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The TMJ & Related Disorders

The Temporo-Mandibular Joint (TMJ)

The Temporo-Mandibular Joint, more commonly known as the TMJ, is the joint complex that connects the lower jaw (mandible) to the skull and helps you move your jaw to chew, eat and talk. Most of us have a set of two TMJs, one on each side of the face in front of the ears. The TMJ is made up of an intricate system of muscles, ligaments, bone, cartilage and synovial fluid that work together to allow us to use our jaw.

 

It is important to recognize that there are many structures outside of the TMJ complex that can contribute to pain and dysfunction in the facial region.

Pain in the Jaw, Face, Head, Tooth & Ear Pain:

If It's Not My TMJ, Then What Else Could It Be?

To begin with, remember that the TMJ is a joint. Not a disorder. Disorders related to the TMJ complex are collectively referred to as TMJ Disorders (TMJD or TMD).

Most of the time, it is not the actual joint or TMJ that is causing pain or dysfunction. Believe it or not, muscles, not the joint, are the most common source of non-odontogenic (not related to tooth structures) pain and dysfunction in the jaw region. Muscles have the unique ability to develop trigger points (areas of tight muscle fibers, commonly known as "knots") that can refer pain outside of the immediate muscle. Muscle pain can mimic tooth aches, ear aches and head aches. Identifying the true source of your pain can help to prevent unnecessary dental and medical procedures.

Dr. Wang is trained to identify the true source of your pain or dysfunction.

Muscle Referral Patterns:

Oh, The Places Your Muscle Pain Can Go

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Reference: Wright EF. Referred craniofacial pain patterns in patients with temporomandibular disorder. J Am Dent Assoc. 2000 Sep;131(9):1307-15. doi: 10.14219/jada.archive.2000.0384. Erratum in: J Am Dent Assoc 2000 Nov;131(11):1553. PMID: 10986831.

The Importance of an Accurate Diagnosis

Dr. Wang recognizes that there is a lot of unnecessary confusion around TMJ-related disorders, which can contribute to increased patient anxiety. A proper diagnosis with a proper explanation so that you can understand your body, are key steps to starting your healing journey.

At your initial visit, Dr. Wang's goal is to accurately diagnose the source of your jaw pain or dysfunction. She will review a detailed history of your symptoms and conduct a clinical exam. Imaging is not always necessary for a diagnosis, but in situations where additional imaging is required, Dr. Wang will explain and order the appropriate scan(s). If you already have recent scans, Dr. Wang will instruct you to forward them for her review. Panoramic x-rays and radiology reports of CBCT (3D cone-beam CT) within the past 5 years are typically the most useful scans for evaluating the TMJ structure.

Without an appropriate diagnosis, how will you know what needs to be treated?

Therapy Plan

Before creating a therapy plan, it is important to determine what exactly is causing your pain or dysfunction. The diagnosis will dictate the treatment.

Based on your diagnosis, a personalized care plan will be created for you. Dr. Wang begins by explaining her findings, down to the exact muscle group if appropriate.

 

After your initial visit, typically a 3-4 week follow up visit will be necessary to review progress and modify the care plan as symptoms resolve. Dr. Wang follows a stepped therapy plan by beginning with the most conservative care first and integrating additional therapies as needed. Additional visits are determined on an individual basis and are always explained in advance.

 

Potential therapies may include:

  • Home care therapy (stretching, heat, anti-inflammatory medications/supplements)

  • Oral appliance therapy

  • Review of health history and medications (some medications are known to cause or aggravate jaw tension) and care coordination with the prescribing physician(s)

  • Trigger point injection therapy

  • Sleep hygiene care plan

  • Stress management skill development

  • Supportive care coordination (physical therapist, chiropractor, massage therapist, acupuncturist, psychotherapist)

  • Referral for evaluation with other dental specialist (ie oral surgeon, orthodontist)

 

Contact our office to schedule an evaluation today.

At The Orofacial Pain Center, we are dedicated to helping you find relief.

Call us today: 773.873.6372

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