TMJ DISORDER

 It is a group of disorders that cause pain and loss of normal function of the temporomandibular joint (TMJ), or jaw joint. The temporomandibular joint is located in front of the ear, on either side of the head.  The joint is made up of the lower jaw and the skull. A disc of cartilage, which acts as a shock absorber and lubricant for the joint, separates these two bones. The TMJ and masseter muscles allow you to open your mouth, speak, and chew.  TMJD can originate from the masticatory muscles, the cartilaginous disc, or the articular bone. 

 

 Position of the temporomandibular joint:- 

 

 1.Normal closed position :

 

 The lower jaw is separated from the skull by a cartilaginous disc that acts as a cushion when the joint functions, i.e., when chewing, speaking, and yawning. 

 

2. Normal open position :

 

 When you open your mouth, the disc moves along the lower jaw  and moves with you as you move your jaw up and down or side to side. 

 

 3.Anomalous :

 

 In an abnormal joint, the disc can be displaced or ruptured. If the disc slips or tears, it can cause difficulty moving the joint. When a disc ruptures, excessive wear and tear on the joint bones can occur, causing inflammation and pain. 

 

 Our dentists perform TMJ surgeries of varying complexity. These include: 

 

 # Simple joint cleaning (arthrocentesis) 

 # Inserting a probe through an incision to examine and treat the joint (arthroscopy) 

 # Open joint surgery 

 Signs and symptoms of TMJ disorders: 

 

1. Pain in the masticatory muscles and/or jaw joint (most common symptom) 

 

2. Pain radiating to the face or neck. 

 3.Jaw stiffness.  

  4. Limited  or locked jaw movement. 

   5. Painful clicking, cracking, or grinding sounds in the temporomandibular joint when opening or closing the mouth. 

6. Tinnitus, hearing loss, or dizziness. 

 TMJ can be caused by: 

1. Jaw injury (e.g., broken or dislocated jaw). 

2. Teeth grinding or clenching (grinding). 

3. Arthritis of the temporomandibular joint. 

4. Malocclusion (when  teeth do not fit together properly). 

5. Stress. 

 Factors that worsen TMJ dysfunction include: 

1. Using your teeth as tools (e.g., pulling tags off clothes). 

2. Poor posture. (This can put excessive pressure on the muscles of your neck, shoulders, and face.) 

 3.Chewing  pens, pencils, or other objects (a common nervous habit behavior). 

 

4. Chewing  ice or  chewing gum excessively. 

5.  Eating large pieces of food. (This can overstress your jaw muscles.) 

 6. Grinding your teeth during the day. 

 7. Sleeping on your stomach .

 How do doctors diagnose-:

 Your doctor can diagnose TMJ dysfunction during a dental exam or physical exam. During this visit, they will: 

 

 1.Observe your range of motion when you open and close your mouth. 

2. Press  your face and jaw to find areas of discomfort. 

 3.Feel the sensation of your jaw joint when you open and close your mouth. 

 4.They may also perform imaging tests to get a closer look at your jaw joint and the structures around it. 

These visual tests may include: 

 

1. Dental X-rays. 

2. CT (computed tomography). 

3. MRI (magnetic resonance imaging). 

4.TMJ arthroscopy (used for diagnosis and sometimes treatment). 

 Treatment Plan -:

 1.Medications: 

 There are several types of over-the-counter (OTC) and prescription medications that can help relieve TMJ symptoms. 

 

 Pain relievers, such as acetaminophen. 

 Nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen and naproxen.  Muscle relaxants (especially helpful for people who clench or grind their teeth) 

 Antidepressants (can change the way your body interprets pain) 

 Non-surgical treatments for TMJ: 

 Non-surgical treatment options include: 

 

1. Mouthguards- 

            Dental devices such as mouth splints or mouthguards can help place your jaw in a more favorable position or  reduce the effects of grinding . You can buy them at the drugstore, but it's best to get a custom-made mouthguard from your dentist.  

2.Physical therapy-

           This includes temporomandibular joint exercises that stretch the jaw and strengthen the muscles around the jaw joint. 

3.Ultrasound therapy.- 

         This treatment uses sound waves to deliver heat deep into the tissue. It increases blood flow and promotes muscle relaxation. 

 4.Transcutaneous electrical nerve stimulation (TENS). - 

      This method uses a weak electrical current to relax the jaw muscles. 

 Surgical Treatment of TMJ  

 If medications and nonsurgical treatments don't work, surgery may be necessary. Types of TMJ surgery include: 

 

1. Arthrocentesis - 

         Doctors often use this to find out why your TMJ is hurting. However, during this procedure,  a needle may be used to remove fluid from the joint and relieve symptoms. 

 2.TMJ arthroscopy -

               The surgeon makes a small incision just in front of your ear and inserts a thin tube with a light and camera. (You may hear your doctor call this keyhole surgery.) Surgical instruments can be inserted through the tube to reshape the bone, remove scar tissue, or move the disc in the joint. 

 

 Prevention: 

 

1. Wear a mouthguard if you clench or grind your teeth at night. 

 

2. Wear a mouthguard when playing contact sports.  

3.Practice good posture. 

4. Practice meditation, mindfulness, or other stress reduction techniques.