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TMJ Disorders

Definition


Disease: TMJ Disorders TMJ Disorders
Category: Bones, joints, muscles diseases
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Disease Definition:

TMJ (temporomandibular joint) is the joint that attaches the jaw to the skull, permitting it to perform its functions in chewing, yawning and talking. TMJ disorders cause pain and tenderness in this joint. Statistics show that women are more susceptible to develop these disorders.

Usually, TMJ disorders are treated with self care measures and with nonsurgical treatment or dental and surgical procedures if the case is more severe.

Work Group:


Prepared by: Scientific Section

Symptoms, Causes

Symptoms:

People with TMJ disorders may experience the following symptoms:

 

  • Pain or tenderness of the jaw
  • Aching pain in and around the ear
  • Difficulty or discomfort while chewing
  • Aching pain in the face
  • Difficulty with jaw movement
  • Headache
  • Uncomfortable bite
  • An uneven bite, due to the premature contact of one or more teeth


Most TMJ disorders are associated with a grating sensation, clicking sound and limited movement while opening the mouth or chewing.

A dentist or a physician should be consulted when noticing the above mentioned symptoms.

Causes:

The TMJ is one of the most complex joints in the human body, since it combines both translational and rotational motion in one joint. The lower jaw joint is a rounded one that translates in its socket attached to the upper joint while talking, chewing and yawning. Both parts are covered with cartilage and are separated by damper disks to ensure smooth movement.

TMJ disorders are due to:

 

  • Wear or dislocation of disks
  • Damage to the cartilage by arthritis
  • Damage to the joint due to impact
  • Fatigue of the muscle that holds the joint together due to frequent overload


In numerous cases TMJ cannot be diagnosed based on the apparent symptoms. Some of the factors that increase the risk of TMJ disorders are:

 

  • Being a woman between 30 and 50
  • Clenching of the jaw
  • Grinding of teeth (bruxism)
  • Rheumatoid arthritis
  • Fibromyalgia
  • Impact to the face or jaw
  • Congenital deformity of the facial bones

Complications

Complications:

None

Treatments:

Some TMJ disorders may disappear with no need for treatment, and some other persistent cases are treated with medications or bite guards to prevent teeth grinding while asleep. In some other more severe cases, surgical relocation or repair of the joint may not be avoided.

MEDICATIONS:

Nonsteroidal anti-inflammatory drugs (NSAIDs):
Ibuprofen or aspirin, which are over-the-counter NSAIDs, may not relieve the pain resulting from TMJ disorders. But it has been proven that naproxen along with jaw muscle stretching exercises can be helpful.

Tricyclic antidepressants:
When these are taken before going to sleep, they can help in relieving the pain associated with TMJ disorders. Examples are amitriptyline or nortriptyline.

Muscle relaxants:
These may be used for a relatively short period of time (few days to few weeks), since they can be addictive and their dosage should be decreased gradually. Carisoprodol is one example.

Corticosteroid drugs:
In cases of joint inflammation accompanied with severe pain, a corticosteroid medication is injected right into the joint.

Botulism toxin:
When this is injected into the jaw muscles, it can relieve pain while chewing.

THERAPIES:

Bite guards:
These are soft or firm devices put over the teeth to prevent them from grinding while asleep and in some cases they aggravate the symptoms of sleep apnea.

Cognitive behavioral therapy:
In case TMJ disorders are deteriorating due to anxiety or stress, the patient should be transferred to psychotherapist to improve relaxation, stress management techniques along with increasing awareness and possibly change behaviors.

SURGICAL OR OTHER PROCEDURES:

Corrective dental treatment:
This is done by balancing the biting surfaces of the patient’s teeth, via replacing crowns, fillings or missing teeth.

Arthrocentesis:
In this procedure, debris and inflammatory byproducts are flushed away by injecting fluid into the joint through a needle.

Surgery:
When all other procedures fail to treat a case, the patient should be transferred to an oral and maxillofacial surgeon. Surgical removal or repair of the disk between the mandible and temporal bone may yield in successful results. A partial or total joint replacement may help remove bone-on-bone contact and improve joint mechanics and motion, in case advanced osteoarthritis is present.

Prognosis:

Not Available

Expert's opinion

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