TMJ

TMJ (temporomandibular joint) disorders are a family of problems related to your jaw joint. 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. These symptoms occur when the joints of the jaw and the chewing muscles do not work together correctly. TMJ stands for temporomandibular joint, which is the name for each joint (right and left) that connects your jaw to your skull. Since some types of TMJ problems can lead to more serious conditions, early detection and treatment are important.

No one treatment can resolve TMJ disorders completely and treatment takes time to become effective. Dr. Nelson and Dr. Wells can help you have a healthier, more comfortable jaw.

Trouble with your jaw?

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. Injuries and arthritis can damage the joint directly or stretch or tear the muscle ligaments. As a result, the disk, which is made of cartilage and functions as the “cushion” of the jaw joint, can slip out of position. Whatever the cause, the results may include a misaligned bite, pain, clicking, or grating noise when you open your mouth, or trouble opening your mouth wide.

Do You Have a TMJ Disorder?

  • 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?
  • 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 you have teeth that no longer touch when you bite?
  • Do your teeth meet differently from time to time?
  • Is it hard to use your front teeth to bite or tear food?
  • Are your teeth sensitive, loose, broken or worn?

The more times you answered “yes”, the more likely it is that you have a TMJ disorder. Understanding TMJ disorders will also help you understand how they are treated.

TMJ Treatment

There are various treatment options for TMJ that Drs. Nelson and Wells can utilize to improve the harmony and function of your jaw. Once an evaluation confirms a diagnosis of TMJ disorder, Drs. Nelson or Wells will determine the proper course of treatment. It is important to note that treatment always works best with a team approach of self-care combined with professional care.

The initial goals are to relieve the muscle spasms and joint pain. This is usually accomplished with a pain reliever, anti-inflammatory, or muscle relaxant. Steroids can be injected directly into the joints to reduce pain and inflammation. Self-care treatments can often be effective as well and include:

  • Resting your jaw
  • Keeping your teeth apart when you are not swallowing or eating
  • Eating soft foods
  • Applying ice and heat
  • Exercising your jaw
  • Practicing good posture

Stress management techniques such as biofeedback or physical therapy may also be recommended, as well as a temporary, clear plastic appliance known as a splint. A splint (or nightguard) fits over your top or bottom teeth and helps keep your teeth apart, thereby relaxing the muscles and reducing pain. There are different types of appliances used for different purposes. A nightguard helps you stop clenching or grinding your teeth and reduces muscle tension at night. It also helps to protect the cartilage and joint surfaces. An anterior positioning appliance moves your jaw forward, relieves pressure on parts of your jaw, and aids in disk repositioning. It may be worn 24 hours/day to help your jaw heal. An orthotic stabilization appliance is worn 24 hours/day, or just at night, to move your jaw into proper position. Appliances also help protect tooth wear.

What about bite correction or surgery?

If your TMJ disorder has caused problems with how your teeth fit together you may need treatment such as bite adjustment (equilibration), orthodontics with or without jaw reconstruction, or restorative dental work. Surgical options, such as arthroscopy and open joint repair restructuring, are sometimes needed, but are reserved for severe cases. Drs. Nelson and Wells do not consider TMJ surgery unless the jaw can’t open, is dislocated and non-reducible, has severe degeneration, or the patient has undergone appliance treatment unsuccessfully.

Nelson & Wells Oral and Maxillofacial Surgery

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I had a wisdom tooth pulled. The staff was very friendly which helped me relax. Dr Wells was amazing. He is very kind yet extends a feeling of confidence in his knowledge.

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I would - and have - recommend Dr. Nelson to anyone looking for an outstanding and dependable dental surgeon/practice.

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I would recommend this medical practice to anyone. They always treated me with dignity and respect, were so accommodating, made sure I was always informed of what each procedure involved, sent reminders for the appointments, and gave a phone number in case there were difficulties following any procedure. Having dental work done is not the most fun. But this oral surgery practice made very visit something I really looked forward to. Everyone was really wonderful and I am sorry I wont't need to return or see them again. But, I have very positive memories of the entire experience.

- Linda A

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Dr. Nelson is the best oral surgeon I've ever seen. I've been a bit of a challenge and he's always communicated everything to me. Then proceeded to take care of the situation. Dr. Nelson is pretty awesome.

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Would highly recommend. Professional staff. Can't say enough good things. This is my second visit and Dr Nelson was awesome once again. Extraction procedure was done as gently as possible. Experienced minimal discomfort. Thank you so much.

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I needed to have a molar extracted, before the extraction I was told the procedure would take half an hour and it did. I took tylenol for a day or so and today it's been a week since surgery and my sutures have dissolved and no pain at all! The staff was friendly and considerate, Dr Wells thoroughly explained everything. Dr. Wells and his staff made the experience as pleasant as it could be.

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My daughter had her wisdom teeth removed & did very well. She had minimal discomfort & healed quickly. The doctor & staff are highly recommended.

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Dr Wells and his staff were great. They were highly professional, personable, and very caring. I literally had no pain after the surgery. Thanks for everything!

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My son was having his wisdom teeth removed, the staff was very friendly and the oral surgery lasted less than an hour. After the oral surgery the information given to me for post operation was very helpful. Thank you to the staff and the doctor for taking good care of my son.

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I would highly recommend Dr. Nelson to anyone needing oral surgery. His surgical skill and caring manner were exceptional. He explained care options not mentioned by another oral surgeon I consulted. Pricing was more than fair. My recovery was quick and painless.

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I am very happy that I was referred to this office. I am healing from a wisdom tooth extraction, but I cannot wait to see them next week for a follow up!

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Dr Nelson has both excellent skills and a good sense of humor. The office is well arranged and has the best Giant Lifesavers ever! With excellent skills and reasonable prices this is definitely a quality combination for patients needing these services. I can highly reccomend their services!

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The entirty of my wisdom teeth extraction was plesant, due to the professionalism and skill from both the doctor(s) and staff. Dr. Nelson performed so well I didn't have any swelling, bruising, nor pain! I was terribly nervous going into this surgery, but all of my anxieties were washed away soon thereafter. I will recommend Nelson, Rollert & Wells Associates to friends and family in the Denver area.

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