Are you suffering from headaches, facial pain or jaw pain? Are your teeth sensitive, worn, rough along the edges, or has there been a change in your bite or the fit of your dentures? Do your ears feel full, ring or do you hear a popping or clicking sound when chewing or speaking? Do you frequently wake with a headache or experience recurring headaches? Answering yes to any of these questions may be an indication that you have a TMJ disorder.

Temporomandibular Joint Disorder, commonly called TMJ or TMD, often starts with an Occlusal Imbalance. The pain may come on slowly or start suddenly after an accident or trauma. Atlanta dentist Dr. Brenda Paulen has received extensive training in the assessment, detection, and correction of occlusal issues, sometimes called “occlusal disease”.

The term “occlusion” is used in dentistry to refer to the bite relationship. More specifically, this means the alignment of the jaw as the teeth come together along with the relationship of the upper and lower teeth. The lower jaw is a “u-shaped” bone, which has two joints at each end. When the bite relationship is aligned and functioning properly, the lower jaw is able to freely hinge at the joints and close together with the lower teeth contacting the upper teeth very evenly all the way around the arch, without the facial muscles overworking or compensating. This creates a “stable bite” in harmony with the joints and muscles.

When there is a misalignment in the bite relationship to the fully seated joints, then problems can develop.

Signs and symptoms of TMJ

  • Frequent Headaches
  • Clenching and Grinding
  • Disturbed Sleep
  • Fatigue
  • Broken Restorations
  • Excessively Worn Teeth
  • Sore Jaw and Facial Muscles
  • Head and/or Neck Pain
  • Clicking or popping when opening or chewing
  • Limited movement of the jaw, episodes of “getting stuck”
  • Shifting teeth, bite changes

Through a unique and gentle examination, Dr. Paulen will assess the mechanics of your bite and recommend various treatment options to relieve whatever stresses might be found.

Treatment Options

TMJ related issues are multifactorial. Dr. Paulen reviews patients’ overall health history and will coordinate care as needed with an ENT, physical therapist, neurologist or endocrinologist.There is always a dental component to TMJ pain. Improper bite alignment, as well as clenching or grinding habits are triggers for recurring episodes of pain. Splint therapy is a general starting point, followed by detailed evaluation of a patient’s occlusion to determine the source of the problem.

To bring harmony and balance to the bite, TMJ joint and facial muscles any combination of treatments may be recommended.

In many cases, Dr. Paulen may recommend the use of a muscle deprogrammer or centric relation splint. This specially fabricated removable dental device can be worn at your leisure to help relax and relieve those nerves and muscles, thereby avoiding a possible headache. She even wears one herself!

Effective treatment may be as simple as an “occlusal adjustment”, a restorative procedure to slightly recontour one or more teeth to adjust the balance of the bite. Or rehabilitation may be more involved, incorporating orthodontic treatment to correct malocclusion or dental restorations for worn, damaged or missing teeth.

The goal of treatment is to not only relieve symptoms that can affect daily life, but to restore comfort, balance and longevity to the bite and dental health.

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