TMJ

TMJ – Temporomandibular Joint Information

Temporomandibular joint and muscle disorders, commonly called TMJ, are a group of conditions that cause pain and dysfunction in the jaw joint and the muscles that control jaw movement. We don’t know for certain how many people have TMJ disorders, but some estimates suggest that over 10 million North Americans are affected. The condition appears to be more common in women than men. TMJ is referred to by different names such as TMD, TMJ disorder, and TMJ dysfunction.


For most people, pain in the area of the jaw joint or muscles does not signal a serious problem. Generally, discomfort from these conditions is occasional and temporary, often occurring in cycles. The pain eventually goes away with little or no treatment. Some people, however, develop significant, long-term symptoms.

What is the temporomandibular joint?

The temporomandibular joint connects the lower jaw, called the mandible, to the bone at the side of the head, which is the temporal bone. If you place your fingers just in front of your ears and open your mouth, you can feel the joints. Because these joints are flexible, the jaw can move smoothly up and down and side to side, enabling us to talk, chew, and yawn. Muscles and ligaments attached to and surrounding the jaw joint control its position and movement.

When we open our mouths, the rounded ends of the lower jaw, called condyles, glide along the joint socket of the temporal bone. The condyles slide back to their original position when we close our mouths. To keep this motion smooth, a soft disc lies between the condyle and the temporal bone. This disc absorbs shocks to the jaw joint from chewing and other movements.

The temporomandibular joint is different from the body’s other joints since the joint actually dislocates after opening past a certain point. The combination of hinge and sliding motions makes this joint among the most complicated in the body. Also, the tissues that make up the temporomandibular joint differ from other load-bearing joints, like the knee or hip. Because of its complex movement and unique makeup, the jaw joint and its controlling muscles can pose a tremendous challenge to both patients and health care providers when problems arise.

What are TMJ disorders?

What are TMJ disorders?

Disorders of the jaw joint and chewing muscles – and how people respond to them – vary widely. Researchers generally agree that the conditions fall into three main categories:

  1. Myofascial pain, the most common temporomandibular disorder, involves discomfort or pain in the muscles that control jaw function.

  2. Internal derangement of the joint involves a displaced disc, dislocated jaw, or injury to the condyle.

  3. Arthritis refers to a group of degenerative/inflammatory joint disorders that can affect the temporomandibular joint.

A person may have one or more of these conditions at the same time. Some people have other health problems that co-exist with TMJ disorders, such as chronic fatigue syndrome, sleep disturbances or fibromyalgia, a painful condition that affects muscles and other soft tissues throughout the body. It is not known whether these disorders share a common cause.

People who have a rheumatic disease, such as rheumatoid arthritis, may develop TMJ disease as a secondary condition. Rheumatic diseases refer to a large group of disorders that cause pain, inflammation, and stiffness in the joints, muscles, and bone. Both rheumatoid arthritis and some TMJ disorders involve inflammation of the tissues that line the joints. The exact relationship between these conditions is not known.

How jaw joint and muscle disorders progress is not clear. Symptoms worsen and ease over time, but what causes these changes is not known. Most people have relatively mild forms of the disorder. Their symptoms improve significantly, or disappear spontaneously, within weeks or months. For others, the condition causes long-term, persistent and debilitating pain.

What causes TMJ disorders?

What causes TMJ disorders?

Trauma to the jaw or temporomandibular joint plays a role in some TMJ disorders. But for most jaw joint and muscle problems, scientists don’t know the causes. For many people, symptoms seem to start without obvious reason. Research disputes the popular belief that a bad bite or orthodontic braces can trigger TMJ disorders. Because the condition is more common in women than in men, scientists are exploring a possible link between female hormones and TMJ disorders.

There is no scientific proof that clicking sounds in the jaw joint lead to serious problems. In fact, jaw clicking is common in the general population. Jaw noises alone, without pain or limited jaw movement, do not indicate a TMJ disorder and do not warrant treatment.

The roles of stress and tooth grinding as major causes of TMJ disorders are also unclear. Many people with these disorders do not grind their teeth, and many long-time tooth grinders do not have painful joint symptoms. Scientists note that people with sore, tender chewing muscles are less likely than others to grind their teeth because it causes pain. Researchers also found that stress seen in many persons with jaw joint and muscle disorders is more likely the result of dealing with chronic jaw pain or dysfunction than the cause of the condition.

