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TMJ is the quick way of referring to your Temporomandibular Joint. Pardon the pun, but that’s quite a mouthful! What is this joint, what does it do, and, if your Dr. Kathleen Chan and Dr. Ivy Chen and our team have told you that you have a TMJ disorder, what can we do to help?

The Temporomandibular Joint

Your two temporomandibular joints are amazing works of anatomical design. These are the joints where the temporal bone in the skull meets the mandible bone of the jaw, and allow our mouths to open and close, move back and forth, and slide from side to side. Muscle, bone, and cartilage work together to provide easy movement and to cushion the joint. But sometimes, the joint doesn’t work as smoothly as it should, and this can lead to Temporomandibular Joint Disorder, or TMD.

When Should You Suspect You Have TMD?

You might have TMD if you experience any of these symptoms:

• Painful chewing
• Pain around your TMJ, or in your face or neck
• Earaches
• Changes in your bite
• Jaws that are limited in movement or lock open or shut
• Clicking, popping or grating noises when you open and shut your jaw

There are many conditions linked to TMD. If you grind your teeth at night, have arthritis in the jaw, have suffered an injury or infection in the area, or have problems with your bite, for example, you might be more likely to have TMJ problems. If you suspect you have TMD, or suffer from any of the symptoms listed above for an extended period, give us a call.

Treating TMD

During your visit to our Andover office, we will check your medical history, and examine your head and neck. We can take an X-ray or scan if needed for further examination of the joint. Because there is no real scientific agreement yet about the best way to treat TMJ disorders, a conservative treatment plan is often best. If you do show signs of TMD, we might first suggest relaxation techniques, over-the-counter pain relievers, or the use of ice packs or moist heat compresses. A change to a softer diet can help, and you should stop chewing gum and making any exaggerated jaw movements.

If these self-care practices aren’t effective, we might suggest a nightguard. This appliance is a comfortable and flexible mouthguard custom fitted for you, and will bring relief from teeth grinding when worn at night. If this treatment is not effective, talk to us about other options.

Luckily, most cases of TMD are temporary and don’t become worse over time. But any persistent discomfort is a good reason to visit us. Whether you have TMD, or any other problem causing you pain in the head or jaw, we want to help.

You’re in the band and you’re getting braces. Now what? If you are a member of the string or percussion sections, you can go back to rehearsal. You’re good to go. When your talents have seated you in the reed or brass sections, though, a little adjustment might be necessary to keep your instrument and your braces working in harmony.

If you play a wind instrument, you know the term embouchure—the way you position and use your lips, tongue, facial muscles, and teeth to produce the sound you want. Depending on the instrument you play, you might be completely unaffected when you get your braces, or you might need to develop a more comfortable embouchure to accommodate them.

Wires and Woodwinds?

If you play a wind instrument such as the flute or piccolo, you might find that your normal lip positioning or blowing angle is affected by your braces, but usually the adjustment time is fairly short. Reed instruments such as the saxophone, clarinet, oboe, and bassoon are considered some of the easiest to adjust to when you have braces, but even though the single and double reed mouthpieces don’t require as much pressure as brass instruments, there can still be an adjustment period. One thing you should look out for is more condensation in your mouthpiece or instrument—be sure to keep your instrument clean to keep your sound pure.

Brackets and Brass?

Brass instruments require mouthpiece pressure. This leaves your lips pressed between the mouthpiece and your braces. For this reason, many brass players have a more challenging adjustment when wearing braces. Smaller mouthpieces (trumpet, French horn) usually require more pressure than larger ones (tuba, trombone). It’s important to learn how to use technique to avoid cuts, irritation, and other injuries caused by the pressure of your braces against your lips. Learning to play with less pressure on the lips and more air control and breath support will help you to recover your tone and range of notes while protecting your lips and mouth.

How Can We Help?

Let Dr. Kathleen Chan and Dr. Ivy Chen know if you play, or plan to play, a wind instrument. We might be able to offer some suggestions. For regular metal and ceramic braces, some musicians find extra wax is helpful in preventing lip and cheek injuries. There are brace guards available that can be applied over the braces to protect your lips and mouth if wax doesn’t do the trick.

There are also alternatives to regular bracket-and-wire braces, depending on your orthodontic needs, cost factors, and length of treatment. Invisalign® devices fit smoothly over your teeth and can even be removed when it is time to practice or play, as long as you get the necessary hours of wear in per day. In some cases, lingual braces, where the brackets and wires are placed behind the teeth, might be the best choice for you.

Finally, don’t forget to talk to your music instructor. Don’t be dismayed if you find the quality of your playing has been affected. Your teacher might have valuable suggestions for adjusting your embouchure, playing with less pressure on the lips, and developing better air and breath support. You might need to shorten your practice time at first, and there might be another period of adjustment after your braces come off.

Above all, take care of yourself! If something is poking your lip or cheek, call our Andover office immediately before it causes injury. It might be difficult at first, but finding an embouchure that works for your comfort and technique is worth it. And remember, these temporary fine-tunings will lead to a wonderful coda: skilled musicianship and a beautiful, healthy smile. Bravo!

If you’re brushing your teeth twice a day during your orthodontic treatment, Dr. Kathleen Chan and Dr. Ivy Chen and our team think that’s wonderful! But, don’t forget that it’s also important for you to visit your general dentist every six months, or as recommended, in addition to brushing your teeth and flossing. (And visiting Chan & Chen Orthodontics for regular adjustments, of course.)

Dental checkups are crucial for maintaining good oral health. Your general dentist can check for problems that might not be seen or felt, detect cavities and early signs of tooth decay, as well as catch and treat oral health problems early. During an oral exam, your dentist can also check the health of your mouth, teeth, gums, cheeks, and tongue. Checkups will also include a thorough teeth cleaning and polishing.

If you have not been to the dentist in the last six months, let us know during your next adjustment visit and we will provide a few great references in the Andover area!

Happy new year to all our wonderful patients! We are so grateful for our strong relationships and are looking forward to a healthy peaceful new year!

Any new smile new year’s resolutions? We would love to meet with you and let you know how to get started. Please make sure your regular checkups are up to date!

As we continue the battle against the widely prevalent Omicron variant, we wanted to take this time to go over a few procedural reminders for our patients. Check-in procedures remain the same. Please give us a call when you arrive, you will be asked some very important screening questions about symptoms, and we will let you know when to come upstairs, with your mask on. Your assistant will meet you in the hallway and accompany you into the office. We continue to encourage parents and guardians to wait in the comfort of your vehicle, when appropriate, and we will contact you to give you an update on the visit.

We look forward to seeing everyone this new year! As the pandemic wears on, we urge everyone to keep their guard up, stay home if sick, get vaccinated and boosted, and continue with protocols to ensure health and safety for our community.