TMJ Disorder
What Is Temporomandibular Joint Disorder?
Temporomandibular joint (TMJ) is an anatomical part of the body. TMJ disorders are a family of problems related to your complex jaw joint. If you have had symptoms like pain or a “clicking” sound, you’ll be glad to know that these problems are more easily diagnosed and treated than they were in the past. These symptoms occur when the disc in the joints of the jaw is dislocated and slips excessively over the mandibular bones. The chewing muscles (muscles of mastication) also do not work together correctly. Since some types of TMJ disorder can lead to more serious conditions, early detection and treatment are important.
What Are The Causes Of TMJ Dysfunction?
TMJ disorders develop for many reasons. The most common cause is clenching or grinding your teeth, tightening your jaw muscles and stressing your TM joint. You may also have a damaged jaw joint due to injury or disease. Injuries and arthritis can damage the joint directly or stretch and tear the muscle ligaments. As a result, the disc, which is made of cartilage and functions as the “cushion” of the jaw joint, can slip out of position. Whatever the cause, the results may include a misaligned bite, pain, clicking, or grating noise when you open your mouth or have trouble opening your mouth wide.
What Are The Signs And Symptoms Of TMJ?
There are different stages in TMD. Initially Patients may notice early clicking upon opening and closing their mouth. This clicking may become painful later on. Occasionally, patients may find themselves with having a locked jaw. The normal mouth opening ranges from 35 to 45 mm. Open or closed lock means that the patient cannot open or close their mouth fully. If left untreated, the condition will become worse.
What Are The Risk Factors Of TMD?
- Stress
- Class II skeletal with high angle
- Malocclusion
- Trauma
- Arthritis
- Certain medications
How Is TMJ Disorder Diagnosed?
Dr. Jamali feels the best diagnosis is made by a full clinical evaluation with noting the past medical and dental history. A panoramic radiograph is also taken at the initial session. If needed, the patient will be sent to a radiology center to take a CT scan or MRI.
What Are The Possible Treatments For TMJ?
There are various treatment options that Dr. Jamali can utilize to improve the harmony and function of your jaw. Once an evaluation confirms a diagnosis of TMJ disorder, Dr. Jamali will determine the proper course of treatment. It is important to note that treatment always works best with a team approach of self-care joined with professional care.
The initial goals are to relieve the muscle spasm and joint pain. This is usually accomplished with a pain reliever, anti-inflammatory, or muscle relaxant medication or Botox. Steroids can be injected directly into the joints to reduce pain and inflammation. Self-care treatments can often be effective as well and include:
- Resting your jaw
- Keeping your teeth apart when you are not swallowing or eating
- Eating soft foods for 10 days
- Applying ice and heat
- Practicing good posture
Stress management techniques such as biofeedback or physical therapy may be recommended in addition to a temporary, clear plastic appliance known as a splint. A splint (or nightguard) fits over your top or bottom teeth and helps keep your teeth apart, thereby relaxing the muscles and reducing pain. There are different types of appliances used for different purposes. A night guard helps you stop clenching or grinding your teeth and reduces muscle tension at night, ultimately helping to protect the cartilage and joint surfaces. An anterior positioning appliance moves your jaw forward, relieving pressure on parts of your jaw and aids in disk repositioning. It may be worn 24 hours/day to help your jaw heal. An orthotic stabilization appliance is worn 24 hours/day or just at night to move your jaw into proper position. Appliances also help protect from tooth wear. After a few months of treatment with a night guard, if spasm continues, injecting Botox into muscles would be a good option. Botox basically paralyzes the muscles and relieves the tension.
Are There Preventative Steps Or Measures To Avoid A Condition?
If your jaw already clicks or have muscle pain in the area, you should do the following:
- Avoid chewing gum
- Avoid moving and keeping your jaw in an unnatural position
- Once you feel that grinding or clenching has started, night guard should be worn
- Avoid night guards that are sold over the counter in the stores
What Are The Risks If Left Untreated?
If TMD in initial stage is left untreated, it can eventually progress to higher stages. The associated symptoms are pain with opening and closing of the mouth, chewing, locked jaw and ultimately tear in the disc. Once this stage is reached, TMJ surgery is required to have the disc removed.
