Originally posted April 13, 2017; updated
Anywhere from 5 to 12% of the US population has TMJ disorder (TMD) – that is, a problem with the temporomandibular joints that allow your jaw to open and close.
Typical symptoms include clicking or popping sounds when you move your jaw, pain or tenderness in your face or around the joints, headaches, pain through your neck and shoulders, ringing in your ears or other hearing problems, and even toothaches.
In other words, it’s no fun – not just the discomfort but the drag it can be on everyday activities and your quality of life overall.
And there’s no one cause for it either. Bruxing – the habitual clenching, grinding, and gnashing of teeth, often during sleep – is a common culprit as it can damage the joint over time. Sometimes malocclusion – a misaligned bite – plays the lead role. Other causes include injury to the jaw, joint, or facial muscles, and arthritis.
Despite this, treatment of TMD can often seem monolithic, relying heavily on appliances such as splints used to stabilize the bite and prevent bruxing. They allow the muscles and ligaments to relax, as well as protect the teeth from the pressure of constant biting.
In the short term, stabilizing splints can be a big help, but according to a 2017 review in PLoS ONE, they may not be any more effective than other therapies in the long run. As Dr. Bicuspid summarized,
In their analysis, the researchers found that the stabilization splint significantly reduced pain in the short term (less than three months). These results remained for the pooled results of 10 studies conducted on pain with TMDs of muscular origin. They also found that the stabilization splint was significantly more effective than the nonoccluding splint, while they found no difference between the stabilization splint and occlusal oral appliances.
“This indicates that patients with TMDs besides stabilization splint may benefit from other occlusal appliances in reducing symptoms of TMDs,” the authors wrote.
In addition, the researchers found that the stabilization splint was significantly more effective at reducing pain intensity in the short term. This was the case for TMDs of muscular origin examined in six studies as well.
However, they found no difference in pain reduction or pain intensity between the stabilization splint and other treatments for the longer term (three months or longer).
The results indicated a significant decrease in muscle tenderness with the stabilization splint in the short term, according to the authors. Maximum mouth opening also improved only in the short term. The effect of the splint was greater in patients who used it for 24 hours compared with those who used it only at night.
Fortunately, there are far more options available – options beyond appliance therapy. One new treatment that our patients have had consistent success with is the Disclusion Time Reduction (DTR), a computer-guided therapy that lets us reduce friction between the back teeth during chewing – the friction that causes clenching and grinding, leading to the kinds of TMJ symptoms listed above.
It’s treating the cause, not just the symptoms. And no appliances are necessary with DTR.
And in cases where appliance therapy does appear to be the best way to go, there are lots of options there, too, for reducing pressure on your jaw joints and finding relief. Coupled with lifestyle improvements – sleep, nutrition/diet, stress management, and the like – long term solutions are available to you.