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TMJ disorders / CMD Diagnosis and treatment of teeth grinding and joint pain

The masticatory system (the craniomandibular system) consists among other things of teeth, periodontal ligaments, jaw bones, ligaments, muscles and the mandible. Nowadays we have a lot of pressure to at work and in private and some of us do handle these things subconsciously by grinding and clenching of teeth which result in more cases of TMJ.
But not only stress can be the cause of jaw dysfunction, accidents and deformities of teeth may be a cause as well.

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Bruxism – teeth grinding

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Bruxism is defined as the unconscious nocturnal, but also daytime teeth grinding or clenching of the teeth. Consequences are increased wear of the teeth and overloading of the periodontal structure. This unhealthy pressure results in damage on joints, teeth and gums.

In addition, morning temporomandibular joint pain, headaches and even muscle tension in the neck and neck can occur after the nocturnal grinding.
The first major symptoms of TMJ disorders include pain or restricted movement of the jaw joints, as well as cracking or grinding noises during mandibular movements.

According to US studies 30% of the population are either grinding or pressing with their teeth at night.

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The functional analysis of the temporomandibular joint

At the beginning of treatment a detailed examination of the TMJ and structures next to it will be done. Using the findings preliminary diagnosis may be excluded and additional diagnostic procedures (e.g., MRI) should be considered.

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Bruxism is often treated by a combination of physiotherapy and an occlusal splint, which the patient wears at night. Thus, the tooth damage is largely prevented. A physiotherapy treatment can often significantly reduce the tone of the muscles. In most cases, psychological factors contribute the development and maintenance of bruxism. This factor are fear, anger, frustration and stress. Therefore, in some cases the assistance of a psychotherapist in treatment of TMJ patients is required.

The splint

Impressions of the upper and lower jaws are required for making a splint. A bite in a „relaxed“ position (central bite registration) is obtained and the splint will be produced with this position. In general, this splint is worn at night and should be checked regularly.