What are the signs and symptoms?

What are the signs and symptoms?

A variety of symptoms may be linked to TMJ disorders. Pain, particularly in the chewing muscles and/or jaw joint, is the most common symptom. Other likely symptoms include:

  • Radiating pain in the face, jaw, or neck

  • Jaw muscle stiffness

  • Limited movement or locking of the jaw

  • Painful clicking, popping or grating in the jaw joint when opening or closing the mouth

  • A change in the way the upper and lower teeth fit together

How are TMJ disorders diagnosed?

How are TMJ disorders diagnosed?

There is no widely accepted, standard test available to correctly diagnose TMJ disorders. Because the exact causes and symptoms are not clear, identifying these disorders can be difficult and confusing. Currently, we note the patient’s description of symptoms, take a detailed medical and dental history, and examine problem areas, including the head, neck, face, and jaw. Imaging studies may also be recommended.

You may want to consult your doctor to rule out other causes of pain. Facial pain can be a symptom of many other conditions, such as sinus or ear infections, various types of headaches, and facial neuralgias (nerve-related facial pain). Ruling out these problems first helps in identifying TMJ disorders.

How are TMJ disorders treated?

How are TMJ disorders treated?

Because more studies are needed on the safety and effectiveness of most treatments for jaw joint and muscle disorders, experts strongly recommend using the most conservative, reversible treatments possible. Conservative treatments do not invade the tissues of the face, jaw, or joint, or involve surgery. Reversible treatments do not cause permanent changes in the structure or position of the jaw or teeth. Even when TMJ disorders have become persistent, most patients still do not need aggressive types of treatment.

Conservative Treatments

Conservative Treatments

Because the most common jaw joint and muscle problems are temporary and do not get worse, simple treatment is all that is usually needed to relieve discomfort.

Self-Care Practices

There are steps you can take that may be helpful in easing symptoms, such as:

  • Eating soft foods

  • Applying ice packs

  • Avoiding extreme jaw movements (such as wide yawning, loud singing, and gum chewing)

  • Learning techniques for relaxing and reducing stress

  • Practicing gentle jaw stretching and relaxing exercises that may help increase jaw movement

  • Exercises if appropriate for your particular condition

Pain Medications

For many people with TMJ disorders, short-term use of over-the-counter pain medicines or nonsteroidal anti-inflammatory drugs (NSAIDS), such as ibuprofen, may provide temporary relief from jaw discomfort. When necessary, we can prescribe stronger pain or anti-inflammatory medications, muscle relaxants, or anti-depressants to help ease symptoms.

Stabilization Splints

We may recommend an oral appliance called a bruxism splint, stabilization splint, night guard, or bite guard, which is a plastic guard that fits over the upper or lower teeth. Stabilization splints are the most widely used treatments for TMJ disorders. Studies of their effectiveness in providing pain relief, however, have been inconclusive. If a stabilization splint is recommended, it should be used only for a short time and should not cause permanent changes in the bite. If a splint causes or increases pain, stop using it and let us know.

The conservative, reversible treatments described are useful for temporary relief of pain – they are not cures for TMJ disorders. If symptoms continue over time, come back often, or worsen, please let us know.

Surgery

Surgery

Other types of treatments, such as surgical procedures, invade the tissues. Surgical treatments are controversial, often irreversible, and should be approached with caution where possible. There have been no long-term clinical trials to study the safety and effectiveness of surgical treatments for TMJ disorders. Nor are there standards to identify people who would most likely benefit from surgery. Failure to respond to conservative treatments, for example, does not automatically mean that surgery is necessary.

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About Dr. Alex

Dr. Alexander Rubinshtein has been practicing dentistry for over 25 years and has a thriving patient following. He received his DDS from NYU school of Dentistry and was a member of the honorary society. Dr Rubinshtein is board member of ALD | Academy of Laser Dentistry & ADA. Dr. Alex deploys the latest advances in dentistry and business practice enabling him to treat his patients and provide them with exceptional services. His main focus is on oral surgery, implant restoration and laser assisted dentistry. Dr. Rubinshtein is one of the 1.8% of dentist in America offering the latest Laser Dentistry. Laser technology provides unmatched benefits for our patients who seek no drilling, no incisions & no numbness in most dental procedures. Dr.Rubinshtein works with every type of a patient, if you are nervous about visiting the dentist for any reason, he is able to make your experience as painless & pleasant as possible. Please view our testimonials.

