Woman at the dental office holding a hurt jaw

TMJ and Sleep Dentistry: What’s the Connection?

April 6, 2022

It is estimated that over 10 million Americans suffer from TMJ disorders, a common disorder that far too many people are familiar with. But what may be less understood is the connection between TMJ disorders and sleep. Let’s define TMJ disorders and sleep dentistry, talk about the connection between those disorders and sleep apnea, and discuss how to help patients improve their TMJ symptoms and their sleep quality.

Defining TMJ Disorders and Sleep Dentistry

To understand the connection between TMJ and sleep dentistry, let’s first define our terms.

Between your jawbone and your skull lives a little (but crucial) joint: the temporomandibular joint, or TMJ. This joint acts like a sliding hinge. Unfortunately, “TMJ disorders — a type of temporomandibular disorder or TMD — can cause pain in your jaw joint and in the muscles that control jaw movement,” explains the Mayo Clinic.

TMJ disorders, then, “are a group of more than 30 conditions that cause pain and dysfunction in the jaw joint and muscles that control jaw movement,” according to the National Institute of Dental and Craniofacial Research. There are three main classes of TMJ disorders: disorders of the joints, disorders of the muscles used for chewing, and headaches associated with TMJ disorders.

Now, how do we define sleep dentistry? Over the past several years, “doctors, sleep specialists, and dentists have worked together more and more, mostly on easing sleep apnea and snoring symptoms. About 50 million to 70 million Americans have ongoing sleep disorders, including about 18 million with sleep apnea,” according to WebMD. Sleep dentistry is this holistic partnership geared towards improving sleep through dental practice.

The Connection between TMJ and Sleep Apnea

We’ve talked about how TMJ and sleep dentistry are connected. Let’s then discuss how TMJ might factor into a case of obstructive sleep apnea (OSA). In OSA, the airway collapses, causing the body to automatically push the lower jaw forward to open up the airway. This process may occur up to hundreds of times in one night, which causes stress and tension to the TMJ, leading to a TMJ disorder.

One study published in the Journal of Dental Research found that a “high likelihood of OSA was associated with higher odds of chronic TMD.” It was also found that OSA symptoms were significantly associated with TMD, “with prospective cohort evidence finding that OSA symptoms preceded first-onset TMD.”

How to Improve TMJ and Your Sleep Quality

TMJ may go away on its own, but there are treatment options to prevent a chronic issue. Possible treatments for TMJ disorders include medications, therapies, and surgical or other procedures.

Medications to target pain associated with TMJ disorders:

  • Pain relievers and anti-inflammatories
  • Trycyclic antidepressants to help with pain, bruxism control, and sleeplessness
  • Muscle relaxants to target TMJ disorders caused by muscle spasms

Nondrug therapies:

  • Oral splints or mouth guards (the reasons these devices help are not well understood)
  • Physical therapy to stretch and strengthen jaw muscles
  • Education and counseling to understand behaviors that may aggravate pain, such as jaw clenching

Surgical or other procedures when other methods don’t help:

  • Arthrocentesis to irrigate fluid and remove inflammatory byproducts
  • Botox or other injections
  • TMJ arthroscopy, an option that is less invasive than open-joint surgery
  • Modified condylotomy, which may be particularly effective when jaw locking occurs
  • Open-joint surgery to repair or replace the joint

Possible treatments for OSA include oral appliances and treatments, like using a CPAP device, sleeping with a humidifier, and maintaining a healthy weight.

TMJ and sleep dentistry are connected because of the anatomy involved and the professionals who can help. Research has shown that TMJ disorders and OSA co-occur, so it’s important for dental professionals to be aware of the interplay between the two disorders. The good news is that there are treatments for both, and as OSA symptoms improve, TMJ symptoms may improve, too.