TMJ is considered to be a progressive condition, and the four stages of TMJ are frequently used by doctors to provide a treatment guide for patients based on the severity of their temporomandibular joint damage.
What is TMJ?
Temporomandibular joint (TMJ) disorder is a disorder of the jaw, temporomandibular joints, muscles, and nerves associated with chronic facial pain. TMJ can cause pain in the jaw joints and the ligaments and muscles that control the movement of your jaw. TMJ disorders, which are also known as temporomandibular dysfunctions (TMD), can impact your life in a significant way by affecting your ability to chew, speak easily, or yawn.
Stage One
Stage one of TMJ is disc displacement with reduction, sometimes identified as DDwR, and occurs when the disc is displaced in the closed-mouth position and reduces to normal relationship in the open-mouth position.
In stage one, mouth opening is limited and is often accompanied by the jaw moving to the side until a pop or click (reduction) happens and the mouth can be opened fully. In this stage, it’s not likely there will be any restriction in range of motion from the disc relocating when the mouth is opened.
Stage Two
Stage two of TMJ is disc displacement with reduction with intermittent locking. During this stage, the disc will be displaced in the closed-mouth position and will intermittently lock when in the open-mouth position when the disc doesn’t reduce.
Patients who are in stage two may experience episodes of limited mouth opening that can last for various lengths of time. Some people have described the feeling of hitting an obstruction when they attempt to open their mouth, and they may be able to move their jaw past the obstruction, or the obstruction may spontaneously disappear.
Stage Three
Stage three of TMJ is disc displacement without reduction, often referred to as DDwoR. Stage three occurs when clicking noises disappear but limited mouth opening remains. In this stage, the disc is displaced in closed-mouth position, and the disc does not reduce to normal in the open-mouth position. This is also referred to as closed lock.
During stage three, the jaw has a limited range of movement, and limited opening becomes chronic.
Stage Four
Stage four of TMJ, like stage three, is disc displacement without reduction (DDwoR). Similar to stage three, the disc is displaced in the closed-mouth position and does not reduce to normal in the open-mouthed position; however, stage four is also accompanied by perforation of the posterior attachment tissues or the disc.
What Causes TMJ to Worsen?
Dealing with the pain and other symptoms of TMJ can be challenging, but there are things you can control that worsen your TMJ and its symptoms. Knowing what these habits are can help you avoid them.
Some habits you can control that can worsen your TMJ include:
Sleeping on your stomach
Grinding or clenching your teeth during the daytime
Chewing on pens, pencils, toothpicks, or other items (These habits are often related to anxiety.)
Excessively chewing gum
Taking large bites of food (This can overwork your jaw muscles.)
Chewing ice, lollipops, or other hard candies
Using your teeth as tools (e.g., opening packages, tearing tags off clothes, holding items, opening bottle caps)
Stress and anxiety (When feeling stressed or anxious, you might increase tension in your jaw and facial muscles.)
Treating TMJ and TMD
Treatment options for TMJ and TMD depend on the stage of your temporomandibular joint disorder, the underlying cause of your TMJ, and the severity of your pain. When determining an appropriate treatment plan, noninvasive treatment options should be tried first.
Often, TMJ pain and discomfort is temporary and can be managed with self-care, home remedies, and/or other non-invasive and nonsurgical treatments.
Self-managed care options are things you can do for yourself. This includes identifying activities that cause TMD flare-ups and can worsen your TMJ. Understanding what causes flare-ups allows you to set goals to manage your condition and prevent TMJ issues. Learning all you can about your type of temporomandibular joint disorder can help.
Most home remedies deal with managing pain and include using over-the-counter pain medications such as acetaminophen, ibuprofen, or naproxen. Using icepacks can also help with pain and swelling. While TMJ home remedies may help reduce the pain, it’s important to remember that they are only temporary solutions and won’t always resolve the problems for long periods of time. If the pain and discomfort is persistent, then it’s best to contact an experienced healthcare professional who understands the complications of treating TMJ disorders.
Additional nonsurgical treatment options for TMJ disorders that do not involve medications include physical therapy and TMJ appliance therapy.
What is TMJ Appliance Therapy?
TMJ appliance therapy is a non-invasive treatment option that doesn’t involve the use of any medications. Similar to mouthguards, TMJ appliances are worn in the mouth and fit over your upper or lower set of teeth; however, TMJ appliances are designed specifically to treat conditions related to the jaw joint.
TMD appliances called stabilization splints, also known as bite guards or bite plates, are prescribed, designed, fitted, and adjusted by TMJ specialists. These oral appliances realign the jaw, prevent contact between the teeth, and reduce jaw pressure and pain and are worn while you sleep and occasionally during the day.
TMJ appliance therapy will typically treat most TMD symptoms in a short period of time and can provide long-term stability for your temporomandibular joint. Using oral appliances can help avoid future serious complications. If TMD is left untreated or undertreated, it worsens as time passes and causes further joint damage and worsening symptoms as the condition progresses through the stages of TMJ.
If you think you might have a TMJ disorder, then reach out to the professionals at Sleep Better Columbus by calling 614-777-7350 or contact us online to book an appointment.
Temporomandibular joint (TMJ) disorders can cause pain in the jaw joints and the muscles and ligaments controlling jaw movement. TMJ disorders, sometimes referred to as temporomandibular dysfunctions (TMD), can have a significant impact on your life by affecting your ability to speak easily, chew, or yawn. The TMD experts at Sleep Better Columbus are dedicated to improving and preventing TMJ/TMD symptoms.
Types of TMD (temporomandibular dysfunctions)
Disorders of the chewing muscles, the most common form of TMD, can cause myofascial pain. Myofascial pain is pain or discomfort in the fascia (connective tissue covering the muscles) and muscles controlling jaw, neck, and shoulder function.
