I’m 17 and suffer from temporomandibular disorder (TMD). I was told to use a night guard 24/7 except while eating and brushing. I did so for one year but it was uncomfortable, hence for the past year I’ve been wearing it only at night, for my bruxism. Now I’m worried the condition will worsen.

TMD is a broad term used to describe a condition that causes pain and dysfunction of the muscles that move the jaw and the temporomandibular joints.

TMD could be due to bruxism (grinding of teeth, especially during sleep), any bite problems of the teeth, internal joint derangement, osteoarthritis or synovitis (swelling in the joint). Since you mentioned you have bruxism, it is quite possible that the TMD is a result of this habit. Habitual grinding places excessive force on the jaw joint and the associated structures. This can become damaging to the joint and the muscles surrounding it go into spasm to protect it, leading to TMD pain.

The treatment is focused on relieving the symptoms of pain. Conservative treatments such as local heat application, painkillers, muscle relaxants, a soft diet and simple jaw exercises are helpful. In case these do not work, 
a splint (bite guard) may be recommended. The bite guards are normally used during the night but can be extended during the days if clenching or grinding habits are apparent.

Since your symptoms are relieved, you may continue to wear a bite guard only at night. Have your teeth assessed by a dentist to see if you have bite problems that are triggering the TMD. If your symptoms are due to bruxism there’s no reason why it should get worse with time.

Avoid eating hard foods and chewing gum. Learn relaxation techniques to reduce stress and muscle tension. Consult a dentist who is experienced in treating TMD as it is important that it be diagnosed and treated early so that it does not cause further damage to the joints.

Surgical treatment for TMD is the last option and done only in very severe cases where the pain cannot be managed and the jaw joint movement is severely restricted. I do not think you need to worry about this since your symptoms are well controlled.