Temporomandibular Joint Dysfunction Syndrome

Temporomandibular joint dysfunction Syndrome or Facial Athromyalgia refers to problems that affect the joint between the lower jaw and the base of the skull and the muscles of mastication. Increased activity of the muscles of mastication causes them to spasm and become hypertonic leading to pain in the muscles and the affected tempormandibular joint. Facial Athromyalgia is not usually a serious condition, but symptoms can impact significantly on quality of life. Doctors sometimes also refer to the condition as Temporomandibular pain disorder. It has been estimated that approximately 20-30% of the adult population will experience a TMJDS at some point.

What are the symptoms?

TMJDS can cause:

• clicking at the affected Temporomandibular joint whilst opening the mouth or whilst chewing
• muscle pain/spasms around the jaw
• pain in front of the ear that may spread to the cheek, ear and temple
• difficulty opening the mouth - the jaw may feel tight, as if it is stuck, making eating difficult
• headache or earache
• Increased occlusal/incisal wear of teeth
• presence of several abfraction lesions (small cavities on teeth by the gum margin) making the teeth hypersensitive to thermal stimuli
• Scalloping of the lateral borders of the tongue

What are the causes?

The main causes of TMJDS are:

• clenching your jaw or grinding your teeth during sleep (dental parafunctioning), which overworks the jaw muscles and puts pressure on the joint. This habit is thought to be caused by stress/anxiety. Dental parafunctioning is a common habit and 90% of the population is thought to dental parafunction from time to time.
• wear and tear of the inside of the jaw joint, usually caused by osteoarthritis
• a disease causing inflammation of the jaw joint, such as rheumatoid arthritis
• injury to the jaw joint, for example after a blow to the face or surgery

How is TMJDS treated?

Based upon a thorough extra-oral and intra-oral examination along with detailed history taking, a diagnosis of TMJDS can be made.

There are a number of self-help measures that can help improve TMJDS, including:

• resting the joint by eating soft food and avoiding chewing gum
• holding a warm flannel to the jaw after doing a few gentle jaw-stretching exercises
• avoiding opening the joint too wide
• massaging the muscles around the joint
• relaxation exercises to relieve stress (people tend to clench their jaw when stressed)
• not resting your chin on your hand

An occlusal splint is a thin shield of plastic that is 'U' shaped and fits snugly around either the upper or lower teeth. It separates the upper and lower teeth and in so doing prevents the upper and lower teeth from grinding against each other and protects the teeth from wear. It also encourages the lower jaw to go into a relaxed retruded position. It is also thought to interfere with proprioceptive feedback from the teeth and in so doing encourages the lower jaw to relax. The splint can be made out of a hard material like acrylic or a soft material like vinyl. A michigan type splint fits on the upper teeth and is generally more comfortable. A lower splint like a tanner appliance fits around the lower teeth. Splints are generally worn through the night as most dental parafunctioning is done through the night, whilst asleep. The hard acrylic splint can be shaped to have an ideal bite surface shape. It has a flat posterior bite plane that helps to eliminate occlusal interferences and has a shallow anterior slope/guidance that helps separate the posterior teeth in excursive movements. We custom make the hard acrylic michigan splint on a special mechanical device called a Denar semi-adjustable articulator. The relationship between the upper teeth, TMJ and lower teeth for an individual patient is transferred to this device which then mimics the excursive movements of that individual patient. In this way a customised occlusal shape can be incorporated in the occlusal splint for that individual patient.

An upper Michigan hard acrylic occlusal splint providing protection from dental parafunctioning.

Paracetamol or ibuprofen can also help relieve pain during episodes of severe pain.

We are a popular friendly local dental practice located in Southgate, London, N14 (in the London Borough of Enfield), if you are looking for a new dentist we welcome new patients and invite you to contact us to discuss your needs before you make an appointment and without obligation, in addition we provide Emergency Dental Treatment. If you have any fears or concerns about visiting the dentist or about your dental treatment you are most welcome to ask to speak to the dentist in confidence and without obligation before you start your treatment. We understand many people are aprehensive about a visit to the dentist, especially if you have not visited the dentist for some years, we strive to do all we can to make your visit to the dentist a pleasant one whilst receiving the best dental care. Our dental practice provides an emergency dentist service where urgent treatment is required, so if you are suffering dental pain or require other urgent dental treatment and need to see the dentist urgently please contact us to arrange to see the dentist for emergency dental treatment.

Whether or not we are your local dentist, we feel that the quality of the dental care is what makes us popular whether we are the patients local dentist or patients travel from other locations. Whilst some are tempted to simply opt for their nearest local dentist or search for a "dentists near me", "local dentist", "best dentist near me" or "nearby dentists", it is well worth considering comparing the service provided by your local dentist. Whilst we have many local patients, many patients find travelling from further afield well worth the extra travel to get outstanding dental care. As our surgery is next to Southgate N14 tube and bus station and we are easily accessible from across the London Borough of Enfield as well as neighbouring boroughs such as Barnet, Haringey and Hertfordshire. You will find that we are especially conveniently situated for residents in the following neighbouring areas: Southgate London N14, Palmers Green London N13, Winchmore Hill London N21, Whetstone London N20, Finchley London N12, Barnet Herts EN5, Cockfosters EN4, Enfield EN2, New Southgate N11 and Potters Bar, Herts.