Oral Appliances for TemporoMandibular Disorder
A sleep-related breathing disorder can be the cause of teeth clenching as the body’s reflex to help keep the jaw forward for better breathing. The sleep breathing disorder must be confirmed or ruled out in the course of the oral appliance treatment for a TMJ disorder.
If a sleep-breathing problem is confirmed, then it can be managed at the same time as the TMJ disorder so as not to impede the progress of that treatment or cause recurrence of symptoms. Research indicates that the source of 60% of TMJ (Jaw) problems is an underlying breathing problem during sleep. If this concern is not suspected or ruled out by diagnostic testing, then the appropriate dental appliance worn over the teeth is selected to reduce the intensity of the clenching habit and relax the related facial and neck muscles that are often sore on awakening.
Other custom-designed oral appliances may, alternately, be selected if a patient’s symptoms involve the TMJoints. These devices are often considered when the jaw clicks or there is difficulty and limitation in opening or closing the jaw, usually due to a “dislocation” of the disc.
At the same time, there is often discomfort to function (talk and/or chew). So in addition to selecting the proper appliance for nighttime, or a daytime and nighttime appliance, alternatives to surgical intervention that are very non-invasive and that can be used to provide relief in these cases can include Electrical Nerve Stimulation (TENS), Ultrasound, and therapeutic exercises for improvement. Posture and nutritional concerns are also assessed during evaluation to see if they may contribute to improving one’s condition.
At Pittsburgh Dental Sleep Medicine, our education, training, and experience in providing treatment for TMJ disorders, or muscle-related symptoms in the face or neck, is to correctly identify the underlying source of the symptoms and use the most conservative therapy that resolves the source of those symptoms.
For more information visit the patient portal at AACP.org (the American Academy of Craniofacial Pain)