HEADACHES AND THE TMJ FACTOR

March 3, 2009 by Johan Hartshorne
Filed under Oral Health

HEADACHES AND THE TMJ FACTOR

Stress can induce muscle spasms and jaw misalignment problems thereby starting a vicious cycle of tooth grinding (bruxing) and clenching, ultimately leading to muscle tension, imbalance and strain on the chewing and postural muscles with subsequent headaches and/or migraines. This complex of problems are usually referred to temporo-mandibular joint disorder (TMJD) or jaw joint disorder or dysfunction. The jaw joint is also known as the ‘temporomandibular joint’, known for short as the ‘TMJ’. It can be felt by placing your fingers just in front of your ears, and opening and closing your mouth. The joint allows the jaw to open, close and move sideways and forwards. It plays an important role in jaw functions such as talking, chewing and yawning. It is one of the most complex and frequently used joints in the body.

Harmony between teeth, jaw joint and muscles

Since there is a relationship between the teeth, jaw joints, head and neck muscles, and head posture, a problem in any one of these areas may affect the other. People that have lost some, or all their teeth, have worn down their teeth due to grinding or clenching or have suffered trauma as a result of an accident, can cause compression and change in blood flow of the jaw joint. The reason is that the chewing muscles overwork themselves in an effort to bring balance back to the area. They try to protect the damage being caused, unfortunately they cause more damage in the long term. Overworked muscles begin to tire out and eventually spasm. This causes the muscles to shorten and increase the compression. The patient begins to experience earache, headaches, migraines and related facial pain. Inability to chew, painful mastication, pain in teeth, changes in the way upper and lower teeth meet are commonly reported.

Temporo-mandibular joint disorders

It is important to understand how TMJ problems can not only affect your dental health but also your overall general health and well-being.

A TMJ disorder may affect one or both joints, often causing pain and limiting jaw function. Symptoms usually arise in early adulthood, but children and the elderly can also be affected. TMJ disorders are common, with about seven in ten people being affected at some time in their lives. Although about one person in four is aware of the symptoms or reports them to a dentist or medical practitioner, only five people in every hundred seek treatment. Most symptoms of TMJ disorders or pain are mild and do not need treatment. As with pain in other joints of the body, symptoms often go away with time.

Causes of TMJ disorders

TMD is caused by several interacting factors. The factors most commonly considered include:

Trauma - Acute trauma or injuries to the jaws such as a car accident, a fall or a punch can cause damage to the muscles and/or joint. The acute pain and loss of function is usually responsive to conservative treatment. Sometimes trauma to the joint can cause chronic damage which may eventually contribute to a TMJ problem at a later time.

Clenching or Grinding - Some do this while awake but more often it is done while sleeping. Most people grind their teeth while sleeping to some degree. This constant pressure can damage the TMJs over time.

Malocclusion - This term means “bad bite”. Sometimes when the teeth do not bite together in harmony with the shape and position of the joints, it can place pressure on the joints. Missing and misaligned teeth can sometimes put strain on the jaw muscles and place pressure on the jaw joints.

Psychological factors - such as emotional stress, depression, and/or anxiety are sometimes associated with the onset or worsening of TMD symptoms. Stress increases both the severity and duration of clenching or grinding while asleep. Also, many will subconsciously clench and/or grind their teeth more while awake during times of stress.

Posture & Poise - Your job and how you sit and work on a regular basis can contribute to TMJ and related problems. If you work at a computer all day, for example, you may be holding your head in such a way that places strain on your TMJ system.

Signs and symptoms of TMJ disorders

Symptoms may include: limited jaw movement; difficulty in opening the mouth; clicking, grating or popping noises from the jaw joints;

pain when chewing, yawning or opening the jaw widely; pain in or around the ears and cheeks; headaches, and occasionally, migraine-like headaches; earaches, loss of hearing or ringing in the ears; face, neck, back and shoulder pain; muscle spasms and clenching and grinding of teeth; double and blurred vision.