Alexander Rubinshtein

Laser Dentist

About Dr. Alex

Dr. Alexander Rubinshtein has been practicing dentistry for over 25 years and has a thriving patient following. He received his DDS from NYU school of Dentistry and was a member of the honorary society. Dr Rubinshtein is board member of ALD | Academy of Laser Dentistry & ADA. Dr. Alex deploys the latest advances in dentistry and business practice enabling him to treat his patients and provide them with exceptional services. His main focus is on oral surgery, implant restoration and laser assisted dentistry. Dr. Rubinshtein is one of the 1.8% of dentist in America offering the latest Laser Dentistry. Laser technology provides unmatched benefits for our patients who seek no drilling, no incisions & no numbness in most dental procedures. Dr.Rubinshtein works with every type of a patient, if you are nervous about visiting the dentist for any reason, he is able to make your experience as painless & pleasant as possible. Please view our testimonials.

Alexander Rubinshtein

Laser Dentist

About Dr. Alex

Dr. Alexander Rubinshtein has been practicing dentistry for over 25 years and has a thriving patient following. He received his DDS from NYU school of Dentistry and was a member of the honorary society. Dr Rubinshtein is board member of ALD | Academy of Laser Dentistry & ADA. Dr. Alex deploys the latest advances in dentistry and business practice enabling him to treat his patients and provide them with exceptional services. His main focus is on oral surgery, implant restoration and laser assisted dentistry. Dr. Rubinshtein is one of the 1.8% of dentist in America offering the latest Laser Dentistry. Laser technology provides unmatched benefits for our patients who seek no drilling, no incisions & no numbness in most dental procedures. Dr.Rubinshtein works with every type of a patient, if you are nervous about visiting the dentist for any reason, he is able to make your experience as painless & pleasant as possible. Please view our testimonials.

Alexander Rubinshtein

Laser Dentist

About Dr. Alex

Dr. Alexander Rubinshtein has been practicing dentistry for over 25 years and has a thriving patient following. He received his DDS from NYU school of Dentistry and was a member of the honorary society. Dr Rubinshtein is board member of ALD | Academy of Laser Dentistry & ADA. Dr. Alex deploys the latest advances in dentistry and business practice enabling him to treat his patients and provide them with exceptional services. His main focus is on oral surgery, implant restoration and laser assisted dentistry. Dr. Rubinshtein is one of the 1.8% of dentist in America offering the latest Laser Dentistry. Laser technology provides unmatched benefits for our patients who seek no drilling, no incisions & no numbness in most dental procedures. Dr.Rubinshtein works with every type of a patient, if you are nervous about visiting the dentist for any reason, he is able to make your experience as painless & pleasant as possible. Please view our testimonials.

Alexander Rubinshtein

Laser Dentist

About Dr. Marina

Dr. Marina Rubinshtein “The Doctor with magical hands” – This is how patients refer to Dr. Rubinshtein. She is an experienced and talented dentist, having spent over 24 years in a private practice; specializing in general, cosmetic and restorative dentistry. She received her DDS from NYU school of Dentistry and was a member of the honorary society. Dr. Marina is also a member of the Academy of General Dentistry and the Academy of Cosmetic dentistry. She is a member of American Academy of Cosmetic Dentistry & AGD. Dr. Marina Rubinshtein is one of NY’s most recognized and acclaimed cosmetic dentist for the upper echelon, working with celebrities from entertainment, media & acting. Her skills and artistic vision in cosmetic dentistry is incomparable. Dr. Rubinshtein provides her patients with natural, beautiful & stunning results unrivaled by anyone else. Dr Marina always created new ways to benefit her patients by being on a cutting edge of cosmetic dentistry for many years creating the most artistic & beautiful smiles. Dr. Marina Rubinshtein lives by her motto, “A beautiful Smile is your path to a Bright Future!”

