TMJ Disorders

We have provided a TMJ Questionnaire as both a Microsoft Word document and an Adobe Acrobat file. Click on either to download and complete.

The latest research on TMJ says that clearing up dental infections and bacteria in the mouth gets rid of a high percentage of TMJ pain in many patients. Headaches, joint and muscle pain, etc., get better when cracked teeth, leaky amalgams, gum disease, etc. are treated. It seems logical to us to follow this protocol. Treat what is obviously defective in your mouth first and reassess your symptoms. Keep it simple. If the pain persists, then pursue TMJ specific treatment. You haven’t lost anything or done anything you didn’t need to do anyway. And it may solve your TMJ problems. If it turns out that you need splint therapy, here is some information on it.

Occlusal Splints for Temporomandibular Disorders (TMJ), Bruxism, or Clenching

Purpose: The purpose of this therapy is to influence your lower jaw to function freely and without pain. Many situations cause the malfunction of your lower jaw. Examples are accidents, surgery, developmental defects, peculiar oral habits, many fillings placed over numerous years, naturally occurring malocclusion (poor bite), orthodontics, psychological stress, clenching or bruxing (grinding teeth), and other conditions.

Rationale: You have received a plastic bite splint (occlusal splint). This treatment has been used for many years to keep the teeth from contacting during chewing and to allow the lower jaw to return to a comfortable hinge position without interference and guidance from the teeth.

Wearing Splint:
a. Temporomandibular Disorders: If your condition is temporomandibular disorder, you should wear the splint at all times, unless directed otherwise. This directive includes during eating. If you remove the splint to eat, your treatment will not be as effective. Many fillings placed in your mouth over the years or other conditions have caused your to meet in a position your jaws cannot tolerate. The splint eliminates the tooth-to-tooth contact. Your symptoms will gradually disappear while you are wearing the splint; and your natural teeth, bridges, and/or fillings will be adjusted by us to the new bite. This procedure is called occlusal equilibration. After equilibration, you will wear your splint only at night. Over a period of time, you will not wear the splint at all. The described treatment usually takes from a few weeks to several months.

b. Bruxism and clenching: If your condition is bruxism (grinding of teeth) or clenching, you should wear your splint only at night when you cannot control your jaw movements. During the daytime, make sure your splint is placed in water to prevent warping.

Cleaning splint and teeth: Food will accumulate around and under the splint. At least one time each day, brush and floss your teeth very thoroughly. Brush and rinse the inside and outside of splint, and then return it to your mouth. Dental decay can be stimulated if you are not careful about cleanliness of your mouth and splint. Fluoride containing rinses or gels are useful when placed in your splint once per day if you have a high dental-decay rate.

When the splint is out of your mouth: If the splint is out of your mouth for any reason, your teeth may not meet in harmony. This situation is to be expected because of muscle relaxation while you are wearing the splint. Occlusal equilibration will eliminate this improper meeting of the teeth (malocclusion). If the splint is out of your mouth, place it in a container of water to prevent it from warping. You may desire to soak it occasionally I none of the commercially available denture cleansers or to place a few drops of bleach in a water solution for a soak.

Occlusal Equilibration

Purpose: Teeth and jaws do not occlude (come together) in an acceptable position for many reasons. Some of them are fillings or bridges that have been placed over a period of years, orthodontics, developmental defects, oral surgery, trauma, malocclusion (poor bite), bruxism and clenching.

Occlusal equilibration is the mechanical adjustment of your teeth, dentures, bridges, fillings or other oral appliances to a position that allows your lower jaw to function in a natural hinge in relation to your upper jaw without improper influence from teeth.

Occlusal Equilibration—Is it harmful? Your mouth is being equilibrated because some problem exists: pain, abnormal wear, breaking of restorations, or other situations. The problem is usually present because the teeth and/or restorations do not meet in harmony with your lower jaw at the proper position. The teeth or fillings have not “worn in” properly. Occlusal equilibration “wears” some areas mechanically and allows the teeth to meet harmoniously. It is not harmful but is beneficial.

The Future: A simple occlusal equilibration can be accomplished in a short time. Only slight future changes in your occlusion (bite) occur over a period of time because small movements of teeth in the jawbones. More complex equilibrations may require several appointments, and the teeth may shift more between appointments. When your symptoms are gone and your occlusion is relatively stable, your equilibration will be finished. Placement of any new fillings in your mouth will change the way the teeth contact. The dentist accomplishing this treatment should be advised of your past occlusion problem.

How Your Teeth Feel: After occlusal equilibration, your occlusion (bite) will feel different to you. This is to be expected. You will gradually accept this location as your new chewing position, and it will feel very good.

Common Questions

Q) Is this like a football mouthpiece I buy at Wal-Mart?

A) Absolutely not! Our splits are custom made and engineered precisely to create a harmonious relationship between your upper and lower jaws. It causes a relaxation effect when your joints and muscles are in harmony. The football type will cause more harm than good (due to the fact that it is not fabricated to your mouth) and is ill advised.

Q) How long do I wear it?

A) Wear it for as close to 24 hours a day as possible while your doctor is treating you. Within a few weeks, you’ll be able to only wear it at night to maintain harmony. But when you have flare-ups, you can again wear it during the day. We are managing a cranky joint. It is not a cure.

Physical Therapy for Tempromandibular Disorders (TMJ)

The purpose of this therapy is to influence your lower jaw to function freely and without pain. Many situations cause the malfunction of your lower jaw. Examples are: accidents, surgery, developmental defects, peculiar oral habits, many fillings placed over numerous years, naturally occurring malocclusion (poor bite), orthodontics, psychological stress, clenching or bruxing of teeth, and other conditions.

The follow self-administered treatment will usually relax the jaw muscles considerably if you are consistent in carrying out the exercises. Approximately 80 percent of patients with muscular jaw problems feel better when doing this therapy, but some patients feel worse. Please tell us if this treatment does not help you. Even if you feel better after doing these exercises, additional treatment may be necessary.

These exercises should be accomplished one time per day (unless directed otherwise).

A convenient time for the exercises may be before bedtime. If this time is not acceptable for you, please select another convenient and relaxed time

Therapy

Further treatment such as a plastic bite splint to assist in making you bite in the correct position (occlusal splint), or slight, careful trimming of teeth and fillings to make your teeth and jaws come together correctly (occlusal equilibration), may be needed to assist I your treatment.

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