Disorders of the jaw joints, including disc disorders and degenerative joint diseases, such as osteoarthritis.
Headaches resulting from TMD and/or the associated pain.
Causes of TMJ Disorders
The exact cause of a person’s TMJ disorder is hard to pinpoint, and the pain is usually from a combination of factors, which can be jaw injury, arthritis, or genetics.
TMJ causes may include:
Bruxism (grinding or clenching the teeth)
Malocclusion (improper alignment of your top and bottom teeth)
Arthritis in the jaw joint
Jaw injuries, such as a dislocated or broken jaw
Stress
Symptoms of TMJ Disorders
TMJ disorder symptoms vary widely. People may experience jaw pain, facial pain, and/or shoulder or neck pain. The pain a person feels from TMD can range from mild to severe with some people experiencing chronic pain. Common signs and symptoms of temporomandibular joint dysfunction include:
Pain in the jaw joint and/or chewing muscles (the most common symptom)
Difficulty chewing or pain while chewing
Pain in one or both temporomandibular joints
Aching pain in and around your ear
Pain or tenderness of the jaw
Stiffness in your jaw
Aching facial pain
Swelling of the side of the face
Toothaches
Pain that spreads to the face and/or neck
Shoulder or neck pain
Tinnitus (ringing in the ears), hearing loss, or dizziness
Headaches and/or migraines
Blurred vision
Limited movement or locking of the temporomandibular joint, making it difficult to open or close your mouth
Painful clicking, grating, or popping in your jaw joint when you open or close your mouth
Changes in how your upper and lower teeth align or fit together
TMJ disorders can cause a clicking sound, a grating sensation, or popping in your jaw joint when opening and closing your mouth or chewing that causes pain and/or limits jaw movement.
Sounds without pain in the temporomandibular joints are normal, happen often, and do not need treatment.
Managing and Preventing TMJ/TMD Flare-ups
Any number of things can create issues with your TMJ disorder, but you can take steps to prevent flare-ups and minimize pain and discomfort if you do have a TMD flare-up.
The first preventive measure you can take is recognizing any activities that might cause a flare-up or increase your pain or discomfort. Once you’ve identified these activities, you can work on avoiding them or taking steps to prevent them from occurring. For example, if you have sleep bruxism (grinding or clenching your teeth at night while sleeping), you can wear a mouth guard at night. If you experience pain and discomfort after eating hard, difficult-to-chew foods like taffy, gummy candies, or jerky, avoid eating these foods as much as possible.
Things That Make TMJ Disorders Worse
While you might not be able to control the factors that cause TMJ disorders, you can control things that can make your TMD, and its symptoms, worse. Being aware of these habits can help when it comes to avoiding or preventing TMJ/TMD symptoms so you can decrease pain and TMJ disorder flare-ups.
Habits that can make temporomandibular disorders worse include:
Chewing on pens, pencils, toothpicks, or other items (These habits are often related to anxiety.)
Chewing ice, lollipops, or other hard candies
Excessively chewing gum
Grinding or clenching your teeth during the daytime
Taking large bites of food (This overworks jaw muscles.)
Sleeping on your stomach
Using your teeth as tools (e.g., opening packages, tearing tags off clothes, holding items, opening bottle caps)
Treatment Options for Temporomandibular Joint (TMJ) Disorders
For many people, the pain and discomfort from TMJ disorders is temporary and can be relieved with home remedies, self-managed care, and/or other nonsurgical treatments.
Most home remedies deal with managing pain. Typical home remedies include using ice packs and taking over-the-counter pain medications like ibuprofen, acetaminophen, or naproxen. While home remedies may help reduce the pain, they are temporary solutions and won’t always resolve the problems for long periods of time.
Sedatives, muscle relaxers, and pain relievers can be used to help treat TMJ disorders. Sedatives can help you sleep more peacefully at night. Muscle relaxers will help relax the muscles in the area. Muscle relaxers are often paired with pain relievers that help with the immediate pain.
Self-managed care options are all the activities you can do yourself. These activities can include learning everything you can about your type of temporomandibular joint disorder, identifying activities that cause TMD flare-ups, setting specific goals for managing your condition, and learning meditation and relaxation techniques to reduce and/or eliminate stress that might be contributing to TMJ pain or lead to habits that cause TMJ pain (e.g., clenching or grinding teeth, chewing on non-food items).
Other Options for Preventing TMJ/TMD Pain
Additional nonsurgical treatment options for TMJ disorders that do not involve medications include using a bite guard while you sleep or occasionally during the day, wearing a dental splint or mouth guard to realign the jaw, or physical therapy options. Physical therapy for temporomandibular dysfunctions typically includes stretches and exercises to strengthen the jaw along with using ice and moist heat.
If you have a severe case, your dentist or doctor may suggest other more aggressive treatment options. Corticosteroid injections directly into the joint can be helpful. Arthrocentesis, a medical procedure during which the jaw joint is washed out with sterile fluid to rinse away any debris, may also be helpful. If these and other nonsurgical treatments are not effective, surgery may be suggested as a last resort. Surgical options are generally only used when there is something structurally wrong with the joint of a patient with a TMJ disorder.
What to Do If You Think You Have a TMJ Disorder
If you think you have a TMJ Disorder or have been diagnosed with one, do not ignore the effects of it. Take steps to avoid things that can increase pain or worsen the condition. Consult a dentist or doctor who can help you find ways to treat the condition. Fortunately, there are multiple things a person can do to manage temporomandibular joint disorders, decrease pain, and eliminate symptoms.
Learn how the TMD experts at Sleep Better Columbus can help you manage and treat your TMJ/TMD while preventing TMJ/TMD pain and symptoms. Schedule your consultation today online or call 614-777-7350.