Treatment of TMJ Disorders

TMJ disorders are best treated ‘conservatively’, using treatment methods that do not have any permanent effect on the teeth and jaw joint. As TMJ disorders are often temporary, simple treatment methods are used whenever possible to help reduce symptoms and restore jaw function. Relief from symptoms may take time, particularly if the TMJ disorder has developed over a long period. Effective treatment should: lessen or relieve your pain, restore your jaw function, minimize any clicking or popping noises from your jaw joint, and enable you to carry out your normal daily activities.

In some people, the treatment plan may take several months to be effective. For the best results, follow your treatment plan carefully. It may include some or all of the following treatments:

Occlusal splints

Occlusal splints (also known as bite plates) is a custom made appliance fabricated of plastic that can be worn over the teeth to maintain the derived bite position and used to take pressure off the jaw joints and teeth. These are usually worn at night and should not have any permanent effect on the position of teeth. Custom made by your dentist, occlusal splints must be adjusted regularly and monitored for some months to help relieve pain.

You typically wear this plastic appliance for a prescribed period of time to verify that this new jaw position solves or reduces the problem. If it does, it has proven that the imperfect bite was the cause of the problem and you may elect to go on and have your natural teeth treated to permanently maintain that new bite position.

If symptoms are not substantially alleviated, the bite position is most likely not the cause of the problem. Your natural bite has not been altered and other causes may then be further explored.

Modified Diet

Minimize chewing and rest the jaw, eat only soft foods. When a small amount of chewing is necessary, try to chew on both sides of the mouth. Do not favor one side. Chewing very large pieces of food and hard brittle foods put added stress on your TMJ. Try to improve your eating habits to avoid these actions. Chew smaller pieces.

Physiotherapy

Exercises, massage, gentle movement and muscle stretching can be effective in reducing pain and stiffness and increasing strength and mobility.

Sleep on your back

Many people who suffer from TMJ disorder sleep on their stomach or side. This position puts pressure on the face and seems to encourage teeth grinding. Try sleeping on your back, and you may find your symptoms greatly relieved.

Warm or Cold Packs

Muscle relaxation can be achieved by applying warm or cold packs to tender areas.

Relaxation and Stress Management

Learn how to relax and lessen stress. Cut down on multi-tasking, and slow down your lifestyle. This can reduce tension in the jaw joint. Patients should seek healthy ways to relieve stress through exercise, balanced eating, plenty of sleep and maintaining a positive mental attitude.

Medication

In some cases, your dentist may recommend short-term medication to help relieve symptoms. Your dentist may prescribe a painkiller, anti-inflammatory, anti-anxiety agent, sedative or muscle relaxant. Take medication only as directed. Your dentist will be happy to answer any questions you may have regarding medication. Read the Consumer Medicine Information which most prescription medicines have in the box.

Orthodontic treatment

Millions of adults around the world – many who never had the opportunity to improve their teeth as youngsters – are now getting braces or invisible liners to correct their malocclusion.

Specialist Management

If pain and dysfunction are severe and chronic and initial conservative treatment has not been effective in relieving symptoms and restoring jaw function, your dentist may refer you to a specialist.

See a dentist if you suffer from headaches

If you suspect that you have a temporomandibular joint (TMJ) dysfunction or suffering from headaches, you should see your dentist for an examination. Your problem can often be alleviated by correcting your bite and by prescribing a mouth guard to prevent teeth grinding while sleeping. Reducing or eliminating sources of stress and stopping habits such as teeth grinding can also help. Don’t let the stress of life take a toll on your oral health. Having a healthy mouth can mean having a healthy body and that is a resolution everyone should make.

Tags: Add new tag, Grinding; Malocclusion; Splints, Headaches, Jaw Joint; TMJ dysfunction; TMJ disorders; Clenching

Preventive Dentistry

March 3, 2009 by Johan Hartshorne
Filed under Prevention

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Preventative Dentistry encompasses the branch of dentistry that deals with the preservation of healthy teeth and gums, including prevention of dental caries and oral disease – in a nutshell, what oral hygienists do.

Oral Hygienists can work in all sectors of dentistry. We are uniquely qualified to assist in the prevention and treatment of oral disease - both clinical and health promotional responsibility.

Clinically we help to treat and prevent periodontal (gum) disease by scaling and polishing teeth. Tartar, or mineralized plaque, appears over time on everyone’s teeth; it causes a wide variety of problems like gingivitis, periodontitis and gum recession.

