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Caring for your Jaw and Teeth in Times of Stress

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With Dr. Mefford

If you have seen headlines recently, you may know that dentists across the country are seeing a rise in cracked teeth and issues related to TMJ Disorders (here and here are those articles if you are interested.)

We wanted to be sure to address this important and increasing issue on our blog so that our patients can be informed and be on the watch for symptoms of these disorders. Dr. Mefford had the following to say regarding this issue and what he is seeing.

Are you seeing more cases of cracked teeth and TMJ related problems lately?

In a word, yes. We have seen a spike in the number of our patients needing help with cracked teeth and jaw pain in recent months - definitely a big jump from this time last year. I found myself nodding a lot when reading recent articles regarding it. We shared a video back in the spring related to TMJ disorders. I had a hunch that due to the stress that 2020 was bringing us there was a high potential for dental related problems. (video at the end of this blog).

What is TMJ?

Well, TMJ is actually a bit of a misnomer. TMJ (short for temporomandibular joint) refers to the two jaw joints that everyone has. These joints are located where the lower jaw and the base of the skull come together and articulate. When someone experiences problems with the joints or the supporting structures around them, then that person likely has a TMJ disorder (also called TMD).

But as to what it is, TMJ disorder is a very broad term and can present in different ways. One of the more common TMJ disorders that we are seeing is related to the issue of clenching or grinding your teeth - essentially, holding teeth tight together, clenching jaws, or grinding teeth back and forth. This kind of activity can cause problems of muscle soreness and physical damage to the actual joint itself.

When do people experience issues with TMJ disorders?

While many people believe that clenching and grinding only occurs at night, many people do it during the day as well without thinking about it or realizing it, particularly when going through times of stress. For example, if your teeth are touching when your mouth is closed, your jaw is at least somewhat clenched. You will also notice stress in the facial muscles, and even in the neck and shoulders.

People often experience clenching and grinding in their sleep as well, also attributed to times of stress, or even just as a chronic behavior.

We are now seeing a lot of patients who have not had this issue in the past showing up with it, likely connected to the stress of recent events.

How does a patient know if they have a TMJ disorder?

It usually presents as soreness and aching in the muscles of the jaw and face. You may have a feeling of muscle “tightness”. The muscle soreness can also lead to headaches. Patients often report that the feeling is more noticeable when they wake up in the morning. Sometimes their spouse even tells them that they hear them grind their teeth at night. This is a huge warning sign. Patients may not always feel the soreness, sometimes the only sign of clenching and grinding their teeth is wear and attrition of the teeth causing them to look flat and chipped.

Putting a lot of grinding pressure on your teeth is bad for them, as they are not made to handle that kind of impact and repetitive stress.

How do you treat or address a TMJ disorder?

It always starts with a thorough examination so that we can obtain the proper diagnosis. From there I go to education and awareness - most people do not realize they are doing these behaviors. I can often treat daytime clenching and grinding habits in folks just by making them aware. If you can consciously stop periodically throughout the day and remind yourself to keep air between the teeth you can go a long way towards curing a TMJ disorder. I give them stretching exercises to help decrease the tension in the muscles and that goes a long way too. I encourage them to find ways to relieve stress by practicing relaxation techniques. A warm, moist compress to the muscles helps a lot too. I love these ideas because not only are they very effective, they come with little or no cost!

TMJ disorder therapy also can include the recommendation of medication. Over the counter nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen or naproxen can offer relief too (though patients should check with their doctor to make sure NSAIDs are safe for them). Disrupting the pain signaling can help disrupt the behavior. For 3-5 days I suggest taking these powerful medications at regular intervals (every 6-8 hours). If we can disrupt these pain signals early on, we can often eliminate the acute TMJ flare up.

Lastly, we may intervene by suggesting a specially fit appliance that we often refer to as a night guard or a bite guard. This device helps by putting the jaw in a more stable position from a muscular and skeletal standpoint. We often instruct patients to wear the appliance while they sleep. Sometimes we recommend daytime wear of the guard. Not only does the appliance help to reduce pain, it also helps prevent further wear of the teeth due to the grinding.

What happens if it goes untreated?

It is not a good idea to let a TMJ disorder go untreated. In fact, the sooner you treat the better the outcomes. If we can treat the problem when it arises it is much easier to get under control. When this problem goes on for long periods of time a chronic condition can set in and the pain cycle becomes almost impossible to break. In very serious cases, the continued clenching and grinding can result in deterioration of the joint and ligaments themselves.

Untreated clenching and grinding can also cause permanent damage to the teeth. Broken and worn enamel does not regenerate. Worn teeth can be painful and more susceptible to breaking and splitting. This kind of damage can lead to the need for thousands of dollars in restorative dentistry.

The good news is that these TMJ disorders can be stopped in their tracks by intervention!

What should someone do if they think they have a TMJ disorder?

Schedule an appointment today, or as soon as possible. We will do a thorough clinical and radiographic examination to determine the proper diagnosis. Then we can have a conversation about what your specific needs are and help you make a great informed decision about what to do next. We would also encourage you to commit to a lifetime of good oral health by choosing to team up with us and maintain regular visits periodically so that we can continue to monitor not only your TMJ health but the health of your mouth overall. We believe that the best way to treat dental problems is by preventing them from ever occurring. We believe that good overall health is connected to good oral health. We would be honored if you would consider trusting us to help you obtain you oral health goals.

Concerned about TMJ disorders?

Let us help protect your teeth in this stressful time.

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