplasm in the area of ​​​​dental roots usually grows asymptomatically, and begins to hurt at advanced stages. So it is either detected and removed before orthodontic treatment, or only begins to form during it.

Need help?

Need help?

Sign up for a free consultation

By clicking on the “Waiting for a call” button, you confirm your

consent to the processing of user data

Thank you for your application, our manager will contact you

Pain in the bone

Severe pain in the lower jaw can come from the bone if it is damaged. The reasons are different:

1. Consequence of a complex extraction, if supernumerary teeth or problematic “eights” were removed before the bite was corrected.
2. Trauma (fracture, crack). Orthodontic appliances, even with a significant load error, will not break the bone, but the external application of force as a result of a fall, accident or fight can lead to such consequences.
3. Osteomyelitis. Purulent inflammation of the bone tissue begins for reasons beyond the control of the dentist, so its development during bite correction cannot be predicted.

In these situations, it is the jaw that hurts – the bone. Although the orthodontist must be informed, the problem can be solved outside the dental clinic.

Pain in the joint

Pain in the joint of the lower jaw is quite common during bite correction. Pathologies, especially advanced ones, often cause TMJ diseases:

• dysfunction;
• arthritis;
• damage to the articular disc.

Until the dentoalveolar anomaly is completely eliminated, the joint is still subjected to loads, although they gradually decrease. Therefore, the pain may persist for some time.

Traumatic dislocation can also cause similar sensations. Getting it is possible at any time, and wearing orthodontic appliances has nothing to do with it.

Nearby structures hurt

Sometimes pain sensations have nothing to do with the place where they appear. Irradiation of pain to the lower jaw from other organs is a well-known phenomenon. If the dentist does not find the causes in the oral cavity, they need to be looked for outside of it.

Pain may radiate to the lower jaw from:

• facial muscles;
• salivary glands;
• trigeminal nerve;
• cervical lymph nodes;
• middle ear;
• hearts.

The last situation is especially dangerous. Many remember that a heart attack can manifest itself as discomfort under the shoulder blade, in the arm or stomach.