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The temporomandibular joint (TMJ) connects the jaw to the skull and functions like a hinge to enable the opening and closing of the jaw. It is one of the most complex joints in the body and plays a vital role in chewing, swallowing, yawning and talking.
What Is TMJ Disorder?
Temporomandibular joint disorders are problems which affect the jaw joint. The jaw joint is located just in front of the ear canal, and it joins the jaw bone (mandible) to the skull near to the temple. The jaw joint is also called the temporomandibular joint (TMJ). Problems affecting this joint are usually known as TMJ disorders or jaw problems. However, there are various other medical terms for this condition – for example, TMJ dysfunction, TMJ pain and myofascial pain disorder.
Temporomandibular joint disorders, more plainly called “jaw problems” are terms describing a variety of signs and symptoms originating from the jaws. These might include pain in the jaws or headaches, reduction of range of jaw movement, jaw stiffness, clicking noises, or dislocation of the lower jaw following certain movements.
The pain is usually located just in front of the ear, and it may spread to the cheek, the ear itself, and to the temple. Headaches are very common when the main problem is muscle-related Jaw movements may be reduced. There may be a general tight feeling or a sensation of the jaw getting stuck. Very rarely, the jaw may get ‘locked’, causing difficulty in opening or closing the mouth. Clicks or noises can sometimes be heard coming from the jaw joint when you chew or move your mouth. These noises can be normal, so they are only relevant if you have other symptoms in the joint, such as pain or reduced movement. Because the ear is very close to the jaw joint, some people get ear symptoms such as noise in the ear, sensitivity to sound or dizziness (vertigo). A most common symptom is headaches and feeling “stiff” jaws, not being able to open the mouth wide; this condition may be associated with muscle spasm and fatigue.
The exact causes of TMJ disorders are unknown, but possible reasons are poor posture, gum chewing, grinding the teeth, whiplash, arthritis and stress which can cause teeth clenching. When suffering from any problems that affect the jaw, it is best to access treatment quickly to avoid further complications. Management is often relatively simple and painless and can make a huge difference to your quality of life.
If you’re currently experiencing any of the below issues, it could be a sign that you have TMJ syndrome:
- Difficulty or pain opening the mouth
- Chronic headaches or migraines
- Pain or tenderness in the neck, shoulder, jaw or ear when you speak, chew or try to fully open the mouth
- An uncomfortable bite
- Facial swelling
- Ear aches or ringing
- Noises like a grating, clicking or popping in the jaw joint when you open or close the mouth
- Aching pain in the face
Management of TMJ Problems:
Most problems in the jaw joint can be helped with simple treatments such as painkillers and advice on how to rest the joint, accompanied by some physiotherapy. There are various treatments which are often used in combination:
Resting the Jaw Joint
You can rest the joint by eating soft food and not using chewing gum. Also, avoid opening the mouth very wide – so don’t do too much singing, and try not to yawn too widely. Massaging the muscles and applying warmth can help. Other treatments are relaxation and stress-reducing therapies – presumably because people tend to clench their jaw when they are stressed, or because stress makes pain worse. Splints or bite guards are sometimes suggested. These are made of hard acrylic and are customised to your jaw, usually the upper. They cover the teeth at night to reduce clenching of the jaw. Research shows that they solve muscle issues in a majority of patients.
Painkillers such as paracetamol, ibuprofen or codeine can help. If these are not enough, muscle relaxants or a small dose of a medicine called a tricyclic antidepressant can give added pain relief.
Physiotherapy treatments, such as ultrasound and gentle jaw exercises, can be helpful.
Treatment of Other Conditions
If there is an underlying condition – for example, a type of arthritis which is contributing to the TMJ disorder – this may need treating in its own right.
Surgical Treatment of the TMJ
With more extreme cases of TMJ disorder, one of the below surgeries may be recommended:
- Arthrocentesis: a minimally-invasive outpatient procedure involving the injection of fluid into the joint to flush out the inflammation and decrease pressure.
- Arthroscopy: the insertion of a cannula into the joint through which surgery is performed. This option has a quicker recovery time because only a small incision is made.
- Open-Joint Surgery: the creation of a large incision over the joint that enables the dentist to perform a full operation. This TMJ treatment requires the longest recovery time.
What is the Outlook for Temporomandibular Joint Disorders?
Generally the outlook is good. Most TMJ disorders improve over time and do not get worse. It is very rare to get any complications with this condition. Some people do have symptoms that last longer or come back (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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