JAW LOCKING, DENTAL CLEANING (BRUXISM), JAW SHIFT AND JAW PAIN TREATMENTS
Temporomandibular disorders are very common disorders in the society and can seriously affect the quality of life of the person. Complaints about TMJ can occur not only in the joint area, but also in the jaws, eyes, ears, nose and throat areas. The first complaint of 95% of the patients; pain in the head and neck region that occurs spontaneously or with function, and in this case, the biggest problem faced by physicians is that these pains can turn into chronic pain. Accurate and timely diagnosis is of great importance in the future of the disease. This site has been prepared to be a guide for you.
If you think you have a TMJ disorder;
Attention First of all, take care to eat soft foods, avoid chewing gum and excessive jaw movements, if your pain is severe, you can relieve your pain with a painkiller you always use. However, long-term use is not recommended.
Caution The success of surgical treatments is very low, except for definite indications (tumor), in cases where conservative treatments are insufficient, they can be considered if the existing problem seriously affects the social life of the person.
WHERE IS THE TMJ AND WHAT IS ITS FUNCTION?
The TMJ is located just in front of your ears, connecting the lower jaw to the skull. By placing your hand on this area, you can easily feel the movement of the joint when you open and close your mouth. Your jaw movements are controlled by various chewing muscles. In order for these movements to take place properly, there is a cartilage disc in this area. Thanks to this disc, excessive loads on the joint with chewing can be met.
TEMPOROMANDIBULAR JOINT DISORDERS
Temporomandibular joint disorders are all problems involving soft and hard tissues and/or chewing muscles in the joint. According to the classification made by the American academy, there are 19 subgroups. As it is thought, it may not be caused only by the inside of the joint. For example, the problem of a person with limited mouth opening may not be an intra-articular disorder, but a condition caused by the muscles. Or it may be both. It may affect your joint and/or muscle on one or both sides with varying severity. This may restrict your functions such as speaking, eating, chewing, swallowing, and yawning.
CLINICAL SYMPTOMS OF TEMPOROMADIBULAR JOINT DISORDERS
There are 4 main symptoms;
Limitation in jaw movements
Friction or clicking noises during jaw movements
pain in chewing muscles
Slipping of the jaw tip in different directions while opening the mouth
Other common symptoms;
Ear pain, feeling of pressure in the ear
Bruxism simply means grinding of the teeth. Its incidence in the community varies between 6 and 91%. It can be seen in both children and adults. While it used to be classified as night and day bruxism, it is now classified as sleep and awake bruxism. In sleep bruxism, masticatory muscles contract rhythmically. Sleep bruxism originates from the Central Nervous System and occurs in association with periods of reduced sleep and may be a precursor to some type of sleep disorder. Bruxism seen in the waking state is considered a kind of tic and is related to daily stress. Bruxism can also be divided into primary and secondary. While there is no underlying medical condition in primary buxism, there is a medical or psychiatric condition in secondary bruxism. It is possible to understand whether a person has bruxism by looking at the intraoral symptoms. The most important finding is abrasions on the teeth.
There is no known definitive treatment for bruxism. However, there are treatment options to prevent the damage they cause. For this purpose, it has been shown in a study conducted with EMG that soft appliances, which are frequently used in our country, increase sleep bruxism by 50%. In addition, it has been reported that such appliances cause permanent changes in the closure of the teeth at a rate of 67% and cause impaction in the molars.
BOTOX (BOTULINUM TOXIN)
Botulinum toxin is a poison that acts on the nervous system produced by a bacterium called Clostridium botulinum. It was first used by Scott in 1978 for human health in the treatment of strabismus (strabismus). Botulinum toxin is used in many areas today for aesthetic and therapeutic purposes. However, the use of this toxin only in the "treatment of hemifacial spasm, blepharospasm, strabismus, cervical dystonia, hyperhidrosis, chronic migraine and glabellar lines" has been approved by the FDA. There are only a few studies on the treatment of bruxism with botox, and it has been reported that botulinum toxin alleviates severe bruxism by reducing voluntary muscle contraction in these studies. However, the use of botulinum in bruxism has not been approved by the FDA. In addition, in animal studies, botox showed its effect not only in the chewing muscles but also in the surrounding muscles. It has been shown that it causes osteoporotic changes in the jawbone due to the reduction of the sequential forces.
FREQUENTLY ASKED QUESTIONS ?
(-) When should I go to the doctor?
If you think you have
(+) TMR disorder, it would be beneficial to see a specialist doctor to clarify your situation.
(-) Which specialist should I go to?
(+) There is no institution in the world or in our country that provides expertise on this subject. When choosing a doctor, the criteria of having received long-term training on this subject and documenting it and having conducted scientific studies on this subject should be taken into consideration.
(-) What can I do until I go to the specialist?
(+) You can restrict your jaw movements and if your pain is severe, you can take a painkiller that you always use. You should prefer to eat soft foods.
(-) How is the TMR Examination?
(+) Your doctor will first examine your detailed medical history, both verbally and in writing, in order to understand your situation. He or she will then perform a detailed examination of your jaw joint, teeth, and muscles. It is a painless procedure. 30-60 min in total. takes your time.
(-) How is TMR treated?
(+) TMR is based on multifactorial causes; therefore, its treatment should be multidisciplinary. 50% of the patients benefit from pharmacological treatment, 40% use oral appliances, and 6% benefit from conservative treatments such as physiotherapy. Only 1-2% of patients require surgical interventions such as arthrocentesis, arthroscopy, arthrotomy (open-joint surgery), modified condylectomy.
(-) My doctor gave me a soft night plate, can I use it in treatment?
(+) First of all, your discomfort should be fully diagnosed. It has been emphasized that it can increase the habit of clenching and grinding teeth even more.
(-) My doctor said surgery. Should I be?
The rate of surgical treatments in the treatment of
(+) Temporomandibular joint was found to be 5%. There are two types of indications for surgical treatments, definite and relative. Tumors, growth anomalies, ankylosis are among the definite indications. In relative indications, the parameters recommended by the oral and maxillofacial surgery association should be considered. Surgical intervention is only indicated when non-surgical methods are ineffective and pain or dysfunction is moderate to severe. Surgical treatments are not indicated in cases with asymptomatic or few symptoms. In addition, they should not be used as a preventive treatment when they are painless and in good function.
(-) My doctor said that the wrong closure of my teeth caused joint problems and needed to be corrected. Will my problems be solved this way?
(+) The idea that the closure of the teeth causes TMR is an issue that has existed for a long time but is out of date because it is not supported by scientific data. In the treatment of TMR, irreversible treatment methods (veneers, tooth abrasions, orthodontic treatment, orthognathic surgery, etc.) ) should be avoided.
(-) My jaw was locked during orthodontic treatment. What should I do?
(+) In this case, you should definitely be examined by a TMR specialist, your condition should be determined, and treatment should be interrupted if necessary. In such a case, your orthodontist will direct you to the necessary specialist. It is recommended to record your TMJ condition before orthodontic treatment.
(-) When will the existing voices go away?
(+) The aim of the treatment is not to pass the existing sounds. The important thing is to perform your functions painlessly and effectively.
(-) Will I use appliances for the rest of my life?
(+) No. If your doctor deems it necessary to use the appliance, he will definitely ask you to use it during the treatment. The duration of use of the appliance varies according to each case. At the end of the treatment, your doctor will inform you in which cases you should use the appliance again.