TMJ TREATMENT, TMJ MASSAGE & BOTOX FOR TMJ MUSCLE PAIN

 

What is TMJ?

TMJ refers to the temporomandibular joint, which is the bone structure, muscles and connective tissues that surround the jaw and control chewing. Disorders of this joint are referred to TMJ Dysfunction or TMJ Disease.

The TMJ is one of the most complicated joints in the human body. It can move in 3 dimensions unlike any other joint in our body. Because of the complex movements of this joint, small issues can manifest into large problems rather quickly. If you are experiencing clicking in one or both joints, muscle pain or tension, and/or headaches, ringing in the ears (tinnitus), neck and shoulder pain - you may have a serious TMJ disorder that should be evaluated as soon as possible.

How did i get tmj?

TMJ “Clicking” Occurs When the Disc Slips Off of the Lower Jawbone

In many cases TMJ Dysfunction (TMJD) is due to a discrepancy in how the teeth fit together in a comfortable biting position and the “orthopedically-stable” position, or a position in which the jaw joint is properly supported by muscles and ligaments in our skull. This discrepancy causes muscles that move the lower jaw to spasm or tighten. Some of these muscles are connected to a disc that helps cushion our lower jawbone against our skull. When these muscles tighten, the disc is not allowed to move properly and as a result, a “click” may be felt or heard upon opening and closing. This click is your lower jawbone jumping off of the disc - a serious condition that can lead to arthritis and degenerative joint disease - and a condition that needs to be treated immediately.

WHAT IS THE DIFFERENCE BETWEEN THE COMFORTABLE BITING POSITION AND THE ORTHOPEDICALLY STABLE POSITION?

The comfortable biting position is how our teeth fit together comfortably; however, even though teeth may fit together comfortably, the TMJ jaw joint might be out of place. When this happens, TMJ symptoms start - and usually the first symptom is an audible “click” when you open or close, or muscle pain around the TMJ jaw joint.

The orthopedically-stable position exists when our TMJ jaw joint is in the correct position within our skull with all of the jaw muscles in a state of release. In this position, all of the teeth should fit together perfectly. When the teeth do not fit together perfectly, the lower jaw has to move away from teeth contacting which causes the jaw joint to fall out of place. This, in turn, leads to muscle tension around the TMJ jaw joint which then manifests in pain.

HOW IS TMJ TREATED?

There are many philosophies on how the TMJ is treated ranging from conservative therapy to surgical intervention. Dr. Gulizio - our TMJ specialist and prosthodontist - believes in a conservative approach to TMJ treatment. Depending on the severity of your condition, he may recommend one or more of the following treatment modalities:

  • Myofascial release with TMJ Massage

  • Bite splints

  • Physical therapy

  • Anti-inflammatory medication

  • Botox

Myofascial Release for TMJ Pain

TMJ Treatment

Get relief from TMJ pain and symptoms from New York’s TMJ Specialists

Myofascial release involves gentle manipulation of the muscles associated with the TMJ jaw joint.

Myofascial release is a procedure performed by a trained professional to help release the muscle strain associated with TMJ disorders. Although it will improve the pain and symptoms associated with TMJ pain, myofascial release will not eliminate the cause of TMJ disorders. It is important to understand that “self-massage” in and or around the TMJ may actually may TMJ symptoms worse - the muscles implicated in TMJ pain are delicate and difficult to pinpoint correctly. Additionally, there are ligaments around the jaw joint that should not be manipulated by massage. Ligaments - unlike muscles - do not stretch, but rather elongate. Once ligaments have elongated they no longer protect the TMJ jaw joint from slipping out of position and corrective therapy must then be focused on muscle stabilization.

Once you have been evaluated by Dr. Gulizio, he will formulate a treatment plan for you that may include myofascial release in addition to the implementation of a TMJ bite splint.

TMJ Bite Splints and Orthotics

A TMJ bite splint is a removable appliance made to release the muscle strain and tension in the area of the TMJ jaw joint. This device helps to “reset” the TMJ jaw joint into the correct position within the skull, thereby eliminating the pain associated with TMJ disorders.

