Colleen C. Hickle, DDS
3690 Orange Place, Suite 550
Beachwood, OH 44122
(216) 464-0500

 

TMJ/TMD

stock photo of a mature woman

Temporomandibular Disorder (TMD)

Millions of Americans suffer from chronic facial and neck pain as well as recurring headaches. In some cases, this pain is due to Temporomandibular Disorder, or TMD.

Your temporomandibular joints (TMJ) connect your lower jawbone to your skull. These joints get a lot of use throughout the day as you speak, chew, swallow, and yawn. Pain in and around these joints can be unpleasant and may even restrict movement.

Symptoms of TMD include:

  • Pain in the jaw area
  • Pain, ringing, or stuffiness in the ears
  • Frequent headaches or neck aches
  • Clicking or popping sound when the jaw moves
  • Swelling on the sides of the face
  • Muscle spasms in the jaw area
  • A change in the alignment of top and bottom teeth
  • Locked jaw or limited opening of the mouth

Should you notice any of these symptoms, let us know. Dr. Hickle can identify the presence of TMD and create an effective treatment just for you.

There are a few simple steps you can take at home or work to prevent TMD from becoming more severe or from even occurring at all:

  • Relax your face — remember the rule: “Lips together, teeth apart”
  • Avoid grinding your teeth
  • Avoid constant gum chewing
  • Don’t cradle the phone receiver between your head and shoulder — either use a headset or hold the receiver to your ear with your hand
  • Chew food evenly on both sides of your mouth
  • Do not sit with your chin resting on your hand
  • Practice good posture — keep your head up, back straight, and shoulders squared

Neuromuscular dentistry

Dr. Hickle uses neuromuscular dentistry techniques to treat symptoms of a bad bite and to restore a patient's teeth to a neuromuscular and balanced bite position if the patient so desires. 

Treatment of TMD/TMJ starts with relaxing a patients jaw muscles through the use of electrical muscle stimulation, referred as TENS (Transcutaneous Electrical Neural Stimulation).  A J5 Myomonitor delivers painless gentle electrical stimulation to the muscles to relax them and relieve pain and tension.  The jaw position that results after TENS therapy of 45-60 minutes corresponds closely to a patient’s neuromuscular bite position.  That position is recorded with a bite registration.  Dr Hickle uses molds of a patient’s upper and lower teeth, along with the neuromuscular bite registration, to fabricate a “Neuromuscular Orthotic”.  The Orthotic, a removable clear plastic appliance, is usually made over the lower teeth and precisely fits the contours of the patient’s teeth.  Wearing the orthotic causes repositioning of the patients lower jaw to the new, neuromuscular position.  Patients wear the Orthotic 22 hours a day and only take it out to eat and perform oral hygiene procedures.  Many patients will have relief of TMD symptoms, including headaches and TMJ pain or noise, once they wear their Orthotic as prescribed.  Some patients may decide to have their teeth restored with porcelain to mimick the new relaxed neuromuscular bite after they realize that wearing the orthotic has relieved their symptoms. 

In addition, some patients have no symptoms of a bad bite, but Dr. Hickle may see the signs of a bad bite such as tooth wear and chipping, crowding and tipping of teeth, and erosion of the enamel at the gumline, called abfraction.  Dr. Hickle may recommend Orthotic wear for these types of patients as well.

For more information about the neuromuscular therapy process, see the educational materials at Mytronics.

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