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Procedures

TMJ / Jaw Joint Disorders

One of Dr. Levy’s interests within his specialty is helping patients with jaw joint, or TMJ disease. Not all Oral Surgeons choose to care for patients with this challenging problem.

If you have “TMJ”, you may well find that your physician, Primary Care Provider or your insurance Company has suggested that you see Dr Levy. He cares for MANY patients with this problem.

In New Hampshire, Dr Levy is one of the very few Oral Surgeons who treat patients with TMJ disease. At the Massachusetts General Hospital, Dr Levy received extensive training in this “sub-speciality” area of Oral and Maxillofacial Surgery.

The TMJ ( temporomandibular joint) disorders are related to your jaw joints. If you have had symptoms like pain, limited jaw opening or a "clicking" sound, you'll be glad to know that these problems are more easily diagnosed and treated than they were in the past. Problems occur when the joints of the jaw and the chewing muscles (muscles of mastication) do not work together correctly. TMJ's (right and left) connect your jaw to your skull. Some types of TMJ problems can lead to more serious conditions, and early detection and treatment are important.

No single treatment can resolve all TMJ disorders completely. A through evaluation is vital. Dr. Levy can help you have a healthier and more comfortable jaw.

Trouble With Your Jaw?

TMJ disorders develop for many reasons. You might clench or grind your teeth, tighten your jaw muscles, and stress your TMJ. You may have a damaged jaw joint due to injury or disease. Injuries and arthritis can damage the joint directly or stretch or tear the muscle attachments. As a result, the cartilage disk cushion, which functions as a shock absorber of the jaw joint, can slip out of position. Whatever the cause, this problem can cause a misaligned bite, pain, clicking, or grating noise when you open your mouth. In addition, you might have trouble opening your mouth wide.

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Do You Have A TMJ Disorder?

  • Are you aware of grinding or clenching your teeth?
  • Do you wake up with sore, stiff muscles around your jaws?
  • Do you have frequent headaches or neck aches?
  • Does the pain get worse when you clench your teeth?
  • Does stress make your jaw clenching and pain worse?
  • Does your jaw click, pop, grate, catch, or lock when you open your mouth?
  • Is it difficult or painful to open your mouth, eat, or yawn?
  • Have you ever injured your neck, head, or jaw?
  • Have you had problems (such as arthritis) with other joints?
  • Do you have teeth that no longer touch correctly when you bite?
  • Do your teeth meet differently from time to time?
  • Is it hard to use your front teeth to bite or tear food?
  • Are your teeth sensitive, loose, broken, or worn?

The more times you answered "yes," the more likely it is that you have a TMJ disorder. Understanding TMJ disorders will also help you understand how they are treated.

Treatment

There are various treatment options that Dr. Levy can use to improve the harmony and function of your jaw joint. Once an evaluation confirms a diagnosis of TMJ disorder, Dr. Levy will determine the proper course of treatment.

The initial goals are to relieve the muscle spasm and joint pain. This is usually accomplished with a pain reliever, anti-inflammatory, or muscle relaxant. Self-care treatments can often be effective as well and include:

  • Resting your jaw
  • Keeping your teeth apart when you are not swallowing or eating
  • Eating soft foods
  • Applying ice and heat
  • Exercising your jaw, with specific techniques
  • Practicing good posture

Dr. Levy may refer you to a registered physical therapist (RPT) with significant head and neck rehabilitation experience. He works with some very talented therapists and this frequently helps to increase comfort and avoid surgery.

Stress management techniques such as biofeedback 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 and helps keep your teeth apart, thereby relaxing the muscles and reducing pain. A nightguard helps you stop clenching or grinding your teeth at night.

What About TMJ or Jaw Joint Surgery?

Surgical options such as open joint repair or TMJ Arthroscopy are sometimes the best choice to help your problem. Dr. Levy does not consider TMJ surgery until all suitable non-surgical options have been tried.

An advanced x-ray study, such as an MRI or a CT scan is needed prior to surgery. Our office will work with your insurance for appropriate authorizations and schedule this study at a local hospital.

After this advanced study, Dr Levy will discuss your results. He encourages you to bring your spouse, parent, or partner to this visit so that every question is answered to your satisfaction. Should surgery be necessary, this is a Day-Surgery procedure at the Hospital.