• When you bite down, do you experience pain?
  
• Are you restricted with how much you can open your mouth?
  
• When you open your mouth wide – does your TMJ’s pop or click?
  
• Have friends or family members commented on how loud your clicking jaw or popping jaw is?
  

If you answered yes to even one of those questions, something isn’t right. A healthy and normal TMJ is quiet when it’s working it does not generate noise, limit mobility, or cause pain. During eating, chewing, singing, swallowing, talking, and even breathing – you should feel no discomfort or experience anything unusual. 

The muscles that control your jaw should work in harmony, allowing you to open and close your mouth both smoothly and silently.

If you notice a constant clicking, popping, and snapping when you engage in everyday activities, something isn’t right. Clicking, popping and pain are indicators that your jaw joint may be damaged and unstable.


Jaw popping and your TMJ – pop goes your disc

• You have a disc of thickened ligament inside your jaw joint which keeps the lower jaw bone and the skull from rubbing together. With a malocclusion or unhealthy bite, this disc can be compromised or damaged/torn and over time it no longer sits where it should.
  

• When the disc is out of place, the joints end sitting on soft tissue instead of the disc. When you open your mouth, the TMJ snaps back into place causing the clicking and popping sound you hear (disc displacement and your TMJ). Sometimes, it is loud enough to be heard by other people. Sometimes it hurts and limits the amount your mouth can open.
  

• When your jaw is misaligned and the jaw joint is not properly positioned and supported by your bite, it can be limited in its range of motion. You could be at a friend’s dinner party and suddenly you can’t open your mouth wide enough to eat. When you yawn or talk, you feel as though you need to help support your jaw. If you suffer from a TMJ disorder, the ability to open your mouth fully or widely can be limited and painful.
  

It is a like a muscle – tooth war inside your head

When your teeth bite in one spot but your muscles want your jaw to sit in another spot for balance and comfort, you develop tension within the jaw system. It is like a WAR, between the stable bite and the happiness of the soft structures like the jaw muscles and jaw joints.

 
In this WAR, one of 3 things can happen

1.  If your muscles are winning the war, they will tell the brain to grind your teeth to a spot that is less strained. The result can be rapid tooth wear and possible tooth or root fracture. Continuous bite trauma to the nerve inside the tooth may result in the death of the nerve and the need for a root canal absent the presence of dental decay.

2.  If your teeth win the war, they tell the muscles to work harder and keep clenching to provide support. You will have muscle tension and strain and may have more headaches and other TMJ problems.

3.  In War, everyone loses: you will experience a combination of both tooth wear and jaw pain at the same time.

THOMAS E. BRAMANTI, DDS, PHD, INC 

5660 N. Fresno Suite 110

Fresno, CA 93710

559-438-7800

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Structural stress, mental stress, physical stress elicit the same response in your body. You tighten up. Your muscles tense, your body stops moving as it should. Stress paralyzes and inhibits muscle range and motion.

Many patients with stress complain of clenching and/or grinding their teeth. They may have been told they are too stressed and need to relax. Not an easy task. If you could relax you would not stress.

The problem is, while stress comes in many forms, it is not the only problem. While you may have “Stress” you probably also have “Strain”.

This physical strain within your body can happen due to unintentional misalignments of body structures. Misalignments happen due to growth issues, accidents, and activities. These misalignments require that your body accommodates its strain with your muscles, tendons, and ligaments. This accommodation within the body’s structures can be an important factor in clenching and grinding teeth and other TMJ disorders.

Did you know that you can clench and grind your teeth and be totally unaware of it until it causes you pain or it breaks a tooth? Clenching is used to stabilize the body by bringing the lower teeth into contact with the upper teeth. Teeth and jaws also come together each time we swallow (hundreds of times a day). If the alignment of teeth is unbalanced (a malocclusion), you have structural strain. This is why Dr. Bramanti is able to provide a balanced bite analysis to bring a therapeutic course allowing you to function without as much strain.

Let’s face it, telling yourself not to be stressed is not easy and may not be very effective. But willing away strain is not effective either. Understanding where the strain is present may allow you to have Dr. Bramanti help you. While TMJ function takes part of your head, all body systems can be affected.

When you have a misaligned jaw and a subsequent uneven bite, the wear and tear on your teeth is significantly more rapid. The erosion and clenching of your teeth can lead to uneven tooth wear, loss of range of jaw motion, gum recession and various other symptoms – all connected to a TMJ disorder.

