You can only open your mouth to a certain “comfort zone” before the muscles respond and overwork. If you are open too far, the reflex is for your teeth to work (i.e., grind away the tooth structure) to return your jaw to its correct position. If you are over-closed, the muscles also clench and grind, to try to find their right vertical position(which they cannot ever find, as there is inadequate tooth left).
If you are already in your comfort zone, or if your bite is over-opened, you will have to fight to keep your mouthguard in your mouth, as your muscles and tongue will want to kick it out. If this sounds familiar, it is because it is very common. Your body knows when treatment is not going to help with your problems, and over-opening a bite will create a great number of long-term problems.
If your bite is over-closed, though, there is a good chance that a well-designed and adjusted mouthguard will provide significant relief, and can certainly improve your facial appearance as well. Depending upon how far open the bite needs to be, an orthotic can be worn, invisibly, for months at a time, being removed only for cleaning, or for heavy meals. At Advanced Dental Arts NW, we use these orthotics not only to remedy the immediate problems of grinding and clenching, but also for neck and some shoulder pain, much of which arises from a bad bite.
Once we know WHERE your bite is comfortable, we can get you there through a variety of options, each of which we would discuss with you from the get-go.
Have you been prescribed a mouthguard to treat your TMJ disorder/TMD? Are you still experiencing jaw pain and headaches despite diligently wearing your appliance every night? Unfortunately, this situation is all too common. If you talk to most patients over the long-term, mouthguards actually do very little to solve TMD-related symptoms, and in many cases, they can actually make things worse! Here are the top 4 reasons mouthguards should not be used for TMJ treatment in Portland.
Most of the time, a patient is asked to only wear their mouthguard while they sleep, so on average, the the appliance is helping out about 8 hours each day. Of course, this means that the TMJ muscles are straining and causing pain during the other 16 hours. Mouthguards are only effective as long as you wear them, and once you take them out, symptoms will soon return.
The goal of a mouthguard is generally to alter the bite temporarily, to enable the muscles to relax and refresh. Made properly, in the correctly diagnosed position, and opening the mouth optimally, mouthguards can be a godsend, and bestow almost immediate calmness to the muscles. BUT…
They have to be adjusted as finely as they would be were they crowns or fillings or veneers, or they will continue to tell the muscles to grind and clench. You will have merely replaced the old bad bite with a new bad bite.
The goal is to create comfortable, relaxed muscles by removing the triggers to grinding, clenching, and bruxing, i.e., to make the teeth interact as ideally as possible. Whether this is accomplished by adjustment, or by orthodontic movements (as with Invisalign), or by crowns and fillings, is almost incidental, so long as we get the bite right.
Here at Advanced Dental Arts NorthWest, we like the long-term solutions we provide by using “DTR,” or Disclusion Time Reduction, because it enables us to pinpoint and remove the interferences in your bite. We treat the muscle problems by addressing the cause of the problem, which is the bite.
Mouthguards are great for sports, but are only appropriate for a narrow purpose in treating TMJ problems, and then, only really in the short run. We like to treat causes rather than symptoms, because that is the best care we can provide.
About the Author
Dr. Russ Teasdale is a TMJ dentist in Portland with almost 40 years of experience. Currently, he is the ONLY dentist in the area certified to provide DTR therapy. If you are tired of dealing with constant TMD pain and ineffective mouthguards, contact Advanced Dental Arts of NW to schedule an appointment and learn how we can help you put the condition behind you for good.