Temporomandibular joint disorder (TMJ) affects the jaw joint and surrounding muscles responsible for jaw movement. Located on each side of the head, this joint allows for functions like chewing, speaking, and yawning. Many individuals with jaw pain consider mouth guards as a treatment option. While these devices offer relief for some, a mouth guard can worsen TMJ symptoms if not properly managed.
How Mouth Guards are Used for TMJ
Mouth guards (oral splints or bite guards) are often recommended for TMJ symptoms. These appliances cushion between the upper and lower teeth, absorbing pressure and preventing direct tooth-on-tooth contact. This reduces strain on jaw joints and muscles, alleviating pain and preventing damage.
For individuals who grind or clench their teeth (bruxism), mouth guards provide a protective barrier. By keeping the teeth slightly separated, they minimize muscle tension and reduce involuntary actions that contribute to jaw discomfort, particularly during sleep. Certain mouth guards can also help guide the jaw into a more relaxed position, promoting muscle relaxation and reducing tension that exacerbates TMJ symptoms. This can decrease jaw soreness, facial pain, and headaches.
Reasons a Mouth Guard Might Worsen TMJ
Despite their intended benefits, mouth guards can sometimes worsen TMJ symptoms due to design or usage issues. An improper fit is a primary concern, placing undue stress on the jaw joint. This can improperly distribute bite force, increasing strain on jaw muscles and joints, leading to pain.
Another reason for worsening symptoms is the use of an incorrect type of mouth guard for the specific TMJ condition. Not all TMJ issues are identical; a device for teeth grinding might be unsuitable or harmful for disc displacement. Such a mismatch can fail to address the underlying issue or exacerbate it. Some mouth guards might unintentionally trigger increased clenching or grinding, especially if uncomfortable or creating an unstable biting surface. If the back teeth primarily contact the guard, it can lead to uneven muscle activation and more intense clenching.
Certain mouth guards can also force the jaw into an unnatural or strained position over time. This can lead to muscle strain, uneven pressure on teeth, and bite changes, aggravating the temporomandibular joint. Finally, using over-the-counter or generic mouth guards without professional supervision can be problematic. These “one-size-fits-all” options rarely provide the precise fit for effective TMJ relief and can cause complications if not molded correctly or if they shift the bite. Without a professional assessment, such devices may not address the root cause of the disorder and could worsen the condition.
Differentiating Types of Mouth Guards
Mouth guards for TMJ management vary in materials, design, and purpose. Generally, they can be categorized as soft or hard guards. Soft guards, made from flexible materials, offer comfort and shock absorption, often recommended for mild teeth grinding or clenching. Hard guards, conversely, are crafted from more rigid materials, providing greater durability and protection for moderate to severe grinding and clenching.
Beyond material, mouth guards serve different functions, broadly classified as stabilization splints or repositioning appliances. Stabilization splints typically cover all teeth on one arch, preventing tooth-to-tooth contact, reducing muscle activity, and protecting against grinding. They are commonly used for general bruxism and to relax jaw muscles. Repositioning splints guide the lower jaw into a specific position to alleviate pressure on the jaw joint, particularly in cases of disc displacement. These appliances are usually worn consistently and require professional supervision due to their potential to alter the bite over time.
The distinction between over-the-counter (OTC) and custom-made mouth guards is important. OTC options are widely available and less expensive, but they often lack the precise fit needed for effective TMJ treatment. Their generic fit can lead to discomfort, instability, and exacerbate jaw issues. Custom-made mouth guards are fabricated from impressions, ensuring a snug and accurate fit that provides comfort and therapeutic results. While more costly, these professionally fitted devices are designed to address specific jaw alignment and muscle issues, making them generally more effective and safer for long-term use.
When to Consult a Specialist
Seeking professional guidance for TMJ symptoms, especially when using a mouth guard, is crucial for managing the condition. If jaw pain, clicking, popping, or locking sensations increase or persist after beginning mouth guard use, professional evaluation is needed. These worsening symptoms suggest the current treatment may not be appropriate or the device might be contributing to the problem.
New symptoms such as persistent headaches, earaches, facial pain, or noticeable changes in how teeth come together should prompt a consultation with a dental professional. A mouth guard that alters the bite can lead to new discomfort or exacerbate existing issues. If uncertain about a mouth guard’s type or fit, seeking expert advice is advisable. An ill-fitting or inappropriate device can be counterproductive and cause complications.
If initial TMJ symptoms fail to improve despite consistent mouth guard use, or discomfort continues, a specialist should be consulted. A qualified dentist or oral surgeon specializing in TMJ disorders can provide an accurate diagnosis and determine the most suitable treatment. They can assess the underlying causes of the disorder and adjust the treatment plan, which may include modifying the mouth guard or exploring other therapies.