What a temporomandibular disorder is
The temporomandibular joint (TMJ) connects the lower jaw to the skull, just in front of the ear. When the joint, the disc that cushions it or the muscles that move it don't work properly, symptoms appear: pain in the jaw or in front of the ear, clicking or grating when opening and closing, locking, difficulty opening fully, headache or neck pain, and tooth wear from clenching or grinding (bruxism).
How we assess it
We start by listening to you and examining you: how you open, what hurts, which muscles are tense, how your teeth fit together. When we need to see inside the joint, we take a CBCT and get three-dimensional sections of both condyles, at the clinic itself. With the intraoral scanner we mount your models in an articulator and study the relationship between your bite and the position of your jaw.
Dr Manuel Fernández Cano trained at the Vienna School of Interdisciplinary Dentistry (VieSID) and with Sistemas Ertty, and teaches the TMJ module of the UCAM postgraduate orthodontics programme.
Treatments
Most cases improve with conservative measures: a custom-made occlusal splint, advice to stop clenching, exercises and, when appropriate, physiotherapy or medication coordinated with other specialists. Not every case needs orthodontics.
When the bite contributes to the problem, we plan orthodontic treatment that looks after the joint: we look for a stable position of the jaw and move the teeth so they fit into it. This is the basis of the mandibular repositioning we teach in our courses for professionals.
TMJ and orthodontics
In all our orthodontic treatments, with braces or with aligners, the joint is part of the study: we look at the condyles on the CBCT before starting and check that the jaw ends up in a comfortable position at the end. Looking after function, not just aesthetics, is what sets us apart.
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