Temporomandibular dysfunction and bruxism
What's TMJ dysfunction?
The temporomandibular joint joins the jaw with the skull, and is what allows us to chew and speak. Sometimes there is a problem in this joint either due to basic problems such as bruxism, congenital abnormalities of the condyles or due to a bad way of biting. This can trigger a series of symptoms:
- Pain in the area of the jaw.
- Overload and pain of the neck muscles.
- Limitation in the opening of the mouth.
- Clicks when moving the jaw.
What is bruxism?
Bruxism is the habit of clenching or grinding the teeth, usually during sleeping hours. It is usually caused by anxiety situations although it can also have genetic causes. In the short term, bruxism can cause wear and sensitivity in the teeth, muscle and joint pain. In the long term, this dental wear can end up causing fractures or a considerable decrease in the size of the teeth.
How are temporomandibular dysfunctions diagnosed?
- The first thing that is done is a clinical history to know the existence of previous symptoms - and / or systemic pathologies that lead to joint problems - and a manual exploration is performed, both of the temporomandibular joints and of the facial and cervical muscles.
- To examine the occlusion we use the T-Scan, an electronic device with which we register its characteristics, assigning them objective values.
- The possibility of reconstructing the skull and jaw in 3D gives us very valuable information about the real state of joint surfaces, as well as the symmetry of facial structures and their relationship. This symmetry and the relationship of the bony bases to each other constitutes the central axis of the three-dimensional facial skull diagnosis
- For this we have a state-of-the-art CBCT scanner.
- When, after these diagnostic tests, we obtain evidence of dysfunction of the temporomandibular joint, we resort to nuclear magnetic resonances.
- By making two records, one with an open mouth and the other with a closed mouth, we can direct our treatment plans with all the necessary information about the condition of the temporomandibular joints.
How are temporomandibular dysfunctions treated?
Depending on the diagnosis (if it is articular or muscular) and the severity of the dysfunction, they are treated with physiotherapy, dry puncture, drug therapy, botulinum toxin, splint discharge and / or disc supplementation, reaching surgery in the most severe cases.
Recommendations and tips to relieve jaw pain
The intention of this information is to offer you a series of general tips that will help us in the treatment of your pathology. Read it carefully, as the improvement of your symptomatology depends largely on your collaboration.
It is very important to promote rest, both of the temporomandibular joint, and of the associated structures (muscles, cervical spine, etc.) and of the organism in general. Sometimes it is necessary to use anti-inflammatories and analgesics to relieve the acute phase. Also in cases such as bruxism, a night splint splint helps relieve the joint and protect the teeth from eccentric movements.
- Avoid opening your mouth too much: do not bite into food with your teeth (sandwiches, apples, etc.). Instead you must cut it into small pieces. Control yawning with your hand or by lowering your chin onto your chest; avoid long appointments with the dentist, nose and throat explorations, intubation for anaesthesia, and in general any type of manoeuvre that requires forcing your mouth open for any long period of time.
- Do not grind or clench your teeth. Relax your jaw, keeping your lips together and teeth apart.
- Talk as little as possible.
- Eliminate habits such as biting your nails, chewing your cheeks or lips, biting pens or other objects
- Do not chew chewing gum, soft sweets, nuts, raw vegetables or any other type of food that requires chewing for long periods.
- Eat a semi-soft diet: pasta, cooked vegetables, eggs, soups, etc
- Use heat and cold:
- Cold for recent injuries and worsening of previous injuries
- Damp heat (warm cloths) on chronic injuries
- Adopt a correct posture during the day: a straight back, with your shoulders back.
- Avoid holding the phone with your shoulder, or use specially designed devices for this purpose.
- It is advisable to carry out some sort of gentle physical exercise que mantenga el tono muscular general. to maintain general muscle tone. Swimming is ideal, especially backstroke and breastroke. Energetic activities such as aerobics that force the spine are not advisable. You should complete any physical exercise 4 to 6 hours before going to bed.
- Improve the amount you sleep and the quality of your sleep
- Do not drink coffee, cola drinks or alcohol before going to bed. Although alcohol can help you get to sleep, it tends to fragment it in the second half of the night.
- Quit smoking. If it is not possible, at least try to not smoke after 7.00 p.m.
- Do not drink or eat large amounts for at least 3 hours before going to bed. However, eating a small amount prior to going to bed may be useful.
- Keep your bedroom dark, quiet, well ventilated, and at a comfortable temperature throughout the night.
- Avoid sleeping in places that are not familiar.
- Make sure your mattress is not too soft or too hard. Your pillow should have the correct height and texture.
- Avoid afternoon naps if you have difficulty going to sleep at night.
- Do not stay in bed longer than is necessary to sleep. Remember that staying too long in bed can reduce the quality of your sleep on successive nights.
- Create a ritual for going to bed. Reading before turning off the light can be useful, providing you read literature and not material connected with your work.
- The occasional use of sleeping pills is not a problem.
- It may help to have a warm bath for 30 minutes two hours before going to bed, so that your body temperature is raised by approximately 2 degrees. Also, a warm drink may help you to relax as it will slightly raise your body temperature.
- If you are worried at night, write down a list of problems with a sentence stating the first things you will do to solve them the next day.
- If you wake up during the night, do not look at the time, or smoke to relax.
- If you cannot sleep, do not try and force yourself to sleep. Instead, think about pleasant, relaxing things.
- Get up every day of the week at the same time.