I recieved a recent question from someone through email who was asking how come their jaw still hurts even though they wear a nightguard for TMJ treatment.
There are many factors that can explain this. The first is that a nightguard helps relax the muscles. If a properly fabricated nightguard does not help, then it is not only a muscle problem. TMJ pain can be caused by degenerative changes in the joint and the neck as well. If someone has clicking or popping, or deviation on opening, earaches, headaches or even neck pain, there is most likely other factors involved rather than just the muscles.
These can require different types of TMJ treatment and a nightguard can even make the symptoms worse. A comprehensive neuromuscular dentistry exam including electrosonography can allow us to see what the problem is and how to treat it. Jaw joint 3D films and films of the neck reveal valuable information with regads to treatment and the type of damage that has been done.