Frequently Asked Questions

As an oral and maxillofacial surgeon, Dr. Simonton specializes in effective surgical treatment for TMJ disorders, wisdom teeth extraction, orthognathic (corrective jaw) surgery, and dental implant placement.

What is TMJ?

Do you wonder, “what is TMJ?” Do you feel you might have problems with TMJ? Dr. Fred Simonton is experienced in exactly what TMJ is and how it can be treated.

TMJ refers to a variety of medical and dental conditions that affect the temporomandibular joint, or jaw joint. The temporomandibular joint includes the muscles that move the jaw as well as the tissues where the lower jaw connects to the skull. A small disc of cartilage separates the jaw bones, allowing the mandible to slide easily every time you move it.

You can locate the TMJ joint by putting your finger on the triangular structure in front of your ear and then moving your finger slightly forward. The temporomandibular joint is one of the most active and complex joints in the human body. This joint is used every time you chew, talk, and swallow, making it one of the most frequently used of all joints in the body.

TMJ problems are often painful and can seriously impair the functions and sensations of the face, jaw, mouth, ears, neck, and shoulders.

For more information regarding TMJ, contact Dr. Fred Simonton today.

Who gets TMJ?

Dr. Fred Simonton can accurately detect if your ear or jaw pain is in fact TMJ. The National Institute of Dental and Craniofacial Research (NIDCR) has reported that there are over 10 million people in the U.S. who have ear and jaw pain related to TMJ issues at any given time. TMJ syndrome is a condition that can afflict anyone, and while TMJ does not seem to be more prevalent in one particular gender or ethnic group, research has shown that it is diagnosed more frequently in certain demographic groups.

There is a large majority of females between puberty and menopause who are diagnosed with TMJ. The greater prevalence of TMJ problems in women during child-bearing years suggests a need for research that examines the influence of gender-specific hormones on TMJ. However, the high rate of occurrence can also be attributed to this group’s greater tendency to report the problem.

TMJ research has not uncovered trends in the incidence of TMJ in any other ethnic or racial group. Most researchers believe there are other physiological causes of TMJ conditions that have yet to be explored.

So if you are experiencing ear or jaw pain that you feel may be TMJ related, contact Dr. Fred Simonton today.

What causes TMJ?

While many theories regarding the causes of TMJ syndrome have been proposed, scientific research has yet to validate the various theories. Doctors do know that TMJ can be precipitated or aggravated by healthcare procedures, trauma, oral habits and postures, and other diseases. There are also instances of TMJ symptoms occurring without an identifiable cause.

Healthcare Procedures
There are certain dental procedures that appear to be linked to the development of TMJ syndrome in some patients. Prolonged jaw opening during some dental treatments can cause problems. Also, we often hear about patients developing TMJ symptoms after dental procedures like the removal of wisdom teeth, root canal therapy, and bridgework. Many of these patients experienced muscle spasms, jaw popping and clicking, and jaw joint pain during the procedure. TMJ symptoms can also be attributed to poorly fitting caps, bridges, fillings, and dentures, which can affect the alignment of the bite and the jaw joint as a whole. If teeth do not fit together properly, or the jaws don’t line up correctly, this can cause TMJ pain. TMJ pain can also be caused by missing back teeth and persistent wear of the TMJ cartilage as a result of the disc being in the wrong position.

There are also medical procedures that have been shown to aggravate TMJ syndrome. If a patient must be intubated during surgery, the procedure can aggravate existing conditions of the jaw joint. When a patient is intubated, the jaw is open widely for a short period of time and closed during the duration of the surgery. If you suffer from TMJ pain, inform your doctor before undergoing any operation requiring intubation.

Trauma
TMJ syndrome can be experienced after various traumas, including auto accidents, sports injuries, and blows to the head or neck. These types of events trigger TMJ pain and dysfunction in the jaw joints by shearing and tearing of facial soft and hard tissues, such as teeth, muscles, nerves, ligaments, and bones. Jaw mobility can also be limited by scar tissue following an injury.

