Procedures

• Dental Implants
• Teeth-"In-A-Day"
• Bone Grafting
• Wisdom Teeth
• Facial Trauma
• Jaw Surgery
• Pre-prosthetic Surgery
• Distraction Osteogenesis
• Oral Pathology
• TMJ Disorders
• Sleep Apnea
• Cleft Lip & Palate
• Platelet Rich Plasma / Growth Factors

TMJ Disorders

TMJ (temporomandibular joint) disorders are a family of problems related to your complex jaw joint, and most often represent a maladaptive stress response (a behavioral response to stressors that causes harm rather than helping). If you have had symptoms like pain or problems chewing, you'll be glad to know that these problems are more easily diagnosed and treated than they were in the past. These symptoms occur when the joints of the jaw and the chewing muscles (muscles of mastication) do not work together correctly. TMJ stands for temporomandibular joint, which is the name for each joint (right and left) that connects your jaw to your skull. Since some types of TMJ problems can lead to more serious conditions, early detection and treatment are important.

No one treatment can resolve TMJ disorders completely and treatments take time to become effective.  Surgery is rarely necessary to treat TMJ disorders.  Dr. Heggland can help you accurately diagnose any problems you may have with your jaw joint, and work with you to make sure you receive the appropriate non-surgical treatments.

Trouble With Your Jaw?

TMJ disorders develop for many reasons. You might clench or grind your teeth, tightening your jaw muscles and stressing your TM joint. You may have a damaged jaw joint due to injury or disease. Injuries and arthritis can damage the joint directly or stretch or tear the muscle ligaments. As a result, the disk, which is made of cartilage and functions as the “cushion” of the jaw joint, can slip out of position. Whatever the cause, the results may include a misaligned bite, pain, clicking, or grating noise when you open your mouth or trouble opening your mouth wide.

Some signs and symptoms common in TMJ disorders

• Are you aware of grinding or clenching your teeth?
• Do you wake up with sore, stiff muscles around your jaws?
• Do you have frequent headaches or neck aches?
• Does the pain get worse when you clench your teeth?
• Does stress make your clenching and pain worse?
• Does your jaw click, pop, grate, catch, or lock when you open your mouth?
• Is it difficult or painful to open your mouth, eat, or yawn?
• Have you ever injured your neck, head, or jaws?
• Have you had problems (such as arthritis) with other joints?
• Do you have teeth that no longer touch when you bite?
• Do your teeth meet differently from time to time?
• Is it hard to use your front teeth to bite or tear food?

Treatment

There are various treatment options that Dr. Heggland can utilize to improve the harmony and function of your jaw. Once an evaluation confirms a diagnosis of a TMJ disorder, Dr. Heggland will determine the proper course of treatment. It is important to note that treatment always works best with a team approach of self-care joined with professional care.

The initial goals are to relieve the muscle spasm and joint pain. This is usually accomplished with a combination of anti-inflammatory medications, muscle relaxants, and physical therapy. In rare instances steroids can be injected directly into the joints to reduce pain and inflammation. Self-care treatments can often be effective as well and include:

• Resting your jaw
• Keeping your teeth apart when you are not swallowing or eating
• Eating soft foods
• Applying ice and heat
• Massage
• Exercising your jaw
• Practicing good posture

Stress management techniques such as biofeedback or physical therapy may also be recommended, as well as a temporary, clear plastic appliance known as a splint. A splint (or nightguard) fits over your top or bottom teeth and helps keep your teeth apart, thereby relaxing the muscles and reducing pain. There are different types of appliances used for different purposes. A nightguard helps you stop clenching or grinding your teeth and reduces muscle tension at night and helps to protect the cartilage and joint surfaces. An anterior positioning appliance moves your jaw forward, relives pressure on parts of your jaw and aids in disk repositioning. It may be worn 24 hours/day to help your jaw heal. An orthotic stabilization appliance is worn 24 hours/day or just at night to move your jaw into proper position. Appliances also help to protect from tooth wear.  These appliances are custom made to fit your bite by your dentist or another non-surgical specialist, and may require periodic adjustments.

What About Bite Correction Or Surgery?

If your TMJ disorder has caused problems with how your teeth fit together, you may need treatment such as bite adjustment (equilibration), orthodontics with or without jaw reconstruction, or restorative dental work. Surgical treatment of TMJ disorders is very rarely necessary. Dr. Heggland does not consider TMJ surgery unless the jaw can't open, is dislocated and cannot be repositioned, or has severe degeneration.  Interestingly, clinical research has indicated that patients who manage their TMJ disorders non-surgically predictably have better outcomes than those who have surgical treatment.  Pain is not an indication of a need for surgery, it is an indication of a need for treatment and behavior modification.