Just like with a knee joint, the TMJ can be damaged in
a number of ways, including dislocation, adhesion (getting
stuck), torn muscle or ligaments, and derangement (improper
relationship to the disk).
TMJ injury can happen as a result of
degenerative changes in the joint due to arthritis or
other diseases of the joint, or it can be the result of
a traumatic injury like a car accident, fall, or blow
to the jaw. TMJ problems can also appear gradually as
a result of clenching the jaws and bruxism (teeth grinding,
usually during sleep).
Symptoms
TMJ disorders are not uncommon and have
a variety of symptoms. Patients may complain of earaches,
headaches and limited ability to open their mouth. They
may also complain of clicking or grating sounds in the
joint and feel pain when opening and closing their mouth.
What must be determined, of course, is the cause.
The Joint, the Muscles or Both are the
Problem
Stress may trigger pain in the jaw muscles that is very
similar to that caused by TMJ problems. Affected patients
frequently clench or grind their teeth at night causing
painful spasms in the muscles and difficulty in moving
the jaw. Patients may also experience a combination of
muscle and joint problems. That is why diagnosing TMJ
disorders can be complex and may require different diagnostic
procedures.
| Function of the TMJ |
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| Temporomandibular joint — Normal closed position.
Jawbone is separated from skull by a soft disk that
acts as a cushion when you chew, speak or swallow. |
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| Temporomandibular joint — Noraml open position.
Disk stays in place when jaw is in use. |
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| Temporomandibular joint — Abnormal. Disk is pulled
forward when jaw is in use, causing the bone structures
to grind together. |
The Role of the Oral and
Maxillofacial Surgeon
When symptoms of TMJ trouble appear, an oral and maxillofacial
surgeon should be consulted. A specialist in the areas
of the mouth, teeth and jaws, the oral and maxillofacial
surgeon is in a good position to correctly diagnose the
problem.
Special imaging studies of the joints may be ordered
and appropriate referral to other dental or medical specialists
or a physical therapist may be made.
Determining the cause of a TMJ problem is important,
because it is the cause that guides the treatment.
Arthritis is one cause of TMJ symptoms. It can result
from an injury or from grinding the teeth at night. Another
common cause involves displacement or dislocation of the
disk that is located between the jawbone and the socket.
A displaced disk may produce clicking or popping sounds,
limit jaw movement and cause pain when opening and closing
the mouth.
The disk can also develop a hole or perforation, which
can produce a grating sound with joint movement. There
are also conditions such as trauma or rheumatoid arthritis
that can cause the parts of the TMJ to fuse, preventing
jaw movement altogether.
Range of Possible
Treatment
TMJ treatment may range from conservative dental and
medical care to complex surgery. Depending on the diagnosis,
treatment may include short-term non-steroidal anti-inflammatory
drugs for pain and muscle relaxation, bite plate or splint
therapy, and even stress management counseling.
Generally, if non-surgical treatment is unsuccessful
or if there is clear joint damage, surgery may be indicated.
Surgery can involve either arthroscopy (the method identical
to the orthopaedic procedures used to inspect and treat
larger joints such as the knee) or repair of damaged tissue
by a direct surgical approach.
Once TMJ disorders are correctly diagnosed,
appropriate treatment can be provided.
| Treatment Options for TMJ Disorders |
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| Bite splints or guards are commonly
used to treat TMJ disorders. |
 |
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|
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| Some of the TMJ surgical options your OMS may
consider include (a) Arthrocentesis — flushing fluid
from the joint and gently stretching it. (b) Arthroscopy
— using a miniature telescoping instrument to diagnose
and repair the joint. (c) Arthrotomy — open joint
surgery for more complex cases. |
TMJ | Top
