What are the first signs of TMJ?
The first signs of temporomandibular joint disorder (TMD) or orofacial pain are often clicking or popping noises in the jaw joint, limited or abnormal jaw opening, pain when chewing or talking, jaw pain or discomfort, pain in the facial muscles, earaches, and headaches. The growing interest in TMD disorder is explained, in part, by the fact that more than half of all physician visits are for head pain.

Are there any particular group of individuals who are more likely to get TMD?
The most common group of individuals who manifest symptoms of TMD are women 60-70% over men, usually in the 20 – 50 year old age group. However, TMD is also common in children, as well as senior citizens, and crosses all socioeconomic boundaries.

Is TMD more likely to be hereditary or acquired?
There are more acquired factors that can cause TMD symptoms (i.e. trauma, whiplash injury, clenching and grinding of the teeth, failure to replace missing teeth, bad habits such as chewing on nails, pencils, lips, and posture, etc.). However, hereditary factors causing TMD signs and
symptoms are also abundant.

What are the treatment options?
Because TMD symptoms can be so varied and mimic so many other conditions, the most important step in evaluating a possible TMD patient is to make a proper diagnosis. Once diagnosed, treatment for TMD is relatively simple. Again, however, because of the vast and
varied number of possible symptoms, a dentist specially trained in the diagnosis and treatment of TMD is necessary to prescribe the appropriate type of treatment for that particular patient’s
needs. Most patients require an oral orthopedic appliance (or splint), designed specifically for each patient’s individually diagnosed symptoms. This splint is made of clear acrylic and usually fits over the upper teeth.

For the muscular component of the TMD, physical therapy (i.e. ultrasound, massage, exercise therapy) is usually required. Patient education on how to protect the temporomandibular joint and how to prevent future occurrences should also always be provided. In some cases, when indicated to help relax muscles, manage pain, and help reduce stress, medications (i.e. anti-inflammatory and muscle relaxants), and stress reduction (i.e. bio-feedback) are also incorporated into the treatment. Once the symptoms are alleviated and the jaw and muscles are stabilized (healed to their best potential), the patient is usually provided with a nightguard. In only a very small percentage of instances, and only after conservative treatment (splint and physical therapy) has been performed, will crowns, orthodontics, or surgery be required to treat the TMD.

Is it ok to use a store bought appliance?
Store bought, nightguards, or pre-made appliances supplied by dentists are not usually appropriate for TMD treatment. As stated previously, oral orthopedic appliances need to be designed and custom made for each individual patient’s diagnoses. Store bought and pre-made
appliances are made one-size-fits all and can negatively affect or change teeth, bite, gums, and bones. Also, as mentioned earlier, splints should be made to cover all the teeth and need to be periodically adjusted by the TMJ specialist

How long does treatment generally last?
Patients usually wear the splint for three to six months full-time (during which time the splint is adjusted approximately once every three weeks), followed by being weaned from the splint for two to three months.

What is the best way to research or check out the TMJ specialist?
A dentist who specializes in the treatment of TMD should have extensive continuing education in the field of TMD and orofacial pain, and be board certified by an appropriate academy (i.e. American Board of Orofacial Pain, www.AAOP.org, American Academy of Pain Management), or they should be a graduate from a residency program in TMD and Orofacial Pain.

Is TMD treatment generally covered by insurance?
Our offices are covered by almost all of the medical insurance companies and HMO’s in the state of Wisconsin, and are exclusive providers for many of those in southeastern Wisconsin. This enables the vast majority of our patients that suffer from TMD and sleep apnea to receive insurance coverage for their treatment.