Professional cleaning by an Oral Hygienist is the best way to address this issue. In this way, basic tooth and gum health can be maintained and, potentially, serious problems can be dealt with as early as possible before they cause significant damage. Regular cleaning and check-ups are good ways to avoid the expense, pain and inconvenience associated with cavities and other dental problems. We advise having a professional cleaning at least every 6 months. X-rays are excellent tools for diagnosing problems like bone loss, abscesses, cysts or cavities.

Gingivitis is the first stage of periodontal disease. It causes the gums to become red, swollen and bleed easily. There is usually little or no discomfort at this stage. Gingivitis is often caused by inadequate oral hygiene. Gingivitis is reversible with professional treatment like a scale and polish, as well as good oral home care.

Untreated gingivitis can lead to periodontitis. With time, plaque can spread below the gum line. Toxins produced by the bacteria in plaque irritate the gums. The toxins stimulate a chronic inflammatory response with which the body in essence turn on itself, and the tissues and bone that support the teeth are destroyed. Gums separate from the teeth, forming pockets (spaces between the teeth and gums) that become infected. As the disease progresses, the pockets deepen and more gum tissue and bone are destroyed. Often, this destructive process has very mild symptoms and most patients do not have the slightest idea that there is a problem. Eventually, teeth can become loose and may have to be removed.

Oral Hygienists apply topical fluorides and fissure sealants in order to reduce dental caries (tooth decay). Fissure sealants are a preventive treatment applied to the grooves of back teeth to prevent decay. Fissure sealants are tooth coloured and designed to make the biting surface of our teeth smooth and prevent cavities developing in our teeth. Commonly, as molar teeth erupt from the age of six years onwards, we place fissure sealants in the teeth.

Fluoride is a natural element that can be found in many things, like the water we drink and the food we eat.

Fluoride helps prevent cavities in two different ways: systemically and topical.

Systemically fluoride concentrates in the growing and developing teeth of children, helping to harden the enamel on primary teeth (milk teeth) and permanent teeth before they erupt. This is usually taken in through drinking water, fluoride drops and tablets. After teeth have erupted, fluoride helps to strengthen the enamel on adult teeth by having it applied it professionally or with home use gels, toothpastes and mouth rinses.

We focus on periodontal health by monitoring oral hygiene practises and assisting the patient to develop a home care plan to maintain their oral health. As well as performing scaling and polishing, hygienists can give advice on;

 Prevention –

 Scale and polish to prevent gum disease

 Giving the correct brushing and flossing techniques

 Mouth rinses for a specific purpose – for preventing caries or preventing gum disease or maintaining oral health

 Placement of fissure sealants.

 Nutrition – what food and drinks are better, what causes baby bottle caries?

 Use and application of fluoride

 Smoking cessation

 Teeth whitening – Believe it or not, but whitening treatments can also prevent plaque/tartar build up. Whitening not only whitens and brightens your smile, but it actually dissolves the harmful bacteria which cause gum disease and cavities especially when using professional home whitening kit provided by us. You can use it over a period of time to keep bacteria at bay and teeth at their whitest.

We also make use of in office whitening treatments to give you a healthy and confident smile. A quick 2 hour session and you are done.

Teeth whitening procedures are the most non invasive treatment in dentistry. It does not change or damage the enamel. It is a pure oxidation reaction where peroxide is broken down into water and oxygen. When they come into contact with the organic stain molecules, they will oxidize them. These stain molecules will then reflect light in a totally different way – all visible light which is white, making your teeth look whiter!

Preventive dentistry begins with the first tooth. Visit your Oral Hygienist when the first tooth erupts. You will learn how to protect your child’s dental health - the earlier the dental visit, the better the chance of preventing dental disease. We do an introduction program with all our first visit patients to help them relax and enjoy each and every visit thereafter.

Oral Hygienists therefore play a critical role in the maintenance of oral health. Please contact me if you have any queries regarding oral health, maintenance routines or teeth whitening.

Marcha van Niekerk, Diploma in Oral Hygiene, UP

Intercare Tygervalley 021 943 3500

Tags: Add new tag, Oral Hygiene; Oral Health Promotion; Disease Prevention; Fluoride;