TMJ splints are not nightguards as they function very differently than a nightguard appliance. A nightguard will only help protect your teeth from wear during clenching and grinding, but it will not fix your TMJ symptoms nor will it help correct TMJ dysfunction.

TMJ bite splint therapy requires a visit to our clinic on a monthly basis. These visits are usually very quick and they allow Dr. Gulizio to evaluate the progress of your TMJ treatment. It is important to understand that although a bite splint may eliminate your TMJ pain entirely, additional treatment may be needed to correct the position of your teeth so that your TMJ jaw joint remains stable and pain-free.

TMJ Splint: Unlike a nightguard, this device helps reposition the lower jaw to release muscle strain & set the TMJ jaw joint into the correct position.

Physical Therapy

Physical therapy plays a crucial role in the comprehensive management of patients with TMJ (temporomandibular joint) symptoms. TMJ disorders can cause various issues, including jaw pain, stiffness, reduced jaw mobility, and even headaches. Physical therapy aims to alleviate these symptoms and improve overall jaw function. It involves a range of specialized techniques tailored to each patient's needs. One key component of TMJ physical therapy is exercises that help strengthen weak jaw muscles and improve jaw range of motion. These exercises promote flexibility and stability in the jaw joint, alleviating pain and restoring normal functionality. Another important aspect is manual therapy, where a trained therapist applies specific techniques to release muscle tension and realign the jaw joint. This can help reduce pain and improve joint mobility. Additionally, physical therapists may provide education on posture, relaxation techniques, and lifestyle modifications to minimize stress on the jaw joint. By addressing the underlying causes and providing targeted therapies, physical therapy can significantly improve TMJ symptoms, enhance jaw function, and promote a better quality of life for patients.

Trigger Point Injections and Medications

Another option to manage TMJ symptoms include trigger point injections of anesthetic or steroids. These injections can provide targeted relief by numbing the specific trigger points that are causing pain and discomfort. By blocking the pain signals, the injections help to relax the muscles and alleviate the symptoms of TMJ disorder. In some cases, a combination of anesthetic and steroids may be used for optimal results. Moreover, oral medications can also be prescribed to help the muscles around the TMJ jaw joint relax. These medications work by reducing inflammation and promoting muscle relaxation, which can significantly improve the patient's comfort and overall well-being. Patients with complex TMJ dysfunction who require steroid and/or anti-inflammatory injections, or surgical intervention, are referred to an orofacial pain specialist.

BOTOX for TMJ

Botox can be beneficial for TMJ patients who present with myofascial pain, but it may not be suitable for those with TMJ disc dislocations. Myofascial pain involves muscle tension and trigger points in the jaw muscles, leading to discomfort and limited jaw function. Botox, when injected into these specific muscles, can help relax them and reduce muscle contractions, providing relief from myofascial pain.

However, for patients with TMJ disc dislocations, where the disc that cushions the jaw joint slips out of its normal position, Botox is not typically recommended as a primary treatment. Disc dislocations often require a different approach, such as splint therapy or corrective dental procedures, to address the underlying issue and realign the jaw joint.

“TMJ sufferers, Dr. Gulizio is your guy. He’s head of NYU’s post-doctoral program for occlusion (jaw alignment) and esthetics. Do yourself a favor & make an appointment; you don’t have to live in pain. I wish I’d found him sooner. I was debilitated by TMJ pain before I came to Core Smiles.”
— Yelp! review from Aliya J., New York, NY

How can I be evaluated for a tmj disorder?

Our Prosthodontist and TMJ specialist in NYC, Dr. Michael Gulizio, will take a thorough medical and dental history, assess your diet, daily habits and review any medications you are currently taking. He will then examine your bite and jaw joints using 3D scanning technology. Based on Dr. Gulizio’s assessment, he will then determine which course of treatment is best for you. Dr. Gulizio’s initial approach is always conservative treatment using physical therapy techniques and a TMJ bite splint. For patients with complicated TMJ disorders, referral to an orofacial pain specialist who may prescribe medications and implement trigger point injections is necessary.