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What is TMD?

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What is TMD?

TMJ, short for temporomandibular joint, serves as the connection point between the lower jaw (mandible) and the side/base of the skull (temporal bone). Together with facial muscles and teeth, it facilitates proper alignment of the jaw and enables essential functions such as chewing, speaking, and swallowing. When structural changes occur in the TMJ or if supporting bite, muscles, and ligaments function inadequately, it can lead to alterations in bite, ability to open and close, facial appearance, and pain. This condition, often misidentified as TMJ, is actually Temporomandibular Dysfunction ( TMD)

What are the Signs or Symptoms of TMD
(Temporomandibular dysfunction)

  • Jaw discomfort or pain
  • Clicking/popping or grinding sounds in the jaw joints
  • Jaw locking, either unable to fully open (closed lock) or unable to close completely (open lock)
  • Limited range of motion in the jaw
  • Jaw / facial asymmetry
  • Canted bite
  • Pain experienced when opening the mouth or chewing
  • Alterations in the alignment of upper and lower teeth
  • Front teeth no longer making contact
  • Increased pressure and wear on back teeth
  • Headaches
  • Earaches or ringing in the ears unrelated to inner ear infections
  • Tooth sensitivity without signs of oral disease
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What causes TMD?

  • Trauma or Injury to the joint (internal derangement)
    Stretching injuries
    Compressive injuries to the joint
    TMJ disk herniation
    Torn or stretched ligaments in the joint
  • Overloading the joint and facial muscles
  • Myofacial Pain
  • Degenerative Joint Disease
  • Parafunctional habits like:
    Nail biting
    Clenching and grinding
    Jaw thrusting
  • Bite misalignment

TMJ Examination Protocol

At Kwon & Jabbour Dental we specialize in addressing the complexities of TMJ dysfunction. Many of our patients come to us after seeking various treatments and experiencing ongoing frustration and pain. Often, this stems from a lack of accurate diagnosis. We understand that TMJ issues can have diverse root causes beyond just muscular problems.

Initial Assessment

Our approach is to begin with an accurate diagnosis before recommending any treatment. We achieve this through a meticulous examination protocol in our TMJ examination Protocol.

TMJ Pre Imaging Recordsappointment

  • We start with a detailed history of symptoms.
  • We conduct thorough clinical examination of the joint and facial muscles
  • We take photographs to identify jaw asymmetries or underdevelopment.
  • Digital models of your bite will be taken
  • 4-D Jaw motion recordings of the patient’s specific motions are taken to see how well the jaw is
  • CBCT radiology will be ordered to evaluate bony structures in the joint.
  • MRI Imaging will be ordered to assess the condition and position of the articular disk joint or bone edema, and soft tissue structures in the joint.
  • High-resolution pulse oximetry will be used to screen annd identify potential sleep-disordered breathing issues which may contribute to parafunctional habits like clenching or grinding at night.

Post Imaging Consultation & Treatment planning

After all examination, bite, and radiology data has been reviewed we can offer our patients useful insights an about the condition of their TMJ and discuss appropriate treatment options specific to their condition. Our goal is to empower patients with knowledge and guide them towards effective solutions for their
TMJ issues.

Appointment Flow to TMJ Diagnosis.

Initial TMJ Exam

After all examination, bite, and radiology data has been reviewed we can offer our patients useful insights an about the condition of their TMJ and discuss appropriate treatment options specific to their condition. Our goal is to empower patients with knowledge and guide them towards effective solutions for their
TMJ issues.

TMJ Pre-Imagin Records APPT

If a full TMJ work up with joint imaging is required the first appointment will be a TMJ PRE-IMAGING RECORDS APPOINTMENT. This will take 90 minute to collect records which include: Facial photographs, Intra oral scans, 4D Jaw motion captures, Bite Records for CBCT and MRI will also be custom made and Imaging orders will be given. All images will be sent for a secondary read by a radiology
specific to TMJ conditions. Patients will also take home a High Resolution Pulse Oximeter for a 2 night screening.

Post Imaging Consultation APPT

Once all clinical data has been gathered and analyzed, you will be invited back for a Post Imaging consultation to discuss findings and diagnosis. From there appropriate Treatment recommendations can be discussed.

TMJ treatment requires a Diagnosis

Treatments for Temporomandibular Dysfunction (TMD) vary depending on the specific type and severity of the disorder. Therefore, an accurate diagnosis is essential before any treatment recommendations can be made.

We typically initiate the diagnostic process with a comprehensive examination to assess for signs of internal joint derangement or structural risks within the joint. If warranted, TMJ imaging, including Cone Beam Computed Tomography (CBCT) and Magnetic Resonance Imaging (MRI) with the Piper protocol, is ordered. These imaging techniques provide detailed visualization of both hard and soft tissue structures, revealing the condition, size, and position of the TMJ. Additionally, the MRI helps identify joint or marrow space edema and assesses the position and condition of the articular disk.

Our specialized imaging protocol allows us to determine if the jaw or bite can be optimized for ideal orthopedic stability. In essence, TMJ imaging plays a pivotal role in making an accurate diagnosis, which, in turn, enables us to offer tailored treatment options and prognosis to the patient.

Recommending treatment without knowing the full diagnosis could be detrimental and make the joint worse.
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Potential TMJ Treatment

After diagnosing Temporomandibular Dysfunction (TMD), personalized treatment recommendations can be tailored, potentially including some of the following approaches:
  • Palliative pain management using NSAIDs or other pain relievers
  • Muscle relaxers or BOTOX injections
  • Laser Photobiomodulation therapy
  • Physical therapy
  • Myofascial release techniques
  • Behavior modification strategies to address parafunctional habits
  • Identification and management of airway-related parafunction
  • Diet modifications to support jaw health
  • Prescription of an orthopedic oral appliance to alleviate joint pressure and optimize orthopedic bite position
  • Orthopedic bite stabilization through restorative dentistry and/or orthodontics
  • TMJ surgery options such as autogenous fat grafting or total joint replacement

Meet Dr. Julie Kwon

Dr. Kwon's commitment to education, combined with her investment in digital technology, enhances her
effectiveness in diagnosing and planning treatments for TMJ disorders. With advanced education from Spear Education, The Kois Center, Implant Pathways, and the American Equilibration Society, she has honed her skills
in comprehensive dental care. Her involvement in the Chicago Study Club, dedicated to TMJ treatment, further solidify her expertise in this area. As a visiting faculty member at Spear Education and co-leader of a local Spear Study Club, she actively advances dental knowledge among her peers. Dr. Kwon's wealth of experience and
dedication ensure that her patients receive the highest level of care and accurate diagnosis for TMJ disorders..
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