Dental Issues
A Pain in the Neck: Modern Treatment Options for Teeth Grinding and TMD
Feb 6, 2015 - 9:30:19 AM

( - Have TMD? What have you tried to fix it? Maybe you've done all the home remedies you could think of. Now, you need more help. You need the touch of a skilled dentist or doctor. Here's what you can expect from a pro.

The Diagnostics

More than 15 per cent of the population experiences chronic facial pain, with many of these symptoms being attributable to Temporomandibular Disorder (TMD). Diagnostics are usually done in the office of a dentist. The doctor will assess symptoms first, and then try to make an assessment as to the likelihood of the disorder.

Common symptoms include pain in or around the ear, headaches and neck aches, tenderness of the jaw or jaw muscles, jaw pain (especially when chewing, biting, or yawning), clicking or popping noises when you open your mouth, difficulty opening and closing your mouth, and sensitive teeth when no other known dental problems exist.

This Winnipeg dentist sees TMD on a somewhat frequent basis, and the symptoms usually tell the story - which is good, because not many diagnostics exist to confirm TMD. It's largely a symptom-driven disorder. Sometimes, there is a mechanical component in cases where a clear injury to the jaw has occurred.

So, what causes TMD? A lot of things, actually. It can be caused by arthritis, an improper or misaligned bite pattern, or jaw dislocation or injury.

Sometimes stress is thought to be a contributing factor in TMD, especially when the teeth are clenched during physical activity, like lifting heavy objects or engaging in some other strenuous activity.

Fortunately, there are many treatments for the condition.

Customized Mouth Guards

Customized mouth guards can make a huge difference in both the day and night symptoms of TMD. A dentist makes a mould of your teeth, and then casts a special mouth guard or retainer that you wear when you sleep.

The mouth guard protects your teeth by preventing you from grinding. Night guards can also realign your teeth so that you're less likely to snore, if that's also a problem.

The biting surface of the guard is usually flat, but they can also be made at inclines to address unstable joint ligaments and displaced discs.

Crown and Bridge Work

When teeth are damaged, or there is an indication that tooth extraction would help a TMD case, then the dentist will recommend crown and bridge work. A crown is a cap that fits over a damaged tooth. Sometimes, crowns are complete replacements for a tooth when a dentist drills  into the jaw to anchor a screw/post.

These types of dental implants may end up replacing several teeth side-by-side. This is called a bridge.

Occlusal Adjustments

An occlusal or bite adjustment is an irreversible adjustment that changes the bite pattern. For some, this brings immediate and lasting relief. But, it's not for everyone. Because it's a permanent change to how you bite, you may experience disorientation when chewing or talking. Basically, a dentist will adjust your bite using precision filing and drilling tools.

When the procedure is done, your bite pattern is changed, with the hope that this solves the problem.


Another way to cope with the pain of TMD is to get a MORA splint. A MORA splint is a "mandibular repositioning splint". The splint moves the lower jaw either forward or backward and is supposed to put the jaw into a position.

This may result in a permanent change in the person's bite pattern. It's a more invasive treatment, but doesn't require filing or drilling, like occlusal adjustments.


Another way to change the bite pattern is to install various orthodontics - braces. Braces come in all shapes and sizes, and can change the appearance of your smile, make it easier or more difficult to speak depending on the work being done, but can often resolve a lot of TMD symptoms.

You are physically realigning your teeth using force and pressure over time. This is one of the most accepted and practiced ways of resolving TMD and the one option almost all dentists are familiar with.

When you think of braces, you probably think of the stereotypical mouth of metal.

But, new braces don't require you to wear gaudy headgear and hardware. Some of the newest options are practically invisible since they are installed on the backside of the tooth.

Whatever option you choose, you should speak with a qualified dentist or doctor to resolve the pain. While pain medications can help relieve the symptoms temporarily, they are never a permanent solution.

Dr. Bruce Bohunicky is an alumni of the University of Manitoba Faculty of Dentistry. He carries a wide range of experience in general dentistry. A life-long learner with a penchant to provide the best possible care, he consistently upgrades his skills with advanced post graduate courses and training alongside some of the top dentists in the world.


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