 

TMJ Disorder symptoms – clicking – pain – limitations…

What’s going on?

"For we are God’s handiwork, created in Christ Jesus to do good works, which God prepared in advance for us to do."

Jaw Locking, Clicking, Clenching

My chin is getting closer to my nose as my teeth wear away!

Jaw misalignment and tooth wear greatly influence the appearance of your face. A poorly aligned jaw can create deterioration and breakdown of your teeth, slowly altering the shape of your face. While there are other problems like GERD and acidic diet, wear on front or back teeth can happen.

This can be distressing. Some have experienced new restorations suddenly snapping off due to constant grinding of the teeth. Some have had tooth roots fracture, causing the tooth to be lost.


Are you taking a nail file to your teeth?

That sounds like a ridiculous question. But dentists often see teeth that have been worn in such a way that unless you are using a nail file on them you must be causing excess wear by constantly grinding the upper and lower teeth together.

Now it is not likely that you are not using a nail file but the fact remains that teeth are showing too much wear. This is your body’s response to a misaligned bite (malocclusion). The wear on teeth is slow, you are consciously unaware of it. Often grinding your teeth is so common, you may feel that it is normal.

Whatever you do with your jaw on a routine basis becomes normal to you. That does not mean it is healthy. That tooth grinding can eventually destroy your teeth.

“I don’t think I grind my teeth” is a common comment from patients. But what the patients do not realize is that the grinding does not require conscious thought to happen. In fact, the grinding takes place due to a neural loop from the teeth to the brain stem and back to the muscles of the head and neck. This grinding happens at the same level as blinking your eyes or swallowing saliva. You do not have to be aware of it for it to happen.

Many patients mistakenly think that tooth wear takes place at night and never during the day. But in reality, our teeth touch during the day as well.  This wear pattern is a daytime function happening below our conscious level.

Are your teeth chipping or getting loose? Imagine backing your car out of the driveway every morning and constantly bump the yard fence with your bumper. You don’t hit it hard but you hit it every day. What will happen with that fence? Well, at some point the fence will break.

Now imagine that you are banging your teeth day and night, just a little, but all the time. What will happen? The teeth will break or become loose over time. This constant banging of the teeth can be a long-term problem. In turn, it can damage your teeth, gum tissue and jaw bone.

 
TMJ Jaw pain care

Are you experiencing some of these problems … or worse, all of them? We encourage you to talk to Dr. Bramanti about TMJ Disorder treatment options. Learn how we can help relieve your jaw pain and how TMJ treatments can improve your well-being. Preventing serious issues caused by TMJ Disorders early is important for your health including joint popping noises and lockjaw symptoms.

Schedule a consultation with Dr. Bramanti today by calling us at 559-438-7800.

​Thomas E. Bramanti, D.D.S., Ph.D.

Board-Certified Diplomate American Board of Periodontology/Implant Dentistry

Board-Certified Diplomate American Board of Oral Implantology/Implant Dentistry

​​Certified TMJ Expert, The Pankey Institute

Fellow American Academy of Implant Dentistry
Clinical Assistant Professor at UCSF in the Department of Oral and Maxillofacial Surgery

Clinical Assistant Professor UCSF-Fresno Medical Education Program, School of Medicine 

My jaw locks!

A common TMJ problem is a “Locked Jaw”. This often happens when the soft tissue disc around the TMJ jams up its ability to move freely. It is similar to a bunched up rug preventing a door from opening wide.

The way you bite may be the original cause of the jaw locking. Strain in the bite will affect the TMJ and over time may cause chronic issues like a locked jaw. The most common jaw locking is closed. But sometimes the jaw locks open. This is often because the jaw joint ligaments are too lax or too stretchy and the TMJ disc gets stuck. Torn ligaments and displaced torn discs can result in limited range of motion and locking. People with genetic connective tissue disorders often have an issue with a jaw that locks open.

Locked Jaws can also develop with muscle spasms that prevent the jaw from moving. Even head/neck misalignment can cause a locked jaw. It is important for all of these issues to be assessed.

Time is of the essence. If your jaw locks, get it assessed as soon as you can by Dr. Bramanti. Even if it locks for a while, and then it is fine, have it checked. This could be a warning of problems to come. Some hope that all clicking and locking will go away with time but that can just indicate that function is lost and you cannot open as wide or freely. The TMJ soft tissues will not spontaneously repair themselves, so don’t wait or further damage and increased pain may occur.

 Am I just too stressed?

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