TMJ – Bruxism – Orofacial Pain

Dysfunction of the masticatory apparatus and the craniocervical region.

Orofacial pain and TMJ

What is it? What are its causes?

The term Craniomandibular Dysfunction (CMD) or Temporomandibular Disorders (TMD) refers to a group of pathologies and clinical situations that have in common the possibility of causing pain and/or functional alterations of the masticatory apparatus, fundamentally in the Temporomandibular Joints (TMJ) and the associated craniocervical musculature.The most frequent causes of this disease are situations of instability in dental occlusion (the way in which the upper teeth fit together with the lower teeth), craniofacial trauma, certain psychological disorders (anxiety, stress or depression) that lead to bruxism (grinding and/or clenching of the teeth), or the presence of generalized diseases such as rheumatoid arthritis or fibromyalgia, which can affect the TMJs and the masticatory musculature, respectively.

For whom is this treatment indicated?

For those patients who have chewing difficulties associated with poor dental occlusion, who suffer from jaw pain when getting up in the morning due to nocturnal bruxism or who have clicking or blocking at the TMJ level during jaw movement or chewing.

It should not be forgotten that the Orofacial Pain specialist can also be of great help in the diagnosis and treatment of certain disorders and headaches (migraine pain, cervicogenic headache pain, tension headache or cluster headache) or neuropathic pain (pain originating in the cranial nerves) among which we can highlight the Post-traumatic Painful Trigeminal Neuropathy, Trigeminal Neuralgia and Burning Mouth Syndrome.‍

Clínica Kranion, especialistas en disfunción craneomandibular y dolor orofacial en Alicante.

What are the benefits of this treatment?

The odontostomatologist specialized in orofacial pain (see curricular guidelines advised by the American Board of Orofacial Pain) can offer a high percentage of clinical improvement to patients with TMD, ranging from 90% in terms of pain and functional limitation to 70% in terms of internal TMJ disorders, considerably reducing the different related problems and the pain caused.

It should not be forgotten that the orofacial pain specialist can also be of great help in the diagnosis and treatment of neurovascular pain (certain types of headaches such as migraine) or neuropathic pain, including atypical odontalgia, characterized by a persistent and burning pain that manifests after a dental intervention on a tooth, keeping certain similarities in the phantom limb syndrome.

What does the treatment consist of?

The treatment of TMD is varied and multidisciplinary, and different techniques can be applied: behavioral re-education and stress control (with diaphragmatic breathing techniques, Mindfulness or Bioffedback), dento-maxillary orthopedics through the use of interdental unloading splints, physiotherapeutic rehabilitation, muscular infiltrations (anesthetics, medical ozone or botulinum toxin), pharmacotherapy and, in some cases, surgical treatment of the TMJ by means of arthrocentesis, arthroscopy or open surgery.

Clínica Kranion is a national pioneering center in the treatment of osteoarthrosis (joint wear and tear) of the TMJ with intra-articular infiltrations with hyaluronic acid, growth factors (Orthokine® System) or stem cells.‍

Growth factors‍

Clínica Kranion has the Technology of Plasma Rich in Growth Factors that is obtained from the patient’s own blood and that favors the healing of the soft tissues of any surgical and/or implantological process in addition to being used in infiltrations in the TMJ helping to stabilize the processes of joint osteoarthrosis.

¿Cuál es la duración del tratamiento?

Patients with TMJ disorders are patients that could be defined as chronic, so the patient requires follow-up by the professional and visits at intervals that vary depending on each situation throughout his life.

Clínica Kranion is a leader in the use of new technologies in the treatment of TMJ, Bruxism and Orofacial Pain.

These are the techniques we use:

Unloading splint

Regenerative Medicine

Botulinum Toxin and Orofacial Pain

Dental ozone therapy

¿Me dolerá el tratamiento? ¿Requiere anestesia?

The treatment of DCM is varied and multidisciplinary, and different techniques can be applied, most of which are painless and do not require anesthesia.

On the other hand, surgical treatments by arthrocentesis, arthroscopy or open surgery should be performed under local anesthesia, intravenous conscious sedation or general anesthesia, depending on the procedure.

Kranion Clinic, specialists in craniomandibular dysfunction and orofacial pain in Alicante.

How many days will I be inactive?

The vast majority of the therapeutic procedures applied in the treatment of TMD do not require subsequent inactivity on the part of the patient or time off work, being able to lead a normal life, except for surgical treatments, which will require a few days of recovery.

Are there any contraindications to this treatment?

There are no specific contraindications, except those inherent to any medical surgical procedure.

Bruxism

What is bruxism?

Bruxism is a parafunction (habit with no functional purpose) that consists of clenching and/or grinding the teeth, either during sleep (sleep bruxism) or during the day (waking bruxism).

Of all the parafunctions that affect the masticatory apparatus, bruxism is the most destructive and needs proper clinical evaluation and management to prevent increasingly important health problems in the teeth and oral cavity.

The sensation of grinding the teeth and clenching them with great intensity produces more fatigue, tension and additional stress in daily life.

For whom is the treatment indicated?

The treatment is indicated for all those who present any symptoms associated with bruxism, such as jaw pain, pain and/or clicking near the ear at the temporomandibular joint (TMJ) level, headaches or tooth sensitivity related to the wear and destruction of the structure of the teeth caused by tooth grinding.

At Clínica Kranion we are specialists in treating bruxism.

What are the benefits of bruxism treatment?

This type of treatment slows down the wear and tear of the dental pieces, reducing their sensitivity. Jaw and ear pain disappears, headaches and clicking noises improve. In addition, the risk of TMJ injuries such as mandibular blockage is reduced.

Will it hurt?

The treatment of bruxism is painless and may require a multidisciplinary intervention through: the application of dental splints (designed to prevent tooth wear and facilitate relaxation of the masticatory musculature), the application of craniomandibular physiotherapy and the control of stress and anxiety with diaphragmatic breathing techniques, Mindfulness or Biofeedback.

How many days will I be inactive?

The use of splints and physiotherapy sessions, like the rest of the treatments mentioned above, do not require any type of sick leave.

Does the treatment require anesthesia, what type?

In general, the use of anesthetics is not necessary in the treatment of bruxism, although it is true that in cases of severe and/or chronic muscular pain, infiltrations with medical ozone and anesthetic in the mandibular elevating musculature may be indicated, as well as the application of botulinum toxin infiltrations to achieve a prolonged relaxing effect in the muscles of the head and neck.

If you need more information related to this specialty, please contact us or visit us at our center.

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