Jaw Joint Treatment and Splint Applications

Jaw Joint Treatment and Splint Applications

Jaw joint disorders involve issues in the bones and soft tissues of the temporomandibular joint (TMJ), which connects the lower jaw to the upper jaw. Symptoms can range from mild, such as clicking sounds, to severe, like jaw locking. These issues can arise due to various reasons, including accidents, improper dental treatments, stress, and habits. TMJ disorders tend to worsen over time, so starting treatment early significantly increases success rates.

Problems/Conditions Caused by Jaw Joint Disorders

• Clicking sounds while eating
• Jaw locking or sticking
• Pain
• Restricted mouth opening

Causes of Jaw Joint Disorders

The causes can be grouped into three main categories:

1) Due to Dental Treatments:

• Prolonged open-mouth positions, such as during wisdom tooth extractions 
• Post-orthodontic treatment complications
• Improperly fitted crowns and fillings

2) Personal Habits:

• Lip biting
• Sleeping face down
• Resting the hand on the chin
• Chewing gum excessively
• Prolonged exposure to wind (common for motorcyclists)
• Poor posture

3) Stress:

Stress is a significant contributor, as it leads to constant muscle tension in the face, placing undue pressure on the TMJ.

What is Teeth Grinding or Clenching?

Teeth grinding (bruxism) often occurs during sleep and, if left untreated, can lead to serious issues like gum recession, tooth fractures, and TMJ disorders. It is the result of accumulated stress being released at night, causing the teeth to rub against each other unconsciously.

Problems Caused by Teeth Grinding or Clenching

• Tooth wear or fractures
• Gum recession and associated sensitivity
• Excessive pressure on the TMJ, leading to joint disorders
• Disturbance to others due to grinding noises

Treatment for Teeth Grinding or Clenching

Custom-made soft or hard night guards are recommended. These guards need regular replacement. Reducing daily stress also plays a crucial role in treatment success.

Do I Only Clench My Teeth at Night?

Contrary to popular belief, teeth clenching can occur during the day as well. Awareness and conscious effort can help prevent this habit.

Symptoms of Jaw Joint Disorders

Jaw joint disorders do not appear overnight; they develop gradually. Symptoms can range from clicking sounds when opening the mouth to more severe issues like jaw locking or dislocation if left untreated. Common signs include: 

• Clicking sounds while opening the jaw
• Jaw sticking during yawning
• Difficulty opening the jaw in the morning
• Pain near the ear while eating
• Neck and shoulder pain (more common in women)

What Happens If I Don’t Treat My Jaw Joint Disorder?

In advanced stages, permanent deformities may occur in the joint structures. The jaw may dislocate during movements due to the joint head shifting forward from its normal position. While the jaw can be repositioned with simple movements, frequent occurrences and severe pain are the primary concerns.

What Should I Be Careful About If I Have TMJ Issues?

• Stick to a soft diet for at least three weeks
• Avoid excessive yawning
• Do not sleep face down
• Avoid habits like lip biting
• Apply warm compresses to the joint area in the mornings
• Minimize stress as much as possible

The Role of Stress in Jaw Joint Disorders

Facial muscles tend to contract easily under stress, causing prolonged muscle tension. This places excessive pressure on the TMJ as the teeth are forcefully brought together, which can lead to joint disorders.

What is a Splint?

A splint is a custom-made, transparent intraoral device used to relax muscles and regulate jaw closure. It minimizes functional issues and prevents damage from teeth grinding or clenching. Treatment typically lasts between 3-6 months.

How to Care for a Splint?

After removing the splint, clean it under cold water with liquid soap and a brush. Avoid toothpaste or hot water, as they can deform the splint. Store it in a dry environment in its designated case.

How Long Should I Use the Splint?

The average treatment duration is three months, but this can vary depending on the severity of the disorder.

How to Store the Splint?

Store the splint in a prosthetic box with a moistened clean cloth.

How Often Should I Visit for Check-Ups During TMJ Treatment?

Check-ups are typically scheduled for the first week, the third week, and the third month after starting treatment.

How Will I Know If I’m Improving?

Complete recovery may not always be possible, depending on the severity of the condition. The main indicator of improvement is the ability to perform daily jaw movements (eating, speaking, swallowing, etc.) without pain.

Are There Physical Therapy Exercises Along with the Splint?

In some cases, your doctor may recommend physical therapy exercises to strengthen the muscles or improve jaw mobility.

How Do I Know If I Have a TMJ Disorder?

TMJ disorders present various symptoms, from mild clicking sounds to severe pain or jaw locking. Consult your dentist if you notice anything unusual, as the disease stage is critical for treatment.

What is the TMJ and How Does It Work?

The TMJ connects the lower jawbone to the skull at the temple area, facilitating chewing and speaking. A cartilage disc cushions the joint, preventing wear and tear. Ligaments surround the joint, holding the system together. A normal individual uses this joint 1,500–2,000 times a day.

What is TMJ Disorder?

It refers to the disruption of harmony between the TMJ and surrounding structures, either suddenly or gradually. Early symptoms can escalate to severe joint pain, headaches, shoulder pain, clicking sounds, jaw dislocation, and restricted opening if left untreated.

Who Should I Consult for TMJ Disorders?

A TMJ issue should be addressed by a maxillofacial surgeon (oral and maxillofacial specialist). Accurate diagnosis is the first step toward effective treatment, which may involve support from ENT, psychiatry, neurology, or physical therapy specialists, depending on the case.

When Should I Seek Help?

Consult a doctor if you notice any abnormal changes in the jaw joint area. Early detection of the cause increases the chances of successful treatment.

How Do TMJ Disorders Develop?

Several factors contribute to TMJ disorders, including:

• Several factors contribute to TMJ disorders, including:
• Stress
• Chewing predominantly on one side
• Improperly executed dental prosthetics
• Missing teeth
• Trauma to the jaw area
• Sports injuries
• Tumors or systemic conditions affecting the head and neck
• Prolonged and traumatic dental procedures
• Posture issues
• Neurological or psychological conditions
• Congenital anatomical abnormalities
• Parafunctional habits like chewing gum, biting pens, or nail-biting

Symptoms of TMJ Disorders

• Pain or fatigue in the jaw and cheek area while chewing
• Sensation of jaw misalignment
• Reduced mouth opening
• Difficulty opening the jaw in the morning
• Clicking or grinding sounds in the jaw
• Jaw locking
• Ear pain or pressure
• Headaches centered around the temples
• Neck and shoulder pain
• Facial asymmetry due to changes in chewing muscles
• Tooth wear and sensitivity
• Reduced quality of life and psychological distress due to symptoms

The Role of Stress and Teeth Grinding in TMJ Disorders

Daily stress can lead to unconscious teeth grinding both day and night, often going unnoticed. Chronic grinding causes muscles to remain contracted, placing excessive pressure on the TMJ. Early consultation with a dentist is crucial to prevent irreversible damage.

Diagnosis and Treatment of Teeth Grinding

A detailed examination of the teeth, bite system, chewing muscles, and TMJ is conducted. Imaging methods like MRI may be used when necessary. The goal of treatment is to restore normal and pain-free jaw function through methods like splints, exercises, pain relievers, muscle relaxants, or botox, depending on the severity of the condition. Patient cooperation is essential for success.

The Author of the Article: Dt. Alara Naz Kenir, Dr. Dt. Tuğrul Saygı