TEMPOROMANDIBULAR DISORDER

When the masticatory system parafunctions, one or more of its components will present with abnormal wear and eventually injury. Depending on the component that will bear the load of the parafunction we can have the following results.
Τhe masticatory system consists of the teeth, the bone of the maxilla and mandible, the muscles and the tissues that surround them. The masticatory system under the neuromuscular control, performs many functions, such as chewing, speaking, swallowing, etc. Many times though, it can function out and over its functional limits, These cases are called parafunction, mostly in the form of clenching or bruxing (gnawing). In these cases we have the temporomandibular disorder with the following signs and symptoms

  • Teeth: Extreme tooth wear, shortening of their height and leveling
  • Periodontium (the tissues that surround and support the tooth): Tooth mobility, bleeding and sensitivity from the teeth and the gums
  • Muscles: Fatigue, muscle pain and spasms, headaches, difficulty in mouth opening, etc.
  • Temporomandibular joint (the joint just in front of the ear): Joint pain, sounds, difficulty in mouth opening, etc.

In most cases, the wear is on more than one components, therefore the signs and symptoms are proportionate.

 

The cause of the disorder is not yet clear. It is a multifactorial disorder, with each factor affecting more or less in every situation. Some of these factors are:

 

  • Stress
  • Occlussion (the way the teeth close)
  • Gender
  • Age
  • Craniomandibular injury
  • Dental operations
  • Head posture (especially during sleep)

 

How can I tell if I brux?

 

If it is during daytime, we can understand if we clench or brux our teeth.

We shouldn't forget that our teeth are supposed to occlude (touch) only when eating or swallowing (total estimated time 17 minutes a day).

Apart from that, any other tooth contact is uneccessary and only puts more load on the masticatory system, especially if it is extended.

 

If bruxing happens during the night, unfortunately we cannot understand it ourselves, because we are asleep. If we brux the teeth, someone in the room might hear the sound and tell us about it in the morning (or wake us up if it is too loud!). If, on the other hand, we only clench noone can understand it. The only way to find out is by the symptoms we might have the next morning (headaches, tired jaw, muscle spasm, etc.).

 

How can it be cured?

 

The best thing to do really is to calm down and try to take as much stress out of your life as possible. Since this is very difficult, there are certain therapeutic modalities that help minimize the symptoms and the wear in general (to say that we can completely cure it, is I am afraid very difficult with our current knowledge and practices).

 

The most usual modalities are physiotherapy and bite splints. In physiotherapy we usually focus on kinesiotherapy, that is certain movements to help the muscles return to their normal condition and coordination.

Bite splints are made of plastic, fabricated in a way to come between the teeth and decrease the muscle load and the intensity of the parafunctional activity.

 

If you happen to have any of the above mentioned symptoms (clenching or bruxing, morning headaches, joint sounds, difficulty in mouth opening , etc.) a dental evaluation is in order. Even a slight problem, if left unattended, could develop into something serious that would be much more difficult to treat. The dentist will diagnose the condition and guide you through the proper treatment.