TMJ Treatment

   Headaches are one of the most common pain complaints in modern society, and over 90% of all headaches are of the type called muscle contraction (or "tension") headaches. Most muscle contraction headaches are accompanied by clenching of teeth and other symptoms of temporomandibular joint disorder, commonly referred to as "TMJ disorder". Treatment of TMJ disorder frequently reduces or eliminates muscle contraction headaches.

The temporomandibular joint is the joint used to open and close the mouth. Patients with a TMJ disorder often tighten the muscles in their jaw, and may grind their teeth at night, leading to muscle contraction headaches. Usually the patient will have other symptoms, including pain in the jaw, temple or ear, a clicking or "popping" sensation in either jaw joint when opening and closing the mouth, and other problems in the jaw such as stiffness or a shifting of the joint when it is in motion. Other symptoms of TMJ disorder include headaches, neck and/or facial pain, dizziness, and ringing in the ears. The TMJ is a complex joint and injury or overuse of its associated muscles, ligaments and nerves (i.e. due to nighttime teeth grinding) can cause any or all of the above symptoms of TMJ disorder.

The pain of a TMJ (muscle contraction type) headache usually starts in the forehead, temples or back of the head and spreads over the neck and shoulders. Sleeping difficulties are common, including nighttime teeth-grinding or bruxism. Patients often describe feeling a band-like or vice-like tightness around the head.

Conservative treatment of the disorder includes use of an occlusal splint, also called a night guard. The splint reduces the severity of grinding at night, protects the teeth from further wear, and allows the muscles to rest. A new type of splint, called an NTI device, has been approved by the FDA as an adjunct for the treatment of medically diagnosed migraine pain. It attaches to the front teeth only and does not allow the posterior teeth to touch at all. Other treatment options include moist heat, stretching and massage of the muscles around the jaw joint, and medication in some cases. Stress management is important since emotion and stress play an important role in TMJ disorder.