What is a TMJ Disorder?

TMJ is an abbreviation for the temporomandibular joint. The TMJ is not a disorder/disease. It is a part of the body. A joint is a connection between two bones that allows for movement between those bones. Healthy joints allow for smooth, pain-free movement through a wide range of movement or motion.

There are two temporomandibular joints, one on each side of the face, located directly in front of the ears. The TMJs differ from other joints in our body in several ways. The first is that it is the only joint that rotates, slides or translates, and pivots. If a finger is placed on the TMJ directly in front of the ear and the jaw is opened slightly and closed, one can feel the rotation. If the teeth are closed together, and the jaw is protruded straight out or when the jaw is opened wide the sliding motion, or translation, is felt. If the jaw is moved to the left, for example, the left joint pivots while the right joint slides.

The second way the TMJs differ from other joints in our body is that the right side is connected to the left side. The right and left TMJs are in essence opposite ends of the same bone which is the jaw or mandible. The one TMJ cannot be moved independently of the other.

What are the causes of TMJ/TMD?

TMJ disease or damage is often the result of trauma, either singular or accumulated. Traumas can damage the structures of the TMJ just as any other joint in our body. The structural changes that can result may cause changes in how the TMJ functions and changes in how the system functions mechanically.

The “system” is the Stomatognathic System which is more than the sum of its parts. It is more than just teeth, gums, bones, muscles, cartilage, neural tissue and blood vessels. As a functional system, the only moving areas are the TMJs. When there is structural damage in the joints, usually evident by noise in the TMJs with opening and closing, the bite can change. When the bite changes, the muscles cannot work the way they were designed to, and muscle spasms can result. The spasms can then become part of a cycle that results in tissue damage, pain and tenderness of the face, or headache. It is possible that malocclusions – when the teeth do not meet together properly – can lead to muscle spasm and pain.

What are some signs and symptoms of TMJ/TMD?

  • Worn, fractured, or missing teeth
  • Pain in the face
  • Pain in the jaw – Especially with chewing
  • Limited opening of the jaw
  • Headache and ear ringing and/or congestion

How do you treat TMJ/TMD?

Some treatments for TMD/TMJ include muscle relaxants, anti-inflammatories, biofeedback, or wearing an orthotic appliance in the mouth. However, patients seeking long-term relief should seek the care and advice of a doctor who has years of experience.

Dr. Grill can determine the cause of your symptoms via a thorough interview/examination process and by conducting a series of diagnostic tests. These tests may include Doppler examinations, CT & MRI scans of the TMJs, mounted study models of the teeth, and X-rays. Proper diagnosis is essential before the appropriate treatment can be recommended – ultimately saving time, suffering, and money by ensuring you receive the treatment appropriate to manage your particular problem.

Dr. Grill only provides nonsurgical treatment of TMJ. However based on the severity or complexity of the case, he may seek helpful advice from other experienced clinicians.

Is Surgery Required to Treat TMJ?

Usually, no. Dr. Grill only provides nonsurgical treatment protocols himself. He may elicit the helpful expertise of other clinicians based upon the diagnosis and management plan. Surgical referral is indicated in a small percentage of cases.

What is Sleep Apnea?

Sleep apnea can be considered a serious sleep disorder that occurs when a person’s breathing is interrupted during sleep. Patients with untreated sleep apnea tend to stop breathing repeatedly during their sleep, sometimes hundreds of times. This means the brain — and the rest of the body — may not get enough oxygen and other serious complications could arise.

There are three types of sleep apnea:

  1. Obstructive sleep apnea (OSA): The more common of the forms of apnea, it is caused by a blockage of the airway, usually when the soft tissue in the back of the throat collapses during sleep.
  2. Central sleep apnea: Unlike OSA, the airway is not blocked, but the brain fails to signal the muscles to breathe, due to instability in the respiratory control center.
  3. Complex sleep apnea, as the name implies, is a combination of the two conditions. With each apnea event, the brain rouses the sleeper, usually only partially, to signal breathing to resume. In those with severe sleep apnea this can happen hundreds of times a night, often most intensely late in the sleep cycle during rapid-eye-movement (REM) sleep. As a result, the patient’s sleep is extremely fragmented and of poor quality. Meanwhile the disorder continuously reduces the oxygenation of the blood, further stressing the sleeper’s physical system.

Is snoring considered a form of sleep apnea?

Yes, snoring is a result of blocked airway which may be Obstructive Sleep Apnea or OSA. The condition is more common among men than women, and it becomes more likely as you get older. But it’s not a normal part of aging. A common cause of “snoring” is being overweight, which also means a common treatment is to lose weight, although your physician will have to do a series of tests including a sleep study to diagnose the root causes.

What insurance do you accept?

We do not accept insurance; however, as a patient courtesy we will file a claim form with your insurance company. We ask that you pay at the time of service. If necessary, financial arrangements may be made directly with us.

I am a new patient, what do I bring to my first appointment?

First, welcome to our practice. We do ask that you download and print our patient forms prior to arriving. You can send them or arrive 15 minutes early to your appointment to turn them in for your visit.

Center For TMJ Facial Pain

7600 Osler Dr.
Towson, MD 21204


(410) 828-0800

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