TMD (Temporomandibular Disorder)

Temporomandibular Disorders (TMD) is a collective term embracing a group of dental and medical conditions that involve the jaw joints (ie Temporomandibular Joint), chewing muscles and associated structures. It is a major cause of non-dental facial pain and a growing healthcare challenge. Many people have the signs and symptoms of TMD but may not have been diagnosed.

The Temporomandibular joint (TMJ) connects your lower jaw (mandible) to your skull and is situated on either side of your head in front of the ears. It is one of the most frequently used joints in your body and probably the most complex. Being a flexible hinge joint, it can move side to side as well as up and down allowing you to chew, talk and yawn. Its movement and position are controlled by muscles and ligaments attached to and surrounding it.

Tenderness or pain in the face, jaw and ear
Chewing discomfort or difficulty chewing
Headaches
Painful clicking of the jaw
Difficulty opening or closing the mouth
Locking jaw or teeth that don't come together properly while biting or chewing

Bruxism - overuse of the muscles, unconscious grinding and clenching of the jaws during sleep or when awake. Teeth grinding tires your jaw muscles and leads to discomfort, such as headaches or neck pain. Additionally, abnormal function can lead to worn or sensitive teeth, traumatized soft tissues, muscle soreness, jaw discomfort when eating, and temporal (side) headaches.

Trauma / injury - blows to face and/or jaws, biting on extremely hard food or an unexpected hard particle, extremely wide jaw opening etc

Habits - regular gum chewing, eating only on one side

Poor bite and jaw relationships - poorly aligned teeth, skeletal problems etc

Medical conditions - systemic arthritis, certain neurological conditions etc

Stress and anxiety

Psychological conditions - depression, somatisation etc

In treating bruxism we try to change patients' behavior by teaching them how to rest the tongue, teeth and lips properly. In many cases we can make a plastic mouth appliance, such as a nightguard that's worn to absorb the force of biting. This appliance can prevent future damage to the teeth and helps change the patient's destructive behavior.

A full night guard  or a NTI is recommended when teeth grinding or clenching are observed while sleeping. The Night guard will preserve the teeth from wearing down, fracture, and possibly reduce pain in the jaw-joint (TMJ).

TMJ Appliance

The NTI device snaps into place and fits comfortably on either the upper or lower front teeth.  It is worn during sleep and prevents the intensity of muscular parafunction.  For migraine sufferers, there is a more discreet version for daytime use, which is usually required (in addition to the pictured nighttime device) for 6 to 8 weeks for best results.

The NTI device is a plastic mouth piece that snaps into place and fits comfortably on either the upper or lower front teeth. It is worn during sleep and it prevents the intense parafunction of the jaw muscles, which occurs during night time tooth grinding or clenching.

NTI Device