TMJ disorder and sleep apnea – Bothell dentist
TMJ disorder and sleep apnea – Bothell dentist
TMJ disorder is one of the most common oral health conditions. People with this disorder may experience pain, stiffness, and other symptoms in the jaw joint. There are also links between TMJ disorder and sleep apnea. This is a serious health problem, which causes patients to stop breathing multiple times during the night. How is TMJ related to sleep apnea? What treatments can help?
What is TMJ disorder?
The temporomandibular joint, or TMJ, is the joint where the lower jaw (mandible) meets with the skull (at the temporal bone, or temple). This joint moves as the mouth opens and closes. Although it may seem like a simple hinge joint, the TMJ is more complex than it may appear. The lower jaw does not simply hinge to open and close the mouth, but can also move forward and backward as well as side to side. This is why the motion of the joint involves a gliding motion as well as a hinge-type motion. There is a small disc of cartilage between the two bones, which helps to ensure proper function of the TMJ.
TMJ disorder occurs when the TMJ is not functioning properly. (TMJ disorder is sometimes abbreviated as TMJD, TMD, or, confusingly, TMJ. For clarity, we will refer to it as TMJ disorder, and use the abbreviation TMJ for the joint itself.) The cartilage of the joint may become damaged, or the disc may slip out of place.
TMJ disorder may result from trauma to the face (such as during sports), but is more commonly the result of years of wear and tear. Teeth grinding and clenching create large amounts of force in the TMJ, and raise the risk of TMJ disorder. Holding the jaw joint in an improper position can also damage the joint and may lead to TMJ disorder. Misalignment of the teeth can cause the TMJ to be held either too far forward or too far back, as the body seeks to allow biting and chewing to function. Habitually leaning the face onto the hand can also put pressure on the TMJ and cause damage to it.
Symptoms of TMJ disorder include:
- pain or tenderness around the TMJ, which may be felt in the face or ear
- popping or clicking of the joint as the jaw moves
- stiffness of the jaw joints
- “locking” of the TMJ
- pain with chewing or difficulty chewing
How is TMJ disorder related to sleep apnea?
Damage to the structures of the TMJ may cause the joint to become too loose. The ligaments that usually support the lower jaw and hold it in the proper place on the skull become stretched out and damaged, leaving less support for the mandible. When the patient falls asleep, and the muscles relax, the mandible will tend to move under the influence of gravity. Without the proper support, the mandible may move farther than it should. If it falls backward toward the throat, then it can narrow the airway and lead to apnea.
Many people who have TMJ habitually hold the mandible in a retracted position, meaning that the lower jaw is too far back relative to the upper jaw. When this is the habitual position of the mandible, then the airway is already narrowed during the day. At night, it’s more likely that the airway will be compromised, resulting in sleep apnea.
People who have sleep apnea also tend to clench or grind the teeth at night. This happens due to the stress of the apneic episodes, which causes the partial awakenings that characterize sleep apnea (though most people are unaware of having awakened). On a subconscious level, the body is working to find a more comfortable and open position for the airway. As a result, those who have sleep apnea may later develop TMJ as a result of chronic teeth grinding and clenching.
Can treatment help?
If you have sleep apnea, it’s very important to get treatment. Sleep apnea can have very serious consequences for your health. It causes a higher risk for high blood pressure, heart attack, stroke, and even death. It’s definitely important to get treatment.
Treatment can often help with both sleep apnea and TMJ symptoms. Treatment of sleep apnea can help to reduce the amount of grinding and clenching that occurs at night, which then helps the TMJ to function better and reduces pain and other symptoms.
It’s also important to seek treatment from a qualified medical professional. Oral devices are the most comfortable and well-tolerated treatment for sleep apnea. However, if not used properly, an oral device could actually cause TMJ disorder. The device holds the lower jaw in a forward position in order to prevent airway collapse. If the device is not adjusted properly, it could push the lower jaw too far forward, causing damage to the TMJ. This is why it’s very important to have your oral device fitted by a qualified professional.
For patients whose lower jaw is habitually retracted, then placing the jaw into a healthier position can be helpful in correcting both the TMJ and the sleep apnea. This may be accomplished through a surgical procedure. Orthodontic treatment may also be helpful in correcting the alignment of a poorly aligned TMJ.
Ready to learn more? Visit a Bothell dentist with expertise in sleep apnea!
If you’d like to learn more about TMJ disorder, sleep apnea, or the link between these two common problems, please schedule a consultation with Dr. Mulliken. As a sleep dentist, he offers oral device treatment for sleep apnea. With such a qualified professional supervising your treatment, you can be confident that it will be as safe and effective as possible.
Those who suffer from TMJ disorder can experience a variety of problems with the teeth. As a cosmetic and restorative dentist, Dr. Mulliken can help to ensure that your teeth remain healthy, and repair any damage that has already been caused. If needed, he can also refer you to specialists who can help with your TMJ disorder (such as a physical therapist).