TMJ Management

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Does Your Jaw Crack or Pop?

Do You Have Worn, Broken or Chipped Teeth?

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Do You Suffer with Morning or Nightime Headaches?

Clenching or Grinding Your Teeth?

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Do You Have Jaw Joint or Facial Discomfort?

Do You Have Sensitive Teeth?

We Can Help Reduce or Eliminate These Problems!

With Dr. Rickards' special training in bite and TMJ evaluation, we can help you overcome these symptoms. Through analyzing your bite, Dr. Rickards can determine if you are a candidate for splint therapy. Splint therapy is a hard night guard worn while sleeping to help you relax your tired muscles and joint. After the splint is worn for a few weeks we can take records to determine the best course of action for you.

Often times the treatment may be as simple as making a few adjustments to your teeth, with no freezing. This is a very sophisticated area of dentistry and has taken a great deal of studying by Dr. Rickards to provide this special service. If you have been chronically irritated by any of the above symptoms, we encourage you to speak to us about your concerns.

TMJ - Temporomandibular Joint

Although many people associate the letters "TMJ" with jaw joint or facial pain, the letters really stand for "Temporomandibular Joint". There has been quite a bit of controversy regarding, this subject and there are two basic schools of thought:

How the jaw joint and the teeth fit and work together are intimately related and any disharmony between the two can result in numerous dental, muscle and joint problems.
The relationship between the jaw joint and the teeth has no bearing on individuals displaying dental, muscle and jaw joint problems.

This is a simplified explanation but is adequate to introduce this topic to you. Dr. Rickards feels strongly that the first explanation is the accurate one. His mentor in this very sophisticated area of Dentistry is the best-known researcher/clinician on this topic. His name is Dr. Peter Dawson, the author of "The Evaluation, Diagnosis and Treatment of Occlusal Problems" which is regarded as the gold standard in this field.

Signs and Symptoms There May Be a Problem With Your Bite

Tooth signs and symptoms:

Worn back teeth and/or worn front teeth.
History of teeth and/or fillings breaking.
"Notches" in your teeth, usually on the cheek side. These may or may not be sensitive. When sensitive, they can be VERY sensitive to everything: touch, temperature and sweets. Most patients are able to point these areas out by running their fingernail over the surface to find the notch.
Accelerated and/or hard to control gum or periodontal problems (most commonly associated with the back teeth).
Generalized tooth sensitivity, particularly when this sensitivity from time to time increases, decreases and may even go completely away.
Difficulty in chewing on certain teeth, particularly if it comes and goes over time.

Head and Neck muscle signs and symptoms:

A classic symptom is the individual who wakes up in the middle of the night or in the morning with a headache in the temple area of their head. Typically these individuals find that after massaging the area, these headaches often diminish or go away after about an hour.
Stiff and sometimes sore muscles in your cheek area. Again, after massaging these areas, the soreness diminishes or disappears. A similar discomfort can be experienced in the muscles on the side of the neck.
Patients who have a very limited jaw opening.

Jaw joint [TMJ] signs and symptoms:

Clicking and popping in the jaw joint area upon opening and\or closing of the jaw.
History of the above although it may have appeared to have gone away (it may have in fact gone away or it may have advanced to a further stage).
A history of your jaw locking open.
Tenderness in the joint area when chewing.
A progressive opening in the space between your upper and lower front teeth when your back teeth are closed together (this is a sign of a fairly serious problem in the jaw joint itself).

We want to make it clear that people having a disharmony between their naturally seated jaw joint position and their fully closed bite may have no signs and symptoms, only one or two of these signs and symptoms, or many of them. This all depends on many factors such as: gender, age, genetics and good or bad fortune. Just as with any system in our body, some people are more resistant or sensitive to disease.

If You Are Concerned

If any of the points listed above seem familiar to you and you are concerned, the following is what we would typically do:

Do a thorough tooth, gum and jaw joint examination.
Depending upon what we find, we may suggest we fabricate a special splint for you. In most cases the splint will be worn at night for anywhere between 3 weeks and 3 months. For more severe cases, we may recommend the patient wear the splint during the daytime as well. This splint will help us ensure that we have identified the source of the problem as your symptoms should disappear or greatly diminish after wearing a properly adjusted splint. At this point, we will take special records of your teeth and jaw relationship to study and determine our next course of action is.
In some cases, you may not need to go through the splint therapy procedure and proceed immediately to the records.
After we have got our TMJ patient comfortable with the splint, we now go to their options. These can vary between things such as; making minor adjustments to the teeth and no longer needing the splint, an orthodontic referral, an option of crowning certain teeth, continuing to wear the splint at night, or even just the use of Botox in certain muscles. Usually there are a number of ways to eliminate the need to have a splint "forever".
The courses of action we may take could range from making adjustments on your teeth, to crowning (capping).