Many people are aware that problems with the temporomandibular joint (TMJ) can cause headaches and jaw pains. TMJ problems are often treated with splints that fit in a patient’s mouth. There are ads for mouth guards for sale in drug stores, but will they work as well as custom-made appliances? In this report Dr. Roy V. Hakala with Minnesota Craniofacial Center in St. Paul, MN explains that generic appliances won’t solve TMJ problems like an appliance provided by a dentist.
Dr. Hakala explains that there are several problems associated with the use of these generic mouth guards to realign a jaw. One obvious problem is that these guards are bulky, crowding the user’s tongue into places it shouldn’t go. Also, the generic guards don’t fit very well, even when a user boils the guard to fit it to his or her teeth. Any generic appliance will only give an approximate fit. A third problem with these guards is that they are soft, encouraging users to chew on them. Anyone with a bruxism, or clenching, problem will only make the problem worse with a chewable mouth guard.
Dr. Hakala points out that there is no single appliance that will work for everyone. “I wish there were,” he adds. It is necessary for the dentist to do a complete diagnosis to figure out what particular appliance will work best for a particular patient. “There is no ‘one size fits all.’” There are several factors to be considered in the design of a TJM appliance. Most important, says Dr. Hakala, is figuring out exactly what a patient’s problem is. For example, if a patient’s lower jaw sits too far back, the appliance needs to have a biting surface that will move it to the proper position.
Dr. Hakala explains how the process works using a sample appliance he has designed to fit a model he uses for demonstration purposes. The appliance is very compact and does not crowd a patient’s tongue. It is very thin, similar to an orthodontic retainer. The sample has a very well-defined biting surface. The surface is designed after a thorough examination of a patient’s impressions, dental models, and x-rays. This insures that the appliance will do what needs to be done.
The sample appliance has another feature worth noting: it leaves the front teeth open so that a patient can wear it during the daytime. This is very important for a patient with a TMJ problem. The jaw has to be brought into proper alignment and kept that way all the time.
Dr. Roy V. Hakala graduated from the University of Minnesota School of Dentistry in 1975 and has been working in the field of TMJ disorders and obstructive sleep apnea ever since. He established the Minnesota Craniofacial Center, P.C., specifically for the treatment of these disorders in 1994. Dr. Hakala is, among other things, a Diplomate of the American Board of Craniofacial Pain and a Diplomate of the American Board of Dental Sleep Medicine. He spoke with Sleep Better TV, providing online sleep breathing disorder video news content. Sleep Better TV is a featured network of Sequence Media Group.