TMJ Gridding - Buxism

Temporomandibular Disorders (TMD)


What Is the Temporomandibular Joint (TMJ)?


What Causes TMD?

  • Injury to the jaw, temporomandibular joint, or muscles of the head and neck.
  • Grinding or clenching the teeth, which puts a lot of pressure on the TMJ.
  • Dislocation of the soft cushion or disc between the ball and socket.
  • Presence of osteoarthritis or rheumatoid arthritis in the TMJ.

What Are the Symptoms of TMD?

  • Limited ability to open the mouth very wide.
  • A tired feeling in the face.
  • Swelling on the side of the face.
  • May occur on one or both sides of the face.

How Is TMD Diagnosed?




Signs and symptoms

Most people who bruxism are unaware of the problem, either because there are no symptoms, or because the symptoms are not understood to be associated with a clenching and grinding problem. The symptoms of sleep bruxism are usually most intense immediately after waking, and then slowly get better, and the symptoms of a bruxing habit which occurs mainly while awake tend to slowly get worse throughout the day, and may not be present upon waking.[12] Bruxism may cause a variety of signs and symptoms, including:

  • Cheek biting (which may manifest as and/or lineaalba), and/or lip biting, (other parafunctional activity which may occur together with bruxism).
  • A burning sensation on the tongue (glossodynia), possibly related to a coexistent "tongue thrusting" parafunctional activity.
  • Tenderness, pain or fatigue of the muscles of mastication,which may get worse during chewing or other jaw movement.
  • Restricted mouth opening.
  • Clicking of the temporomandibular joints.
  • Headaches, particularly pain in the temples, (caused by muscle pain associated with the temporalis muscle).
  • Pain or tenderness of the temporomandibular joints, which may manifest as preauricular pain (infront of the ear), or pain referred to the ear.
  • Excessive tooth wear, particularly attrition, which flattens the occlusal (biting) surface.
  • Tooth fractures, and repeated failure of dental restorations (fillings, crowns, etc.).
  • Hypersensitive teeth, (e.g. dental pain when drinking a cold liquid) caused by wearing away of the thickness of insulating layers of dentin and enamel around the nerve.
  • Hypertrophy of the muscles of mastication (increase in the size of the muscles that move the jaw), particularly the masseter muscle.



Some consider emotional stress to be the main triggering factor.

Genetic factors - Some research suggests that there may be a degree of inherited susceptibility to develop sleep bruxism.

Occlusalfactors - Inappropriate contacts between teeth,during biting and chewing. May cause bruxism.

Medication factors - Certain drugs, cause the development of bruxism, however others argue that there is insufficient evidence to draw such a conclusion.


  • Tooth wear
  • Tooth mobility
  • Pain


  1. Repairing the damage to teeth

    Bruxism can cause significant tooth wear if it is severe, and sometimes dental restorations (crowns, fillings etc.) Some of these dental structures may be restored with crowns or whitefillings.

  2. Dental guards and occlusal splints

    It is an acrylic plate used mostly at night.

  3. Psychosocial interventions

    Given the strong association between awake bruxism and psychosocial factors. The relationship between sleep bruxism and psychosocial factors is unclear.

  4. Medication

    Many different medications have been used to treat bruxism, including benzodiazepines, anticonvulsants, beta blockers, dopamine agents, antidepressants, muscle relaxants, and others.

  5. Botox

    Botox injections are used in bruxism on the theory that a dilute solution of the toxin will partially paralyse the muscles and lessen their ability to forcefully clench and grind the jaw.

  6. Occlusal adjustment/reorganization







