Lip lengthening

Temporomandibular
Joint Disorders
(TMD, TMJ)

Well as internal components of the joint, are collectively known as temporomandibular disorders

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. Inside the jaw joint, there is a smooth material called cartilage, covering part of the bones. 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.

Temporomandibular Joint Disorders

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
  • Movement 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
Common symptoms include

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).

How is it Diagnosed?

Many other conditions cause similar symptoms — like tooth decay, sinus problems, arthritis, or gum disease. To figure out what’s causing yours, the OMF Surgeon will ask about your health history and conduct a physical exam.

He’ll check your jaw joints; he’ll test your bite and check for problems with your facial muscles.

Full face X-rays may be needed to see both the jaws, temporomandibular joints and all teeth to rule out other problems. Some cases may need to do other tests, like magnetic resonance imaging (MRI) or computer tomography (CT).

TMJ

how is it diagnosed

Till you go to see the OMF Surgeon, there are some lifestyle changes you can do on your own to mitigate TMD symptoms.

  • Analgesicscan relieve muscle pain and swelling temporarily.
  • Use moist heat or cold packs. Jaw stretches should be done only when advised by the doctor.
  • Eat soft foods. Skip hard, crunchy, chewy foods and thick or large bites that require you to open wide.
  • Avoid extreme jaw movements.Keep yawning and chewing (especially gum or ice) to a minimum and don’t yell, sing, or do anything that forces you to open wide.
  • Maintain good posture. Don’t rest your chin on your hand.Don’t hold the phone between your shoulder and ear. Practice good posture to reduce neck and facial pain.
  • Keep your teeth slightly apartas often as you can. This will relieve pressure on your jaw.
  • Learn relaxation techniques to help loosen up your jaw. Consider stress reduction therapy as well.

How to manage TMJ pain?

Traditional Treatments

  • Your dentist can prescribe appropriate NSAIDs & Muscle Relaxants if you need them for pain and swelling. Muscle relaxants, anti-anxiety drugs, and antidepressants should be taken by prescription only.
  • 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.
  • Dental work.Your dentist can replace missing teeth and use crowns, bridges, or braces to balance the biting surfaces of your teeth or to correct a bite problem.
  • 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.

Transcutaneous electrical nerve stimulation

  • Ultrasound. 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.

Ultrasound

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.

  • Arthrocentesis is 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.

Arthrocentesis

  • 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.

Arthroscopy

Open-joint surgery. You may need this type of surgery if:

  • The bony structures in your jaw joint are wearing down
  • You have tumors in or around the joint
  • Your joint is scarred or full of bone chips

You’ll get general anesthesia, then the surgeon will open up the entire area around the joint so he can get a full view and better access.

Open-joint surgery

  • Total joint replacement – very occasionally a jaw joint can be so damaged that replacement with an artificial joint may be beneficial.

Total joint replacement

Surgery for TMD

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. Most people do not need injections or surgery and will get better with simple treatments and time.

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