Temporomandibular joint TMJ dysfunction causes pain and sensitivity in the jaw joints and surrounding muscles and ligaments.
Causes can be teeth grinding, jaw injury, arthritis and daily tooth wear.
TMJ disorders are a group of more than 30 conditions that affect the jaw joint and surrounding muscles. These conditions can cause several problems, including jaw pain, headache and difficulty opening and closing the mouth.
A person has two temporomandibular joints – one on each side of the face, directly in front of the ears. TMJ connects the lower jaw bone with the skull and participates in the processes of chewing and speech.
From 5% to 12% of the adult population have some form of TMJ disorder. This condition is twice as common in women. Most often such disorders are observed in people aged 20 to 40 years.
Types of TMJ dysfunction
TMJ disorders are classified into three categories:
- jaw joint disorders;
- chewing muscle disorders;
- headaches that occur as a result of TMJ dysfunction.
Symptoms and causes
Symptoms of TMJ disorders are very diverse, it can be:
- jaw pain;
- pain in the face area;
- pain in the shoulder or neck;
- stiffness in the jaw;
- difficulty opening or closing the mouth;
- clicking or crunching of the jaw;
- headache;
- migraine;
- ear pain;
- tooth pain;
- tinnitus (ringing in the ears).
There is no single cause of TMJ dysfunction. Rather, it can be the result of many different factors or their combination.
Causes of dysfunction can be:
- jaw injury (for example, broken or dislocated jaw);
- grinding or clenching teeth (bruxism);
- arthritis in the jaw joint;
- incorrect bite (when teeth do not close as needed);
- stress.
It is not always possible to control the factors that cause TMJ dysfunction, but certain habits can increase risks. For example, poor posture can create excessive pressure on the muscles of the neck, shoulders and face. Also, chewing pens, pencils or other objects (a common “nervous habit”), ice or excessive chewing of gum can lead to TMJ problems. Consuming large pieces of food can overload the jaw muscles. You also need to control clenching or grinding teeth during the day and avoid sleeping on your stomach.
What are the complications of TMJ dysfunction
TMJ dysfunction can contribute to the development of a number of complications, including chronic pain, limited chewing function and tooth wear associated with bruxism.
Diagnosis and examination
A doctor can diagnose TMJ disorder during examination. Treatment of TMJ disorders is handled by a gnathologist doctor.
The physician will observe the range of movements when you open and close your mouth, press on the face and jaw to find areas of discomfort.
The specialist may prescribe an examination to get more information about your jaw joints and structures around them.
Digital diagnostics are also used to determine the cause of dysfunction.
Stages of digital diagnostics:
- CT of two jaws, jaw joints and cervical vertebrae;
- scanning of teeth to determine the bite condition;
- periodontal screening to assess gum condition;
- photo protocol, with the help of which the presence of chips, cracks and tooth wear and facial asymmetry is determined;
- assessment of the amplitude and trajectory of jaw movements for the presence of limitations in the joint, presence of movement asymmetry;
- myography to assess muscle condition;
- checking innervation, that is, whether the nerve bundle is compressed.
Treatment
Treatment depends on several factors, primarily the cause itself and the severity of pain. Doctors usually first try non-invasive treatment methods, but if symptoms do not improve, jaw surgery may be needed.
Medications. There are several types of over-the-counter (OTC) and prescription medications that can relieve symptoms of TMJ dysfunction, including painkillers, non-steroidal anti-inflammatory drugs and muscle relaxants (for people who clench teeth).
Mouth guards. Mouth guards can help move the jaw to the correct position or help reduce the consequences of grinding and clenching teeth.
Physiotherapy procedures. Physiotherapy procedures help “eliminate” old muscle memory and spasms and achieve uniform muscle tone. The main tools are shock wave therapy and manual individual work with each ligament.
Also, hyaluronic acid and drug therapy can be used to restore joint elasticity. With the help of kinesiotherapy, all muscles necessary in the work of the jaw system are activated.
Bite correction. After correcting the joint with the help of a cap, it is necessary to fix the obtained bite. For this, aligners or braces are used.
Tooth implantation. Absence of chewing teeth often leads to bite disorders. Therefore, implantation and prosthetics of teeth is an important stage of treatment of TMJ disorders
Lifestyle changes. Improving posture and avoiding chewing ice.
Surgical treatment
If medications and non-surgical methods do not help, you may need surgical intervention. Types of TMJ operations:
Arthrocentesis. Doctors often use this method for diagnostic purposes. Through a small puncture in the temporomandibular joint, a needle is inserted, which can remove fluid from the joint if necessary and relieve symptoms.
Arthroscopy of the temporomandibular joint. The surgeon makes a small incision directly in front of the ear and inserts a thin tube with a light and camera. Doctors call this “keyhole surgery”. They can insert surgical instruments through the tube to reshape bone, remove scar tissue or reposition the disc in the joint.
Open joint surgery. When keyhole surgery is not an option, the surgeon can perform open joint surgery. This requires a long incision so the surgeon has direct access to the jaw joint.
Prevention
You cannot always prevent the development of TMJ dysfunction, as some risk factors are inevitable. But there are things you can do to reduce risk:
- wear a mouth guard at night if you clench or grind your teeth, and during contact sports;
- when walking and sitting, try to keep your back straight;
- practice meditation, mindfulness or other stress reduction methods.
TMJ dysfunction affects everyone differently. For some, it is a temporary problem that disappears in a week or two. For others, it is a chronic condition that negatively affects quality of life. If you often have jaw pain, facial pain, headaches or other TMJ symptoms, contact YAREMA DENTAL clinic. Our specialists will help you find effective treatment.