Do MADs Really Cause TMJ Pain?
Dr. Peter Balacky, DDS
Mandibular advancement devices (MADs) are a popular treatment option for obstructive sleep apnea (OSA) and snoring. These devices work by moving the lower jaw forward, keeping the airway open during sleep. While effective, some users report experiencing temporomandibular joint (TMJ) pain or inflammation. But how common is this issue?
Understanding TMJ’s and Their Role
The temporomandibular joints (TMJs) connect the lower jaw (mandible) to the skull. Think of themlike a sliding hinge thatallows movement of the jaw up and down and side to side. Given their complexity these joints can be susceptible to pain and inflammation, especially when subjected to unusual or prolonged stress.
How MADs Work
MADs are designed to treat OSA and snoring by repositioning the lower jaw forward. This forward movement helps keep the airway open, reducing the risk of airway collapse during sleep. While this treatment mechanism is highly effective for many patients, it can introduce stress on the TMJ’s.
Potential TMJ Pain from MADs
While it's not uncommon for users to experience some level of TMJ discomfort when they first start using a MAD, this pain is typically minor and temporary. As the jaw and surrounding muscles adjust to the new position, the discomfort often diminishes. For many, this acclimation period lasts a few days to a couple of weeks.
Managing TMJ Pain
If TMJ discomfort is experienced while using a MAD, there are several ways to manage and alleviate the discomfort:
- Gradual Adjustment: MADs allow for gradual advancement of the lower jaw. Starting with a small forward position and slowly increasing or decreasingthe position can help the jaw adapt more comfortably (as directed by a dentist).
- Jaw Exercises: Performing specific jaw exercises can strengthen the muscles around the TMJ and improve their resilience. Daybreak provides a morning repositioning device to assist in these exercises.
- Heat and Cold Therapy: Applying heat or cold packs to the jaw area can help reduce inflammation and alleviate pain.
- Over the counter anti-inflammatories: Short term as needed use of over-the-counter anti-inflammatories can alleviate pain and discomfort while accommodating to a new jaw position.
- Soft Diet: Eating semi-solid & soft foods for a few days can help reduce the stress on the TMJ’s while accommodating to a new jaw position.
Long-Term Effects on the TMJ
Prolonged use of MADs involves keeping the lower jaw in a slightly forward position for extended periods during sleep. This can lead to TMJ discomfort for some users, however, significant or long-term damage to the TMJ is rare.
Conclusion
While MADs can cause TMJ pain or inflammation, the intensity is typically minor and temporary with most users reporting TMJ discomfort dissipating after only a few nights of use.