Sleep apnea and temporomandibular joint disorder (TMJD) are two conditions that are intertwined. Treatments for TMJ can often improve the quality of and ability to sleep soundly.

What is Temporomandibular Joint Disorder (TMJ)?

Place two fingers on both sides of your jaw in front of your ears. Then, open your mouth slowly until fully wide. If you heard or felt a pop, click, or shift, or if you felt any pain, you may have temporomandibular joint disorder (TMJD or TMJ.) Men and women experiencing this pain often just live with it because they are unaware that there are treatments available.

If you experience pain in the jaw when chewing, talking, or even at rest, you may have TMJ. This is a condition that often goes undiagnosed, and patients simply live with the pain and irritation. Dr. Seema Ahmed at Old Town Smiles is dedicated to providing accurate diagnoses and proper care so our patients leave feeling great with reduced pain after treatment.

If you’re wondering if you might have TMJ, contact us today. You can call our Alexandria, VA office at (703) 836-7000 to schedule your appointment and a member of our staff will get back to you shortly.

Sleep Apnea and TMJ

Over half of TMJ patients report problems with sleeping.[1] Sleep apnea is a condition where breathing can stop and then start again during the night. Obstructive sleep apnea (OSA) is a condition where the throat muscles relax and narrow, which constricts the airways. The brain then awakens in an effort to alert the throat muscles to open. OSA can cause a cascade of symptoms that include the inability to get a restful night’s sleep (insomnia), daytime drowsiness (hypersomnia), morning headaches, irritability and more.

Cumulative reviews of numerous studies indicate that TMJ and OSA are related due to the high prevalence of patients who suffer from both conditions.[2][3]

Benefits

  • Relief from discomfort
  • Improve your ability to sleep
  • Enhance your overall health
  • Reduce headaches, irritability
  • Improve your quality of life

TMJ Treatment Candidates

TMJ disorder is generally more common in women than men, but patients of any gender who experience the following signs or symptoms may be suffering from TMJ:

  • Clicking, popping, locking and/or soreness in the front of the ear
  • Sore jaw muscles
  • Headaches
  • Bite related problems
  • Ringing in the ears
  • Bruxism (teeth clenching and grinding)
  • Sinus concerns
  • Pain when yawning

Causes of TMJ

There are different causes of temporomandibular joint disorder. Below are some of the more common causes:

BRUXISM

Bruxism, or grinding of the teeth, is one of the main causes of TMJ disorder. Bruxism qualifies as a microtrauma, which means it’s an internal trauma that works on the temporomandibular joint. The continuous side-to-side motion and pressure can irritate and inflame the joint or surrounding membranes. It can also cause misalignment of the teeth, which contributes to the pain. Teeth grinding mostly occurs while sleeping.

CLENCHING

Clenching of the jaw is also considered a microtrauma. The strain placed on the TMJ from continually chewing or biting while awake can contribute to jaw pain. Some related habits include: biting on a pencil, chewing gum, or biting fingernails. Psycho-social stress can also cause jaw clenching.

MACROTRAUMA

Macrotraumas differ from internal microtrauma. Injuries to the jaw caused by an outside source, such as getting hit on the jaw are macrotraumas. Significant impacts on the temporomandibular joint can cause cartilage and joint damage or dislocate the joint.

OSTEOARTHRITIS 

The jaw is just as susceptible to osteoarthritis as any other joint in the body. Normal wear and tear and age are the main triggers, but it can also be caused by instances such as degenerative joint disease. Destruction of cartilage does not happen from a single cause. Some combination of factors over time, such as continual trauma (micro or macro) or aging can lead to osteoarthritis.

While the aforementioned are the more common causes of TMJ disorder, some other causes include:

  • Stress
  • Female sex hormones
  • Chewing gum
  • Prior dental work
  • Infection
  • Autoimmune disease

Your Personal Consultation at Old Town Smiles

At Old Town Smiles, we believe every patient should be made comfortable. It’s our goal to provide you with a supportive environment where you can discuss all your concerns. During your consultation, you will describe any pain or irritation you feel when you open your mouth, chew, or yawn. Then, we’ll conduct an initial examination, which may consist of a normal check up, X-rays, and a few tests to determine if the patient has TMJ disorder. An open and honest dialogue is important during your consultation so we can offer you the best treatment possible. Make sure you provide any details that might relate to your condition. Also, make sure to ask any questions you have during your consultation. Depending on the results of your consultation, we can provide you recommendations and customize a treatment plan.

Over the years, Dr. Seema Ahmed has earned a reputation for specializing in TMJ diagnoses and treatments. She has served as a clinical consultant for other dentists in the area regarding TMJ.

Reach out to Old Town Smiles today and we can help you understand if you are suffering from TMJ and how to best treat that condition. You can call our Alexandria, VA office at (703) 836-7000 or schedule an appointment online.

How is TMJ Disorder Treated?

PHASE 1 TREATMENTS

Phase 1 treatments are not permanent. Phase 1 includes splints, retainers, physical therapy, and medication.

Splints and Retainers

Splints and retainers can help correct poor bites, decrease stress at the joint level, and reduce muscle hyperactivity which includes habitual clenching and grinding. Splints cover the whole surface of the teeth. They work by altering the biting surface or imbalance bit and changing jaw positioning to provide a better bite.

Retainers prevent the teeth from moving a shifting back to their original placement after dental work. Retainers try to shift the jaw into proper placement. Some retainers also cover the teeth’s surface which will help prevent grinding.

