Temporomandibular Joint Syndrome
Ligaments from different areas of the neck and head hold the joint together. This guides the movements of the jaw while providing support. The lower jaw’s motion is assisted by the muscles connected to the ligaments. The joint opens the mouth in two different ways. The joint is similar to a hinge in the way the mouth is opened and closed.
The lower jaw moves upwards and downwards in a sliding motion. This is referred to as translation. Some of the most common actions include eating, singing and yawning.
Quick Tips: Are you feeling the effects of TMJ damage or believe your pain is related to TMJ? Contact our Brooklyn dental office today to schedule your appointment and meet with a dentist to see if it’s a TMJ related issue.
The Potential Causes of TMJ Damage
Temporomandibular joint disorder results when there is damage to the TMJ. When the joint is fractured, it can become sore and swell. This limits the movement of the lower jaw. Severe pain will radiate to the neck and head. Fracturing the articular disc or arthritis of the TMJ is rare. This condition is unable to be treated with just anti-inflammatory drugs. In some cases, sore muscles and ligaments can be relieved with ice.
The Signs and Symptoms of TMJ
There are numerous signs of temporomandibular joint disorder. It is difficult to be certain if the individual has this condition because the majority of the signs can also indicate other issues. A proper diagnosis can be made by a dentist through a complete dental and medical history. The appropriate x-rays must be taken and a clinical examination performed for a diagnosis. The most common signs include:
• Headaches, earaches and pressure in the back of the eyes
• Difficulty biting or chewing
• An out of place, locked or stuck jaw or tenderness in the muscle
• Severe aching in the ear, jaw or face
• Facial swelling
• A popping or clicking sound when the mouth is opened or closed
• A sudden change in the way the individuals lower and upper teeth fit together (a dental occlusion)
Diagnosing TMJ Symptoms and Causes
There are numerous different causes of temporomandibular joint disorder. The individual needs to visit either a medical or dental professional for an examination. This is when the jaw will be examined and potential causes discussed. In most instances an examination involves the following:
• Feeling and listening to the joint when the mouth is opened and closed
• Pressing on areas near the jaw to identify the cause of the discomfort or pain
• Observing the jaw’s range of motion
If an issue is suspected, the following may become necessary.
• An examination of the jaw and teeth through x-rays
• Revealing issues with the surrounding soft tissue or joint disc through an MRI
• Detailed images of all the bones required for the joint through a CT scan
Diagnosis is an important step before treatment. Part of the dental examination includes checking the joints and muscles for tenderness, clicking, popping or difficulty moving. Depending on the diagnosis, the dentist may refer you to a physician or another dentist.
A temporomandibular joint disorder can sometimes be diagnosed with an arthroscopy. A small, thin tube called a cannula is inserted by a doctor into the joint space. An arthroscope or small camera can then be inserted so the area can be viewed. This can assist in the determination of a diagnosis.
In some instances, the symptoms of a temporomandibular joint disorder will go away with no treatment necessary. If the cause is unknown and the symptoms continue, there are numerous treatment options. Sometimes, more than one is used simultaneously. Medications combined with a non-surgical treatment can offer relief from the pain of a TMJ disorder.
If over the counter medications such as anti-inflammatories and pain relievers do not provide relief, the dentist or physician may prescribe pain relievers for a short period of time including prescription strength ibuprofen. Tricyclic antidepressants including amitriptyline are sometimes prescribed for depression.
In low dosages, these medications are effective for pain relief, sleeplessness and bruxism control. Muscle relaxants can be used for a few weeks or just a few days for the pain resulting from muscle spasms due to TMJ.
In many cases, the NIDCR also recommends a “less is often best” approach in treating TMJ disorders
The therapies not involving drugs used for TMJ disorders include:
Physical Therapy: Exercise is important for treating Temporomandibular joint disorder. In addition to exercise, strengthening and stretching the jaw muscles is important. The treatments may include ultrasound, ice, moist heat and exercise.
Occlusal Appliances: Appliances are used for TMJ such as mouth guards or oral splints. Individuals experiencing jaw pain often benefit from a firm or soft device placed over the teeth.
Counseling: Counseling and education enable the individual to understand the behaviors and factors triggering the pain so they can be avoided. This includes grinding or clenching the teeth and biting fingernails.
Surgical TMJ Procedures
When standard treatments are ineffective, the physician may recommend the following procedures.
Arthrocentesis: This procedure is minimally invasive. Small needles are inserted into the joint. This enables the irrigation of the fluid through the joint. Inflammatory byproducts and debris can then be removed.
TMJ Arthroscopy: In certain instances, arthroscopic surgery can treat different types of temporomandibular joint disorders as well as open-joint surgery. There are fewer risks and complications associated with TMJ arthroscopy than open-joint surgery. This procedure also as limitations.
Injections: Certain individuals will benefit from corticosteroid injections directly into the joint. Injections of (Botox) botulinum toxin type A directly into the muscles of the jaw may provide relief from the pain resulting from TMJ disorders.
Open-Joint Surgery: This is generally only an option if there is a structural issue diagnosed within the joint or if conservative treatments have been ineffective. The dentist or physician may recommend (arthrotomy) open-joint surgery to replace or repair the joint.
There are more risks with open-joint surgery than any of the other treatments. This procedure requires careful consideration. The individual should be aware of the pros and cons.
Modified Condylotomy: This is a way of indirectly addressing the TMJ. Surgery is performed on the mandible as opposed to the actual joint. This treatment is helpful for both locking and pain.
Contact our Brooklyn dental office today to schedule your appointment and meet with a dentist to see if it’s a TMJ related issue.