Posture and Oral Habits
Any activity that causes the head to be held in an unnatural position may intensify TMJ pain. Some examples of these unnatural positions include carrying a heavy bag, slouching over a desk, or cradling a phone between your ear and shoulder. If TMJ pain can be associated with this type of habitual movement, an ergonomic solution such as a hands-free headset or ergonomic seating can help.

There are also certain oral habits that can lead to TMJ syndrome. Nail biting, pencil chewing, and wide yawning can increase your TMJ pain and symptoms. Also, certain hard or crunchy foods can trigger TMJ pain.

Other Diseases
Various diseases have also been shown to cause or aggravate TMJ pain. Immune disorders, like rheumatoid arthritis or osteoarthritis, can cause TMJ pain. Also, viral infections, such as mumps and measles, can cause damage to joint surfaces, which can lead to internal derangement of the joint.

Stress is another cause of TMJ pain. Stress can cause the muscles around the shoulder, neck, and jaw to tighten which puts abnormal pressure on the TMJ. This is usually a temporary condition, but prolonged stress can also produce permanent muscle and ligament damage, leading to TMJ syndrome.

What are some of the most common TMJ symptoms?

TMJ symptoms can vary for each patient. Many people who suffer from TMJ don’t know the true cause of their pain. Countless patients will see ear specialists, convinced that their pain is caused by an ear infection.

Some common TMJ symptoms are

• Ear pain
• Sore jaw muscles
• Temple/cheek pain
• Jaw popping/clicking
• Jaw locking
• Difficulty in opening the mouth fully
• Frequent head/neck aches

Symptoms of TMJ may be a sharp, searing pain that sufferers feel when they talk, yawn, swallow, and chew, or it can be a dull and constant pain. The pain can usually be felt in the joint, in front of the ear, but TMJ pain can also radiate elsewhere, especially if the TMJ causes muscle spasms. In this instance, the TMJ pain will be felt at the temple, cheek, teeth, and lower jaw.

Other symptoms include a popping or clicking sound when the jaws are opened widely, or TMJ can prevent the jaws from fully opening.

One commonly known TMJ symptom is jaw locking. A locking episode occurs when there is an interruption in the jaw movement while opening or closing the jaw. The TMJ patient must physically jiggle or manipulate the jaw to retain proper movement. This catch happens within the joint gets stuck in the wrong place and prevents the jaw from moving.

If you have questions about possible TMJ symptoms you are experiencing, contact Dr. Simonton. We are experienced in diagnosing and treating TMJ.

I hear a lot of clicking, crunching, and grinding noises when I move my jaw. What’s going on?

The clicking jaw noise many patients describe is one of the more common symptoms of TMJ. However, the presence of these TMJ symptoms without other symptoms means it may not be as serious.

A clicking jaw during movements is a sign that the functional elements of the jaw are not working smoothly. A crunching or grinding noise is usually associated with hard tissue contact during movement. The clicking is the result of the joint components not moving together properly.

In the absence of other symptoms, a clicking jaw noise is not always serious. However, the noises should not be ignored, as they are a sign that the joint is not functioning smoothly. Each occurrence of the noise indicates trauma to the joint tissues, meaning that over time there is a possibility of the TMJ disorder fully developing. The best approach is to keep this condition under observation.

If you have questions about whether your clicking jaw is related to TMJ, contact Dr. Simonton today.

What treatments are available for TMJ?

Before discussing treatment for TMJ, Dr. Simonton will first collect a detailed patient history and a physical examination. The teeth, jaw joints, and muscles will also be carefully assessed. If TMJ is diagnosed early, treatment for TMJ may be simple self-remedies. In these instances, the doctor’s recommended TMJ treatment might include

• Resting the muscles and joints by eating soft foods
• Not chewing gum
• Avoiding clenching or tensing
• Relaxing muscles with moist heat or medicines

If a joint injury occurs, ice packs should be applied soon after the injury to help reduce swelling. Other doctor recommended treatment for TMJ options include relaxation techniques and stress reduction, patient education, non-steroidal anti-inflammatory drugs, muscle relaxants, or other medications.

