TMJ Syndrome: What You Need to Know

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If you have TMJ pain, you might wonder where to go for treatment. Your primary care physician? An orthodontist? You may not think of seeing a prosthodontist for TMJ syndrome, but prosthodontists receive specialized training in the diagnosis and treatment of temporomandibular joint disorders. At Integrated Aesthetic Dentistry, we provide effective TMD treatment that is minimally invasive and preserves your overall oral health.

What is TMJ Syndrome?

TMJ syndrome, also known as temporomandibular joint disorder (TMD), is a disruption of the normal function of the temporomandibular joint (TMJ) and its surrounding musculature. The TMJ is the joint that connects your jawbone and your skull. You have one on each side of your head and they act as a sliding hinge when you open and close your mouth. Most people rarely think about these joints until they start causing issues.

The TMJ is a small joint that has the ability to cause a tremendous amount of pain thanks to its location adjacent to retrodiscal tissues. These tissues have many nerves running through them, which is why even slight pressure can be painful for TMD sufferers.

What Are the Symptoms of TMJ Syndrome?

There are many signs of TMJ disorders. Patients with TMD experience one or more of the following symptoms:

  • Migraines and chronic headaches
  • Earaches and tinnitus
  • Facial pain
  • Damage to the teeth, usually from malocclusion
  • Pain in the jaw and temporomandibular joints
  • Difficulty chewing
  • Locking of the joints, making it difficult to open or close your mouth
  • Clicking and popping when you open your mouth or chew food
  • Swelling of the sides of the face
  • Muscle tension in the neck and upper shoulders
  • A feeling that your upper and lower jaw are no longer aligned when you close your mouth

When TMD is in its earliest stages, you may only have occasional, mild pain in the jaw and TMJ. As TMD progresses, you will begin to experience more severe symptoms like chronic headaches, a locked jaw, and tooth damage. This is why early intervention for TMJ syndrome is so important.

What Causes TMJ Disorders?

Repetitive behaviors such as teeth grinding, jaw clenching, chewing gum, fingernail biting, and ice chewing lead to overactive and enlarged muscles. When these muscles are tense, you begin to experience the symptoms outlined above. Often, these repetitive behaviors are brought on by stress and anxiety. Patients find that their TMJ symptoms are at their worst when they are under a great deal of stress.

While behavioral causes of TMJ syndrome are most common, there are also physical factors that can put you at a higher risk of developing TMD. These include arthritis, jaw injuries, erosion of the joint, and structural jaw problems present at birth. Bad posture can cause muscle strain that exacerbates TMJ symptoms as well; stress, poor diet, and lack of sleep also compound TMJ pain.

We often see patients who have a history of orthodontic treatment come to our office for TMJ syndrome. Do braces cause TMD? We know that there is a correlation between having braces as a child or teenager and developing TMJ disorders as an adult, but currently there is not enough evidence for researchers to conclude that braces cause TMD.

How is TMJ Syndrome Diagnosed?

When you come to our office for TMD treatment, we will first discuss your symptoms and medical history. Next, we will examine your jaw––this includes listening and feeling around the temporomandibular joints when you open and close your mouth, assessing your jaw’s overall range of motion, and putting gentle pressure on different areas of the jaw and face to identify areas that are causing pain.

We may also want to take x-rays to get a better look at your jawbone, the temporomandibular joints, and your teeth. These x-rays help not only with diagnosis, but with planning a course of treatment for your TMJ syndrome.

How is TMJ Syndrome Treated?

TMJ syndrome seems like it should be a simple disorder to treat, but effective solutions have proven elusive. Traditional TMD treatments include:

  • Botulinum toxin injections (Botox)
  • Night/bite guards or splints
  • Bite adjustments
  • Full mouth reconstruction
  • Acupuncture
  • Surgery to replace the temporomandibular joints
  • Over-the-counter and prescription medications that temporarily reduce pain, inflammation, or muscle tension
  • Physical therapy
  • Arthrocentesis, a procedure that removes debris and inflammatory byproducts from the joints

Some patients experience temporary relief from these therapies, but they rarely produce long-term results. Aggressive treatments, like full mouth reconstructions and bite adjustments, can worsen the condition over time and should be avoided.

Prosthodontists prefer taking a conservative approach to treating TMD pain. We believe conservative treatments are even more effective than invasive surgical options. At Integrated Aesthetic Dentistry, we offer botulinum toxin injection, commonly referred to as Botox injections, for TMJ syndrome.

Botox injections in certain muscles of the head and neck are a very effective treatments for TMJ syndrome, headaches and facial pain––in fact, a study of Botox for TMD found that 91% of patients experienced symptom relief. This treatment provides long-term relief of TMD, reducing the intensity, frequency, and duration of symptoms.

Botox has few side effects; most adverse events are related to improper needle positioning, which is why it is important to choose an experienced provider, like the prosthodontists at Integrated Aesthetic Dentistry, for your treatment.

What Can I Expect When Getting Botox for TMJ Syndrome?

Getting Botox injections for TMD is a simple outpatient procedure done right in our office. Individual treatment plans may vary, but in general, patients usually need about three visits to our office for treatment, with each visit lasting no more than 30 minutes.

Injections are typically done in the muscles of the jaw, forehead, and temples, along with any other sites that cause you pain. You may feel a small amount of discomfort with each injection, but anesthesia and sedation are not required for the procedure. Most patients see their TMD symptoms begin to improve after a few days. Immediately after the procedure, you may experience soreness and bruising or redness at the injection sites. These are usually mild, and they can be treated with cold compresses on the injection sites and over-the-counter pain relievers or anti-inflammatory medications.

Botox injections are a long-term solution for TMJ syndrome, but maintenance is required. Patients typically need to come back to our office every three to five months as the effects of the injections begin to wear off.

Will My Insurance Cover Botox for TMD?

Most dental and medical insurance plans do not cover Botox for TMJ syndrome. As Botox becomes more commonly used and accepted as a treatment for TMD, more insurance plans will begin to cover the costs. In the meantime, you can use FSA and HSA funds to pay for your treatment. Our billing coordinators are also happy to discuss financial arrangements with you prior to treatment.

The Bottom Line on TMJ Syndrome

When TMD symptoms are severe, it can have a dramatic impact on your quality of life. Frequent headaches may cause you to miss work, a sore jaw can prevent you from eating your favorite foods, and damaged teeth are susceptible to decay. You may have tried many different solutions in the past with no relief, but Botox has proven to be highly effective in the treatment of TMJ syndrome, with few side effects.

If you would like to learn more about Botox for TMD, schedule an appointment at our Greenwich Village office by calling 212-533-6782 or our Gramercy Park office by calling 212-254-5454. You can also book an appointment at either of our offices online.