Jaw Joint Problems

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Temperomandibular Joint Disorders (TMD)

Your Temporomandibular joint is a hinge that connects your jaw to the temporal bones of your skull, which are in front of each ear. It lets you move your jaw up and down and side to side, so you can talk, chew, and yawn.

There is also a cartilage disc within the joint. The joint is lubricated by fluid called synovial fluid.

Problems with your jaw, the muscles in your face that control the joint, as well as internal components of the joint, are collectively known as temporomandibular disorders (TMD). But you may hear it wrongly called TMJ, after the joint.

 What Causes TMD?

It is believed that the symptoms arise from problems with the muscles of your jaw or with the parts of the joint itself. Injury or undue stress to your jaw, the joint, or the muscles of your head and neck can lead to TMD. Other causes include:

  • Grinding or clenching your teeth, which puts a lot of pressure on the joint
  • Wear / Displacement  of the soft cushion or disc between the ball and socket of the joint
  • Arthritis in the joint
  • Stress, which can cause you to tighten facial and jaw muscles or clench the teeth

 How do I recognize it ?

Common symptoms include:

  • Pain or tenderness in your face, jaw joint area, neck and shoulders, and in or around the ear when you chew, speak, or open your mouth wide
  • Jaws that get “stuck” or “lock” in the open- or closed-mouth position
  • Clicking, popping, or grating sounds in the jaw joint when you open or close your mouth or chew. This may or may not be painful.
  • A tired feeling in your face
  • Trouble chewing or a sudden uncomfortable bite — as if the upper and lower teeth are not fitting together properly
  • You may also have toothaches, headaches, neck aches, dizziness, earaches, hearing problems, upper shoulder pain, and ringing in the ears (tinnitus).
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How is it Diagnosed? 

FMS has an exclusive department for the diagnosis and management of the TMJ disorders.

The diagnosis involves

  • clinical examination
  • TM Joint view Xrays
  • CT SCAN / MRI scans if required
  • BIO-PAK system- T scan, 3D JAW TRACKER, EMG, JVA and TENS

(FMS has established the first TMD center in the state)

How to manage TM Joint disorders ?

The management of the TMJ disorders depends on the diagnosis and severity of the problem.

Mild cases it can be managed with home care combined with medication 

Till you go to see the TMJ Specialist, they will guide with lifestyle changes

  • Analgesics can relieve muscle pain and swelling temporarily.
  • Use moist heat or cold packs.
  • Eat soft foods.
  • Avoid extreme jaw movements like yawning and chewing  gum
  • Maintain good posture. Don’t rest your chin on your hand. Don’t hold the phone between your shoulder and ear.
  • Keep your teeth slightly apartas often as you can. This will relieve pressure on your jaw.
  • Learn relaxation techniquesto help loosen up your jaw. Consider stress reduction therapy as well.

Moderate TM Joint disorders

Your dentist can prescribe appropriate NSAIDs  & Muscle Relaxants

  • A splint or night guard.These plastic mouthpieces fit over your upper and lower teeth so they don’t touch. They lessen the effects of clenching or grinding and correct your bite by putting your teeth in a more correct position.
  • Occlusal correction Your dentist can replace missing teeth, use crowns, bridges, or braces to balance the biting surfaces of your teeth and correct the bite problems
  • Other Treatments
    • Transcutaneous electrical nerve stimulation (TENS).This therapy uses low-level electrical currents to provide pain relief by relaxing your jaw joint and facial muscles.
    • Deep heat applied to the joint can relieve soreness or improve mobility.
    • Trigger-point injections.Pain medication or anesthesia is injected into tender facial muscles called “trigger points” to give relief.
    • Radio wave therapy.Radio waves stimulate the joint, which increases blood flow and eases pain.

Severe cases of TM Joint disorders

Surgery for TMD

If other treatments can’t help you, or in very severe cases surgery is required. There are three types of surgery for TMD. The type you need depends on the problem.

  • Arthrocentesisis used if you have no major history of TMJ but your jaws are locked. It involves inserting needles into the joint to wash it out. He may use a special tool to get rid of damaged tissue or dislodge a disc stuck in the joint, or to unstick the joint itself.
  • Arthroscopy is surgery done with an arthroscope. This special tool has a lens and a light on it to let the surgeon see inside your joint. You’ll get general anesthesia, then the doctor will make a small cut in front of your ear and insert the tool. He may remove inflamed tissue or realign the disc or joint.
  • Open-joint surgery. You may need this type of surgery if the bony structures in your jaw joint are wearing down or joint is scarred
  • Total joint replacement – very occasionally a jaw joint can be so damaged that replacement with an artificial joint may be beneficial
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What is the Prognosis for TMJ disorders?

Generally the outlook is good. Most TMJ disorders improve over time with appropriate treatment. It is very rare to get any complications with this condition. Some people do have symptoms that last longer or recur, but even these can usually be improved with the treatments described above.

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