TMD vs. Dr Wong

Bruxism is a condition in which you grind, gnash or clench your teeth. It can happen during the day or even during sleep. Certain conditions can cause patients to be predisposed to bruxism, like stress, lifestyle, uneven bite or malocclusion, medications like antidepressants, obesity and sleep apnea.

This condition can contribute to severely worn down teeth, loose teeth, headaches, tense and tender orofacial muscles, and locked jaws.

Treatment for bruxism would depend on the cause. Dr Wong would perform a thorough review of your medical and dental history, an examination of the joints, jaws and teeth and the relationship between them all, to determine an appropriate treatment that is tailored to you.

Besides trying to eliminate the causes, an attempt to alleviate the symptoms and the resulting damages can be employed by wearing a custom made bite guard. A well designed bite guard con reduce the force of clenching by working on the nociceptive reflex mechanism.

The temporomandibular joint (TMJ) is the name of the joint located on either side of your head, just in front of your ears. These joints connect your mandible (jawbone) to your temporal bone (skull). The TMJ, which can rotate and move forward, backward and side to side, is considered one of the most complex joints in the body. This joint, in combination with other muscles and ligaments, lets you chew, swallow, speak and yawn. When you have a problem with the muscle, bone or other tissue in the area in and around the TMJ, you may have Temporomandibular Joint Disorder (TMD).


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Treating TMD

In most cases, TMD is caused by a combination of factors like jaw injuries, joint disease, arthritis, and the causes of bruxism mentioned above. It is believed that bruxism itself and head or neck muscle tension may make TMD symptoms worse.

Other things that may lead to TMD is partial or full dentures that are not the right fit and certain habits such as fingernail biting and pen/pencil biting.

Most patients with TMD get better by themselves without any treatment. To help ease sore jaw muscles, place a cold or warm compress to your Jaw and gently massage your jaw muscles. Eat a soft food diet, cut food into small pieces and avoid hard, chewy or sticky foods. Try not to open your mouth too wide, even when you yawn. And most importantly, relax your jaw muscles.

When you are relaxed, your teeth should be slightly apart and your tongue should rest on the floor of your mouth with your lips barely touching or slightly apart. There should be a slight space between your upper and lower teeth except during chewing, speaking or swallowing.

If the symptoms persist, then a treatment plan may be initiated that includes relaxation techniques, referral to a physiotherapist, a chiropractor or a behavioural therapist to help you ease muscle pain. Other treatment options may include medicine for pain, inflammation or tense muscles. If getting a good night’s sleep is a problem, a number of approaches to improve sleep may be used.

Dr Wong may suggest wearing a bite splint (similar to the bite guard). It is made of clear plastic and fits over the biting surfaces of the teeth of one jaw so that you bite against the splint rather than your teeth.

If your pain continues, Dr Wong would refer you to a dental specialist with extra training in TMD. This could be a specialist in oral medicine or orofacial pain, an oral surgeon, or an orthodontist.