TMJ Disorders

Although Dr. Buche has a broad background in understanding the nature of pain associated with the masticatory process, most such pain is not surgical. Fewer than 5% of all patients who have pain with or near the temporomandibular joint will require surgery. In fact, most oral and maxillofacial surgeons are reluctant to operate on this joint unless there is specific bone pathology . Because of this, Dr. Buche will suggest that you seek pain management with your general dentist Your dentist will fabricate appliances and offer symptomatic care that is not surgical. These are things a surgeon usually does not do. The discomfort associated with the temporomandibular joint and associated muscles represents a family of problems related to your complex jaw joint. Most pain is muscle related, and it is very real- and can be quite severe. But it is usually not managed by surgery. Internal changes in the joint, described as internal derangements, will many times get better if just left alone for some time. If you have had symptoms like pain 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. Most surgeons also strongly agree that conservative management, conservative NON surgical intervention is best. So, if any dental practitioner advises irreversible procedures to manage muscle pain, such as significant alteration of the bite with the grinding of many teeth– or lots and lots of crowns, it might be advisable to at least seek a second opinion

TMJ disorders develop for many reasons. You might clench or grind your teeth, tightening your jaw muscles and stressing your TM joint. You may have a damaged jaw joint due to injury or disease. There are many things about the discomfort associated with the masticatory system that we do not fully understand. For instance, the vast majority of patients with painful muscles or a painful joint are—- women! There is much to learn. However, for your information, the following questions might help you decide whether to seek consultation with your dentist.

  • 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 that seem to be associated with your teeth?
  • Does the pain get worse when you clench your teeth?
  • Does stress make your 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 jaws?
  • Have you had problems (such as arthritis) with other joints?
  • Do your teeth meet differently from time to time?

ThThe VAST majority of those with TMJ symtoms are not surgical candidates! Most patients will respond to very conservative care. Understanding your disorder becomes the first priority.