Marina Rubinshtein

Cosmetic Dentist

About Dr. Marina

Dr. Marina Rubinshtein “The Doctor with magical hands” – This is how patients refer to Dr. Rubinshtein. She is an experienced and talented dentist, having spent over 24 years in a private practice; specializing in general, cosmetic and restorative dentistry. She received her DDS from NYU school of Dentistry and was a member of the honorary society. Dr. Marina is also a member of the Academy of General Dentistry and the Academy of Cosmetic dentistry. She is a member of American Academy of Cosmetic Dentistry & AGD. Dr. Marina Rubinshtein is one of NY’s most recognized and acclaimed cosmetic dentist for the upper echelon, working with celebrities from entertainment, media & acting. Her skills and artistic vision in cosmetic dentistry is incomparable. Dr. Rubinshtein provides her patients with natural, beautiful & stunning results unrivaled by anyone else. Dr Marina always created new ways to benefit her patients by being on a cutting edge of cosmetic dentistry for many years creating the most artistic & beautiful smiles. Dr. Marina Rubinshtein lives by her motto, “A beautiful Smile is your path to a Bright Future!”

Marina Rubinshtein

Cosmetic Dentist

About Dr. Marina

Dr. Marina Rubinshtein “The Doctor with magical hands” – This is how patients refer to Dr. Rubinshtein. She is an experienced and talented dentist, having spent over 24 years in a private practice; specializing in general, cosmetic and restorative dentistry. She received her DDS from NYU school of Dentistry and was a member of the honorary society. Dr. Marina is also a member of the Academy of General Dentistry and the Academy of Cosmetic dentistry. She is a member of American Academy of Cosmetic Dentistry & AGD. Dr. Marina Rubinshtein is one of NY’s most recognized and acclaimed cosmetic dentist for the upper echelon, working with celebrities from entertainment, media & acting. Her skills and artistic vision in cosmetic dentistry is incomparable. Dr. Rubinshtein provides her patients with natural, beautiful & stunning results unrivaled by anyone else. Dr Marina always created new ways to benefit her patients by being on a cutting edge of cosmetic dentistry for many years creating the most artistic & beautiful smiles. Dr. Marina Rubinshtein lives by her motto, “A beautiful Smile is your path to a Bright Future!”

Marina Rubinshtein

Cosmetic Dentist

About Dr. Marina

Dr. Marina Rubinshtein “The Doctor with magical hands” – This is how patients refer to Dr. Rubinshtein. She is an experienced and talented dentist, having spent over 24 years in a private practice; specializing in general, cosmetic and restorative dentistry. She received her DDS from NYU school of Dentistry and was a member of the honorary society. Dr. Marina is also a member of the Academy of General Dentistry and the Academy of Cosmetic dentistry. She is a member of American Academy of Cosmetic Dentistry & AGD. Dr. Marina Rubinshtein is one of NY’s most recognized and acclaimed cosmetic dentist for the upper echelon, working with celebrities from entertainment, media & acting. Her skills and artistic vision in cosmetic dentistry is incomparable. Dr. Rubinshtein provides her patients with natural, beautiful & stunning results unrivaled by anyone else. Dr Marina always created new ways to benefit her patients by being on a cutting edge of cosmetic dentistry for many years creating the most artistic & beautiful smiles. Dr. Marina Rubinshtein lives by her motto, “A beautiful Smile is your path to a Bright Future!”

Marina Rubinshtein

Cosmetic Dentist

About Dr. Daniel

Dr. Daniel Rubinshtein has graduated from the prestigious Yale University, where he did his general practice residency. Dr. Rubinshtein also is a graduate of New York University College of Dentistry where he received his doctor of dental surgery degree. At NYUCD Dr. Rubinshtein was a member of the Aesthetic Honors program where he displayed his artistic and keen eye for beauty. He won the Empire State Academy of Aesthetic Dentistry first place for his smile makeover and placed among the top at the national American Academy of Cosmetic Dentistry Conference. Dr. Rubinshtein’s desire to help others who are less fortunate has been apparent in his involvement with many charities from oral cancer to feeding the homeless. He also went on several dental outreaches that served under privileged communities throughout the country. Dr. Daniel Rubinshtein is excited to be back in Bensonhurst where he grew up, and help people in his community.

