TMJ treatment and night guards

You have two temporomandibular joints, one in front of each ear, where the lower jaw hinges and slides against the skull. They work every time you talk, chew, swallow or yawn. TMJ is the name of the joint itself. When the joint or the muscles that move it become inflamed, sore or out of sync, the problem is called temporomandibular disorder, or TMD. Most people just call the whole thing TMJ.

You don't need all of these. Two or three together are worth a conversation:

• Soreness in your jaw, face or temples, especially in the morning
• Clicking, popping or grating when you open or chew
• A jaw that feels tired, tight, or gets stuck open or closed
• Headaches around the temples, or aching around the ears with no ear infection
• Teeth that look flat, chipped, cracked or worn
• Teeth that feel sore or sensitive without a cavity
• A partner who hears you grind at night

Usually more than one thing. The most common:

• Grinding or clenching (bruxism), often during sleep, which overworks the jaw muscles and wears teeth down
• Daytime clenching during stress, focus, driving or exercise
• A bite that doesn't meet evenly, so some teeth and muscles take more force than they should
• An injury to the jaw or face
• Wear and inflammation in the joint itself
• Wisdom teeth or a dental infection causing pain that feels like it's coming from the jaw

Jaw pain has a lot of possible sources, so we start with a proper look before recommending anything. The dentist checks your bite, the wear pattern on your teeth, how your jaw opens and closes, whether it clicks or shifts, and how the muscles of your face and neck feel.

Imaging helps us see the joint and rule out other causes, like an infected tooth or an impacted wisdom tooth. When it helps, the i-CAT 3D cone beam scanner in our Mesquite office gives a detailed view of the bone around the joint. You'll see the images with us, and we'll explain what we think is driving the pain and how sure we are.

Many TMJ problems are tied to grinding and clenching. A custom occlusal splint, often called a night guard, is a thin, hard appliance made to fit your teeth. You wear it mostly at night. It keeps your top and bottom teeth from grinding against each other, spreads out the force when you clench, and lets overworked jaw muscles relax. It also protects your enamel from further wear.

Because it's made from your own bite, the splint is balanced so your jaw can rest in a comfortable position. We check the fit when you pick it up and adjust it at follow-up visits as your muscles settle. Many people notice less morning soreness within a few weeks, though it varies.

Drugstore guards can help in a pinch, but they're one-size or boil-and-bite, so they tend to be bulky, loose, and soft. Some people chew on soft guards, which can keep the muscles working instead of letting them rest. A custom guard is thinner, stays in place, and is made to your bite, so it's more comfortable to sleep in and more likely to actually get worn. It also lasts longer.

These help most people with jaw soreness, alongside a splint:

• Rest your jaw. Choose softer foods for a while and cut food into small bites.
• Skip gum, and avoid chewing ice, pens or fingernails.
• Use a warm compress for tight muscles, or a cold one for a sharp flare-up, 10 to 15 minutes at a time.
• Notice daytime clenching. At rest, your lips should be together and your teeth slightly apart.
• Support your chin when you yawn, and avoid opening very wide.
• An over-the-counter pain reliever, taken as directed, can help during flare-ups.

A splint helps many people, but it isn't a cure for every jaw problem. If the pain comes from a tooth, we treat the tooth. If a bite problem is the root cause, straightening or adjusting the bite may be part of the plan. If what we find points to something outside what we treat, like a joint that needs a specialist, we'll tell you plainly and point you to the right kind of care.

Go to the ER if your jaw is locked and won't open or close, or if the pain started with a hard blow to the face. Those need care right away.

The exam comes first, then a written estimate for any appliance or treatment before we make anything. Some dental plans cover night guards or splints, often only for grinding, and many don't. We check your plan and put the numbers in writing. Without insurance, the Sunshine Membership and Sunbit or Cherry monthly payments can help.