Temporomandibular joint (TMJ) disorders involve pain and dysfunction in the jaw joint and the muscles that control jaw movement. These conditions can manifest as discomfort in the jaw, face, or neck, along with difficulty chewing or opening the mouth. For many individuals experiencing these symptoms, an oral appliance, often referred to as a mouthguard, is considered as a potential treatment approach.
Mouthguards and Their Role in TMJ Management
Mouthguards, also known as occlusal splints or night guards, are custom-fitted devices worn over the teeth. Their primary purpose in managing TMJ symptoms is to create a more stable bite and reduce stress on the jaw joints and surrounding muscles. By providing a protective barrier, these appliances can prevent teeth from grinding or clenching, especially during sleep.
Some mouthguards are designed to temporarily reposition the jaw, allowing the jaw muscles to relax and potentially reducing inflammation within the joint. They distribute biting forces more evenly across the teeth. While some basic mouthguards are available over-the-counter, many effective TMJ appliances are custom-made by a dental professional.
When a Mouthguard Can Aggravate TMJ
Despite their intended benefits, a mouthguard can sometimes worsen TMJ symptoms if not properly designed or monitored. A poorly fitted appliance, particularly an over-the-counter type that isn’t customized, can inadvertently shift the jaw into an unnatural position. This misalignment can place undue stress on the temporomandibular joint, leading to muscle spasms, headaches, or earaches.
An incorrect diagnosis of the underlying cause of TMJ dysfunction can also lead to aggravation when a mouthguard is used. If the appliance is prescribed for a condition it cannot address, or if the wrong type of splint is chosen, it may exacerbate symptoms. For instance, a stabilization splint might be appropriate for muscle pain, but a repositioning splint could be detrimental if the joint disc is already severely displaced.
Prolonged or unmonitored use of a mouthguard without professional oversight can also lead to adverse outcomes. Continuous wear without adjustments may cause subtle but significant changes to the bite over time, known as occlusal changes. These alterations can create new imbalances in the jaw system, potentially masking the progression of the underlying TMJ disorder. The material or specific design features of an appliance, such as excessive thickness or hardness, might also induce discomfort or allergic reactions in some individuals.
Signs of Worsening Symptoms and Next Steps
Recognizing signs that a mouthguard might be worsening TMJ symptoms is important. Individuals might experience increased jaw pain, or new discomfort in areas such as the neck, shoulders, or ears. Other indicators include persistent headaches, a change in how the teeth fit together, increased clicking or popping sounds from the jaw joint, or new difficulties with chewing or speaking.
If any of these signs emerge after beginning mouthguard use, discontinue wearing the appliance immediately. The next step involves consulting a qualified dental professional specializing in TMJ disorders or orofacial pain. This could be a dentist with advanced training in TMJ, an oral surgeon, or an orofacial pain specialist.
A professional can re-evaluate the initial diagnosis, assess the fit and design of the current mouthguard, and determine if adjustments, a different type of appliance, or alternative treatments are necessary. Custom-made appliances, followed by regular check-ups, offer the best chance for effective and safe TMJ management. Consistent monitoring ensures the appliance remains beneficial and does not contribute to further complications.