Daniel Rubinshtein

Cosmetic Dentist

About Dr. Daniel

Dr. Daniel Rubinshtein has graduated from the prestigious Yale University, where he did his general practice residency. Dr. Rubinshtein also is a graduate of New York University College of Dentistry where he received his doctor of dental surgery degree. At NYUCD Dr. Rubinshtein was a member of the Aesthetic Honors program where he displayed his artistic and keen eye for beauty. He won the Empire State Academy of Aesthetic Dentistry first place for his smile makeover and placed among the top at the national American Academy of Cosmetic Dentistry Conference. Dr. Rubinshtein’s desire to help others who are less fortunate has been apparent in his involvement with many charities from oral cancer to feeding the homeless. He also went on several dental outreaches that served under privileged communities throughout the country. Dr. Daniel Rubinshtein is excited to be back in Bensonhurst where he grew up, and help people in his community.

Daniel Rubinshtein

Cosmetic Dentist

About Dr. Daniel

Dr. Daniel Rubinshtein has graduated from the prestigious Yale University, where he did his general practice residency. Dr. Rubinshtein also is a graduate of New York University College of Dentistry where he received his doctor of dental surgery degree. At NYUCD Dr. Rubinshtein was a member of the Aesthetic Honors program where he displayed his artistic and keen eye for beauty. He won the Empire State Academy of Aesthetic Dentistry first place for his smile makeover and placed among the top at the national American Academy of Cosmetic Dentistry Conference. Dr. Rubinshtein’s desire to help others who are less fortunate has been apparent in his involvement with many charities from oral cancer to feeding the homeless. He also went on several dental outreaches that served under privileged communities throughout the country. Dr. Daniel Rubinshtein is excited to be back in Bensonhurst where he grew up, and help people in his community.

Daniel Rubinshtein

Cosmetic Dentist

About Dr. Daniel

Dr. Daniel Rubinshtein has graduated from the prestigious Yale University, where he did his general practice residency. Dr. Rubinshtein also is a graduate of New York University College of Dentistry where he received his doctor of dental surgery degree. At NYUCD Dr. Rubinshtein was a member of the Aesthetic Honors program where he displayed his artistic and keen eye for beauty. He won the Empire State Academy of Aesthetic Dentistry first place for his smile makeover and placed among the top at the national American Academy of Cosmetic Dentistry Conference. Dr. Rubinshtein’s desire to help others who are less fortunate has been apparent in his involvement with many charities from oral cancer to feeding the homeless. He also went on several dental outreaches that served under privileged communities throughout the country. Dr. Daniel Rubinshtein is excited to be back in Bensonhurst where he grew up, and help people in his community.

Daniel Rubinshtein

Cosmetic Dentist

About Dr. Geoff

Born and raised in New York, Dr. Rubinshtein completed his Doctorate of Dental Surgery at the prestigious New York University College of Dentistry and advanced his education at their Post Graduate Program in Periodontics. As a board certified periodontist for the community and those traveling from around the world, he offers a unique and compassionate approach to each individual patient. Dr. Rubinshtein’s goal is to improve patients’ oral health and deliver a life changing smile that enhances your teeth as well as your self-confidence.

Geoffrey Rubinshtein

Periodontist

About Dr. Geoff

Born and raised in New York, Dr. Rubinshtein completed his Doctorate of Dental Surgery at the prestigious New York University College of Dentistry and advanced his education at their Post Graduate Program in Periodontics. As a board certified periodontist for the community and those traveling from around the world, he offers a unique and compassionate approach to each individual patient. Dr. Rubinshtein’s goal is to improve patients’ oral health and deliver a life changing smile that enhances your teeth as well as your self-confidence.

Geoffrey Rubinshtein

Periodontist

About Dr. Geoff

Born and raised in New York, Dr. Rubinshtein completed his Doctorate of Dental Surgery at the prestigious New York University College of Dentistry and advanced his education at their Post Graduate Program in Periodontics. As a board certified periodontist for the community and those traveling from around the world, he offers a unique and compassionate approach to each individual patient. Dr. Rubinshtein’s goal is to improve patients’ oral health and deliver a life changing smile that enhances your teeth as well as your self-confidence.

Geoffrey Rubinshtein

Periodontist

About Dr. Geoff

Born and raised in New York, Dr. Rubinshtein completed his Doctorate of Dental Surgery at the prestigious New York University College of Dentistry and advanced his education at their Post Graduate Program in Periodontics. As a board certified periodontist for the community and those traveling from around the world, he offers a unique and compassionate approach to each individual patient. Dr. Rubinshtein’s goal is to improve patients’ oral health and deliver a life changing smile that enhances your teeth as well as your self-confidence.

Geoffrey Rubinshtein

Periodontist

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