DEAR DR. GOTT:
I am currently having problems sleeping because I grind my teeth badly. I was told I have TMJ.

I tried using a plastic mouth piece and I found I’m tearing it up in my sleep. I hope you can advise me of a better way to control the situation.

DEAR READER:
Temporomandibular joint dysfunction (TMJ) covers a variety of conditions that cause pain and tenderness at the site of the ball-and-socket joint on each side of the head where the lower jaw bone joins the temporal skull bone. Jaw clicking is common in people and doesn’t always indicate there is a problem. Without pain, or limitation of movement with the clicking, an individual does not suffer from TMJ.

There are numerous reasons for the disorder. Stress, trauma, a severe blow to the jaw, poor posture of the shoulders, neck and head, osteoarthritis, jaw clenching and more have been associated with TMJ.

Persistent pain and tenderness should not be ignored. You have your choice of several professionals to consult. First, consider a visit to your primary care physician. If he or she feels the problem is beyond diagnosing or questionable, then a referral to a dentist or oral surgeon would be in order. In most cases, the pain and discomfort can be alleviated or controlled with self-managed, non-surgical treatment, while more severe cases might require surgical intervention. Self-help techniques include deep breathing exercises, meditation and yoga. As breathing slows and an individual relaxes, muscle tension will be lessened.

Anti-inflammatory medications such as ibuprofen or warm, moist heat might be tried as a first step. Relaxation techniques assist in managing stress. A specialist might then recommend a bite plate. For those, such as yourself, who grind their teeth, a night guard applied over the teeth can often prevent the grinding. Beyond this, corticosteroid drugs might be appropriate. Lastly, sophisticated surgery might be attempted.

If your mouth piece is being battered during sleep, speak with your dentist or oral surgeon. He or she might consider a heavy duty unit, step you up to a different night guard, or even progress to a trial of corticosteroids. I am at a disadvantage since I do not know if you have a medical history that might come in to play, or if you are on medications that could have a bearing on any traditional treatment. Speak with the medical professional who knows your case best and follow the advice given.