TMJ Disorders

TMJ stands for Temporomandibular Joint, the name for each joint (right and left) that connects your jaw to your skull.  TMJ disorders include a family of problems related to this rather complex joint. If you have had symptoms like pain or a "clicking" sound, you'll be glad to know that these problems are better diagnosed and managed than they were in the past.

These symptoms occur when the joints of the jaw and the chewing muscles (muscles of mastication) do not work together correctly.  Since some types of TMJ problems can lead to more serious conditions, early detection and treatment may be important. To discuss a possible TMJ disorder in the Wilmington, DE area, please feel free to contact us at 302.477.1800 to setup a consultation appointment.

No one treatment can resolve TMJ disorders completely and treatment takes time to become effective. Dr. Rafetto can help you have a healthier and more comfortable jaw.

What are the Causes of TMJ Disorders?

TMJ disorders develop for many reasons. You might clench or grind your teeth, tightening your jaw muscles and stressing your TM joint. You could also have a joint damaged after injury or disease. These processes can cause damage directly to the structures of the joint itself (cartilage, bone, etc) or stretch or tear the supporting muscle and/or ligaments.  Whatever the cause, the results may include a misaligned bite, pain, clicking or grating noise when you open your mouth or trouble opening your mouth wide.

TMJ Treatment

There are various treatment options that Dr. Rafetto can utilize to improve the harmony and function of your jaw. Once an evaluation confirms a diagnosis of TMJ disorder, Dr. Rafetto will determine the proper course of treatment. It is important to note that treatment always works best with a team approach of self-care joined with professional care.

The initial goal is usually to relieve the muscle spasm and joint pain.  This is usually accomplished with a pain reliever, anti-inflammatory or muscle relaxant.  Steroids can be injected directly into the joints to reduce pain and inflammation.  Self-care treatments can often be effective as well and include:

1. Resting your jaw
2. Keeping your teeth apart when you are not swallowing or eating
3. Eating soft foods
4. Applying ice and heat
5. Exercising your jaw
6. Practicing good posture.

Stress management techniques such as biofeedback or physical therapy may also be recommended, as well as a temporary, clear plastic appliance known as a splint.  A splint or nightguard fits over your top or bottom teeth with the design to relax muscles and reduce pain.  There are different types of appliances used for different purposes.  A nightguard helps you stop clenching or grinding your teeth and reduces muscle tension at night and protect the cartilage and joint surfaces.  An anterior positioning appliance moves your jaw forward, relives pressure on parts of your jaw and aids in disk repositioning.  Appliances also help to protect from tooth wear.

What about bite correction or surgery?

If your TMJ disorder has caused problems with how your teeth fit together, you may need treatment such as bite adjustment (equilibration), orthodontics with or without jaw reconstruction, or restorative dental work.  Surgical options such as arthroscopy and open joint repair restructuring are sometimes needed but are reserved for severe cases. Dr. Rafetto does not consider TMJ surgery unless the patient has undergone appliance treatment unsuccessfully.