The temporomandibular joint (TMJ) is the hinge joint that connects the lower jaw (mandible) to the temporal bone of the skull, which is immediately in front of the ear on each side of your head. The joints are flexible, allowing the jaw to move smoothly up and down and side to side and enabling you to talk, chew and yawn. Muscles attached to and surrounding the jaw joint control the position and movement of the jaw.
What causes temporomandibular joint disorders?
The cause of TMJ disorders is not clear, but dentists believe it arises from problems with the muscles of the jaw or with the parts of the joint itself.
Injury to the jaw, temporomandibular joint or muscles of the head and neck – such as from a heavy blow or whiplash – can cause TMJ disorders. Other possible causes include:
- Grinding or clenching the teeth, which puts a lot of pressure on the TMJ
- Dislocation of the soft cushion or disc between the ball and socket
- Presence of osteoarthritis or rheumatoid arthritis in the TMJ
- Stress, which can cause a person to tighten facial and jaw muscles or clench the teeth.
Treatments for TMJ disorders range from simple self-help advice and conservative treatments to injections and surgery. Most experts agree that treatment should begin with conservative, non-surgical therapies first, with surgery left as the last resort. Many of the treatments listed below often work best when used in combination.
To relieve muscle pain and swelling, try non-steroidal anti-inflammatory drugs ( NSAIDs), such as aspirin or ibuprofen which can be bought over-the-counter. DXD dentist can prescribe higher doses of these or other NSAIDs or other prescription medications for pain such as opioid analgesics. Muscle relaxants, especially for people who grind or clench their teeth, can help relax tight jaw muscles. Anti- anxiety medications can help relieve stress that is sometimes thought to aggravate TMJ disorders. Antidepressants, when used in low doses, can also help to reduce or control pain. Muscle relaxants, anti-anxiety drugs and antidepressants are available by prescription only.
Low-level laser therapy
This is used to reduce the pain and inflammation as well as increase range of movement to the neck and in opening the mouth.
Surgery for TMJ disorders
Surgery should only be considered after all other treatment options have been tried and you are still experiencing severe, persistent pain. Because surgery is irreversible, it is wise to discuss this thoroughly with DXD Dental specialists to ensure you are happy with the proposed procedure.
Procedure is performed in the dental surgery under a general anaesthetic. It is undertaken for sudden-onset, closed-lock cases (restricted jaw opening) in patients with no significant prior history of TMJ problems. The operation involves inserting needles inside the affected joint and washing out the joint with sterile fluids. Occasionally, the procedure may involve inserting a blunt instrument inside of the joint. The instrument is used in a sweeping motion to remove tissue adhesion bands and to dislodge a disc that is stuck in front of the condyle.
Patients undergoing arthroscopic surgery for TMJ disorders are first given a general anaesthetic. The surgeon then makes a small incision in front of the ear and inserts a small, thin instrument that contains a lens and light. This instrument is linked up to a video screen, allowing the surgeon to examine the TMJ and surrounding area. Depending on the cause of the TMJ disorders, the surgeon may remove inflamed tissue or realign the disc or condyle.
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