Physical Therapy

Physical therapy can be helpful for sore muscles, cervical neck issues, sleep position, improved posture, and self–help methods such as biofeedback.

Medication

Medications for inflammation, muscle relaxation, and sleep are commonly used to relieve TMJ pain. Dr. Ahmed will assess if a candidate qualifies for medication during the consultation.

PHASE 2 TREATMENTS

If phase 1 treatments don’t sufficiently alleviate the condition, phase 2 treatment may be necessary. Phase 2 treatments are permanent, so phase 1 treatments are usually attempted first.

Dental Work

If a patient’s bite has shifted after phase 1 treatments, dental work may be necessary to maintain proper jaw and teeth placement.

This may include:

  • Crowns: A crown is a small tooth-shaped prosthetic device attached to the top of a damaged, cracked, or misshapen tooth. A crown may be used as a phase 2 treatment for TMJ disorder if the jaw might return to poor placement because of a misshapen tooth.
  • Bridge: If a tooth or teeth are missing, a bridge can be placed to fill the gap and help keep the jaw in place. A bridge consists of a prosthetic tooth adhered in the middle of two crowns. We can place two crowns over the two teeth surrounding the gap, and the prosthetic tooth implant is fastened into place in the gap. This process can keep the jaw in proper alignment.

Surgery

Although non-surgical remedies are ideal if possible, serious joint problems may require surgical intervention.

Reasons for TMJ Surgery

  • Non-surgical treatments have failed
  • Identifiable pathology
  • Extreme pain
  • Poor mechanical function

Determining the cause and effect relationship is key to identifying the problem. TMJ therapy is most successful when initiated at an early stage of discomfort. This is especially true if there is minimal damage to the jaw joints. Contact us today if you suffer from any symptoms of TMJ disorder.

What to Expect After TMJ Treatment

Pain associated with muscle and bite issues usually responds well to treatment in a very short time leaving the patient feeling better. Regardless of the treatment, patients should be conscious of the foods they eat. Try to stay away from hard foods and reduce gum chewing. Patients should try not to open their mouths very wide if possible. Give your jaw time to relax and heal. Jaw exercises can help alleviate the jaw tension. Your doctor may issue a custom regimen depending on your unique circumstances.

Avoid clenching the teeth as well as clutching phones between the jaw and shoulder. Oral hygiene should be maintained, but patients should be cautious of how wide they open their mouth when brushing and flossing.

Results

After TMJ therapy, patients can enjoy the experience of less pain, less irritation, fewer headaches, less popping, and less locking. Careful study of therapeutic treatments have shown they prove effective for many patients.[4] Studies on TMJ treatments found that restoring mouth openings were most important at achieving high levels of patient satisfaction.[5]

How Much Does TMJ Treatments Cost in Virginia?

The cost of TMJ treatments will vary depending on the treatment needed and the extent of the individual case. After the private consultation, a custom treatment plan will create a custom plan and provide you with a quote. We offer financing options, although it’s important to note we are an “out-of-network” concierge dental office.

FAQ

DOES TMJ CAUSE SLEEP APNEA?

They are interconnected conditions. About ¾ of TMJ patients have sleep disorders like OSA and about ½ of sleep apnea patients also have TMJ. The cause and effect is not clear cut, however, and each situation must be diagnosed by a qualified dentist.

IS SLEEPING ON YOUR SIDE BAD FOR TMJ?

Sleeping on your side and with your hand under the pillow can exacerbate TMJ and related conditions such as sleep apnea.

WHAT MEDICATION IS APPROPRIATE FOR TMJ?

The best medications are ones prescribed by a dentist or specialist after undergoing a thorough examination. A danger of TMJ is self-medication is the addiction to dangerous painkillers.

References 

  1. Smith, M. T., Wickwire, E. M., Grace, E. G., Edwards, R. R., Buenaver, L. F., Peterson, S., Klick, B., & Haythornthwaite, J. A. (2009). Sleep disorders and their association with laboratory pain sensitivity in temporomandibular joint disorder. Sleep, 32(6), 779–790. https://doi.org/10.1093/sleep/32.6.779
  2. Sanders, A. E., Essick, G. K., Fillingim, R., Knott, C., Ohrbach, R., Greenspan, J. D., Diatchenko, L., Maixner, W., Dubner, R., Bair, E., Miller, V. E., & Slade, G. D. (2013). Sleep apnea symptoms and risk of temporomandibular disorder: OPPERA cohort. Journal of dental research, 92(7 Suppl), 70S–7S. https://doi.org/10.1177/0022034513488140
  3. Ghani, Z. A., Zwiri, A., Husein, A., Phaik, K. S., Kassim, N., Zainal, S., & Samsudin, A. (2020). Obstructive sleep apnea and its relation with temporomandibular disorders: A narrative review. Journal of International Oral Health, 12(1), 8. doi:10.4103/jioh.jioh_246_19
  4. Gil-Martínez, A., Paris-Alemany, A., López-de-Uralde-Villanueva, I., & La Touche, R. (2018). Management of pain in patients with temporomandibular disorder (TMD): challenges and solutions. Journal of pain research, 11, 571–587. https://doi.org/10.2147/JPR.S127950
  5. Kraus, S., & Prodoehl, J. (2017). Outcomes and patient satisfaction following individualized physical therapy treatment for patients diagnosed with temporomandibular disc displacement without reduction with limited opening: A cross-sectional study. Cranio®, 37(1), 20-27. doi:10.1080/08869634.2017.1379260