Temporomandibular Joint Disorders
The Temporomandibular (TM) Joint termed to as the jaw joint, allow all possible movements of the lower jaw. You have two TM joints which work together as a pair, one in front of each ear. The joints connect the lower jaw bone (the mandible) to the bones of the skull on each side of the head. The muscles controlling the joints are attached to the lower jaw and allow the jaw to move in three directions: up and down, side to side, and forward and back. The synchronized, combined movement of both the joints, and its complex anatomy and biology distinguishes it from the other joints in the human body.
What are Temporomandibular joint Disorders (TMD)?
It is a complex set of conditions characterized by pain in the jaw joint, its surrounding tissues, possibility of production of “click sound” while opening of mouth causing limitation in jaw movements. These conditions can lead to various problems if not detected and treated earlier.
Reasons for TMJ disorders:
Owing to the complexity of the jaw joint, there can be multiple reasons a patient develops TMJ disorders. Here are few of the most common causes:
- Improper restoration of a tooth.
- Injuries to the jaw joint area.
- Various forms of arthritis.
- Autoimmune diseases ( condition where body’s immune cells attack healthy tissue).
- Bruxism ( constant grinding or clenching of teeth).
- Other rare genetic or hormonal factors.
Do you have a TMJ disorder?
- Are you aware of grinding or clenching your teeth?
- Do you wake up with sore, stiff muscles around your jaws?
- Do you have frequent headaches or neck aches?
- Does the pain get worse when you clench your teeth?
- Does stress make your clenching and pain worse?
- Does your jaw click, pop, grate, catch, or lock when you open your mouth?
- Is it difficult or painful to open your mouth, eat or yawn?
- Have you ever injured your neck, head or jaws?
- Have you had problems (such as arthritis) with other joints?
- Do you have teeth that no longer touch when you bite?
- Do your teeth meet differently from time to time?
- Is it hard to use your front teeth to bite or tear food?
- Are your teeth sensitive, loose, broken or worn?
The more times you answered “yes”, the more likely it is that you have a TMJ disorder. Understanding TMJ disorders will also help you understand how they are treated.
There are various treatment options that we utilize to improve the harmony and function of your jaw. Once an evaluation confirms a diagnosis of TMJ disorder, we determine the proper course of treatment. It is important to note that treatment always works best with a team approach of self-care joined with professional care.
The initial goals are to relieve the muscle spasm and joint pain. This is usually accomplished with a pain reliever, anti-inflammatory or muscle relaxant. Self-care treatments can often be effective as well and include:
- Resting your jaw
- Keeping your teeth apart when you are not swallowing or eating
- Eating soft foods
- Applying heat
- Exercising your jaw
- Practicing good posture
Stress management techniques such as biofeedback or physical therapy may also be recommended, as well as a temporary, clear plastic appliance known as a splint. A splint or night guard fits over your top or bottom teeth and helps keep your teeth apart, thereby relaxing the muscles and reducing pain. There are different types of appliances used for different purposes. A night guard helps you stop clenching or grinding your teeth and reduces muscle tension at night and helps to protect the cartilage and joint surfaces. Appliances also help to protect from tooth wear
Surgery is generally reserved for patients with severe locking symptoms and/or pain not responding to conservative, medical treatments. Procedures may range from arthrocentesis (rising joint) to open-joint surgery. One of the most successful, yet conservative TMJ surgical procedures is called Modified Condylotomy. It helps reduce pain and locking symptoms by creating an increase in the space within the joint. It does not involve an incision on the face, thus reducing scarring both of the skin and inside the joint.