If these home remedies fail to provide relief from TMJ pain, TMJ surgery is the next option. By the time TMJ surgery is discussed, most patients have exhausted other therapy options.

TMJ Surgery Patient Evaluation
When evaluating if surgery is the proper treatment for TMJ, we will first obtain an MRI (Magnetic Resonance Imaging), which produces detailed and accurate images of the temporomandibular joint and surrounding soft tissue. If the patient appears to be a candidate for TMJ surgery after the MRI is reviewed, a psychological evaluation is required.

Once TMJ surgery is agreed upon, Dr. Simonton will explain the process to the patient. Dr. Simonton prefers to make his incisions for TMJ surgery behind the ear and in the ear canal because it gets the surgeon closer to the TMJ area needing repair. This not only allows for better positioning, but it also reduces the possibility of complications by moving the incisions away from the facial nerve. Also, with the incision from the TMJ surgery hidden behind the ear, patients won’t have to be concerned that their physical appearance will be altered by surgical scars.

During TMJ surgery, the surgeon shortens stretched ligaments or repairs torn ligaments and pulls the displaced cartilage disc into its correct position. If the patient’s wisdom teeth have not been extracted, they will be removed before the TMJ surgery to ensure they will not interfere with the surgical repair at a later date.

If you have questions about the types of treatment for TMJ will work best for you, contact Dr. Simonton. We are experienced in diagnosing and treating TMJ.

What can I do right now to ease my TMJ pain?

Finding temporary TMJ relief depends on the severity of your symptoms. However, the following self-care techniques may provide temporary pain relief:

• Moist heat from a heat pack or a hot water bottle wrapped in a warm, moist towel can improve function and reduce your TMJ pain.
• Ice packs can decrease inflammation, numb pain, and promote TMJ healing. Wrap the ice pack in a clean cloth and apply it for 10–15 minutes.
• Eat soft foods to allow the jaw to rest temporarily.
• Avoid hard, crunchy, and chewy foods.

Over-the-counter analgesics are helpful in temporarily obtaining TMJ relief. Be sure to check with your doctor before taking any medication over any prolonged period of time.

Slow, gentle jaw exercises may help increase jaw mobility and provide TMJ relief. Your doctor can evaluate your symptoms and suggest appropriate exercises based on your individual needs.

Why are ear symptoms associated with TMJ?

Ear pain and TMJ are related since the temporomandibular joint is in very close proximity to the ear tissues. Therefore, TMJ symptoms often involve the ears. Many TMJ sufferers will first see ear specialists because they believe their pain is caused by an ear infection.

How long do TMJ problems last?

While TMJ disorder has many commonalities for sufferers, the type and severity of symptoms can vary greatly from person to person. TMJ disorder can get better or worse or change completely from day to day.

Some research indicates that TMJ patients will get better with or without treatment. However, other sufferers can experience a lifetime of TMJ-related symptoms and disability. In these instances, Dr. Fred Simonton recommends surgery to fully correct TMJ disorder.

A bite block can help TMJ patients receive dental work they couldn’t otherwise. Often, TMJ sufferers have difficulty receiving general dental care because of their condition.

A bite block during dental procedures allows the mouth to be open a small amount. This allows stability for the mandible as the patient closes into the bite block. Dentists are especially sensitive to the TMJ patient’s jaw tiring and will ask the patient for a sign when they need to close the jaw. Regardless of what dentist you use to perform your dental care, make sure they are aware of your TMJ and ask for frequent rest periods.

If you have any further questions regarding TMJ or a bite block, please contact Dr. Fred Simonton’s office.

To request a consultation and learn more about how we can help improve your smile, please request an appointment now.