TMD, 410-696-4624, Dr. Trepp, Orthodontist

TMD (Tempromandibular Disorder)

If you have questions about TMD, you are not alone. Researchers, too are looking for answers. TMD problems can be caused by a variety of sources. It is most often self limiting but it can be progressive. TMD is often managed, rather than resolved or cured. The symptoms of TMD may persist, change, reoccur intermittently or disappear. Research published in the Journal of Orofacial Pain in 2000 concluded that TMD symptoms tend to diminish with time in nearly half of the people who have symptoms. Occasional discomfort in the jaw or chewing muscles is quite common and is generally not a cause for concern. Jaw clicking is also fairly common in the general population. Research published in the American Journal of Orthodontics and Dentofacial Orthopedics in December 2006, concluded that occlusion once considered the primary and sole cause of TMD, now has at best a secondary role in the cause of TMD and orthodontic treatment does not cause TMD. The National Institute of Dental Research says the key words in treatment are "conservative" and "reversible". A conservative approach is to view TMD as a painful muscle strain. It may respond to the same kinds of conservative muscle treatment that are used else where in the body. Success of treatment is often dependent upon your compliance with prescribed treatment and recommendations for changes in behavior. Discontinue any approach below which aggravates your symptoms and seek local medical or dental advice.

TMJ Joint Image

Home Care Approaches For Mild Problems:

Rest- no gum chewing or nailbiting, eat a softer diet, avoid tough food, cut food into small pieces, limited phone conversations.

Avoidance- no wide yawning, no vocal strains (voice lessons, choir singing, cheer leading), no unnecessary jaw movements to intentionally create clicking or popping, no strenuous lifting

Keep TEETH APART at rest. Place post-it notes all over your home and workplace to remind yourself frequently that in a normal bite, the top and bottom teeth have a slight separation between them at rest.

Physical therapy- ice for acute pain, heat packs for more chronic pain, self message, jaw manipulation, hot showers, saunas, and steam baths.

Over the counter analgesics- non-prescription non-steroidal anti-inflammatory medications such as ibuprofen taken around the clock following package insert for dose, may be very effective in breaking a cycle of pain and inflammation.

Relaxation- try practicing relaxation techniques such as meditation or biofeedback. Use stretching exercises to relieve stress and tension associated with muscle pain.

Professional Care which should initially be the least invasive and most reversible therapy possible:

Plastic splints called night guards or bite plates- may be used as a temporary measure to relax the muscles and reduce the undesirable side effect of oral habits such as tooth grinding or gritting.

Prescribed medications such as muscle relaxants, analgesics, anti-anxiety drugs, and anti-inflamatory medications.

Counseling

Researchers in the Journal of Prosthetic Dentistry in 2001, concluded that altering tooth shape by grinding (occlusal adjustment) had no benefit in relieving TMD disorders in general. Artificial tooth replacement, moving teeth by orthodontics (braces), or joint surgery should also be used as last resorts because they are invasive and irreversible. Researchers in the American Journal of Orthodontics and Dentofacial Orthopedics in December 2006, concluded that the use of occlusal adjustments in orthodontic patients has no evidence-based support.

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You may schedule an orthodontic appointment with Dr. William Trepp in his Severna Park, MD office by calling 410.696.4624 or in his Clinton, MD office by calling 301.868.6200. Written inquiries should be mailed to: 69 Robinson RD, Severna Park, MD 21146, USA or 8918 Woodyard RD, Clinton, MD 20735, USA