Description

The temporomandibular (tem-puh-roe-man-DIB-u-lur) joint, also called TMJ, acts as a hinge slider. Connects the jaw to the skull. There is one joint on each side of the jaw. TMJ disorders — a type of temporomandibular joint disorder or TMD — can cause pain in the jaw joint and muscles that control jaw movement.

The exact cause of TMJ disorder is often difficult to determine. The pain may be due to a combination of factors, including the habit of clenching your teeth, chewing gum, and nail biting; stress; and painful conditions that occur along with TMJ disorder such as fibromyalgia, osteoarthritis or injury in the jaw. The habit of clenching or grinding also known as bruxism.

Most of the times, the pain and discomfort associated with TMJ disorders only lasts for a limited time. Self-administered home care, physical therapy to the jaw, and the use of a mouthguard may be effective in the treatment of the symptoms of TMJ disorder. The surgery is usually a last resort after conservative measures have failed. But surgical treatments may help some people with TMJ disorders.

Symptoms

The symptoms of TMJ disorders may include:

  • Pain or tenderness in the jaw.
  • Pain in one or both temporomandibular joints.
  • Pain in and around the ear.
  • Having a hard time chewing or pain while chewing.
  • Pain facial pain.
  • The locking of the joint, making it difficult to open or close the mouth.
  • The pain of a headache.
  • The neck pain.
  • Pain in the eyes.
  • Pain in the teeth that occurs in conjunction with the jaw tenderness.

TMJ disorders can also cause a clicking sound or grating sensation when you open your mouth or chew. But if there's no pain or limitation associated with the movement of your jaw clicking, you probably don't need treatment.

When to see a doctor

Seek medical attention if you have constant pain or pain in the jaw that occurs suddenly or during the movements of the jaw, or if you can't open or close your jaw completely. Your dentist, specialist in ATM or other health care professional can discuss the possible causes and treatments.

Causes

The temporomandibular joint combines a hinge action with the movement of sliding. The parts of the bones that work together in the joint are covered with cartilage and are separated by a small shock-absorbing disk. This album in general follows the movement smooth.

Painful disorders of the TMJ can happen if:

  • The disk erodes or moves out of its proper relationship between the ball and socket of the joint.
  • A sprain or muscle strain occurs in the ligaments or soft tissue associated with TMJ disorders.
  • The arthritic damage to the joint cartilage.
  • A blow or other impact damages the joint.
  • The muscles of the jaw are associated with the ATM spasms.

Many times, the cause of TMJ disorder has a variety of causes and it is difficult to identify.

Risk factors

Factors that may increase the risk of developing TMJ disorders include:

  • The different types of arthritis, such as rheumatoid arthritis or osteoarthritis.
  • Injury to the jaw.
  • Habits such as chewing gum, nail biting, and grinding of teeth.
  • Certain diseases of the connective tissue.
  • The stress, post-traumatic stress disorder, anxiety, or depression.
  • Conditions such as fibromyalgia, ankylosing spondylitis and sleep disorders.
  • The habit of smoking.

Diagnosis

Your health care professional is likely to talk about their symptoms and the study of his jaw by:

  • Listen to and feel your jaw when you open and close the mouth.
  • Seeing the range of motion in your jaw.
  • By clicking on areas around your jaw to find the websites of pain or discomfort.

If your healthcare provider believes that there is a problem, you may need to:

  • Dental X-rays to look at the teeth and jaw.
  • Computed tomography scans to show detailed images of the bones involved in the joint.
  • The magnetic resonance imaging to show problems with the articulation of the disk or surrounding soft tissue.

Arthroscopy of the TMJ is sometimes used to diagnose a disorder of the TMJ. During arthroscopy of the TMJ, your health care professional inserts a small, thin tube, called a cannula into the joint space. Then, a small camera called an arthroscope is inserted to look at the area and help find a diagnosis.

Arthroscopy of the TMJ is also sometimes used to treat the TMJ disorder. The procedure can help with the therapy, such as the release of scar tissue and the elimination of inflammatory soft tissue and by-products to improve the symptoms of the TMJ and help the jaw to move without pain.

Treatment

Sometimes the symptoms of TMJ disorders may go away without treatment. If your symptoms do not go away, your health care professional may recommend treatment options, often more than one place at the same time.

Drugs

Along with other treatments that do not require surgery, these options may relieve the pain associated with TMJ disorders:

  • Analgesic and anti-inflammatory. If the pain medicines available without a prescription are not enough to relieve the pain in the TMJ, your healthcare provider may prescribe stronger pain relievers for a limited time, such as the prescription-strength ibuprofen (Advil, Motrin IB, others).
  • The tricyclic antidepressants. These medications, such as nortriptyline (Pamelor), are mainly used for depression. But in low doses, which are sometimes used to relieve pain, control bruxism and help with insomnia.
  • Muscle relaxants. These medications are sometimes used for a couple of days or weeks to help relieve pain caused by TMJ disorders to muscle spasms to create.

Therapies

Therapies for TMJ disorders that do not involve medications include:

  • Self-care. To relieve the symptoms, apply heat or ice, depending on the type of the TMJ symptoms. Avoid clenching your teeth, chewing gum, and nail biting. Good practice of resting the jaw posture with the tongue gently rested on the palate, teeth apart and your jaw in a relaxed position.
  • Oral splints or mouth guards. Often, people with pain in the jaw benefit by using a soft cloth or a firm device that is inserted over your teeth. The reasons for these assistive devices are not well understood.
  • The physical therapy. Along with exercises to stretch and strengthen the muscles of the jaw, the treatments may include ultrasound and transcutaneous electrical nerve stimulation, also known as TENS. Also, the damp heat and stretching are effective in repeated applications throughout the day.
  • Counseling. The education and counseling can help you learn more about the factors and behaviors that may worsen your pain, so that you can change your behavior. Examples include teeth clenching or grinding, resting on the chin, or nail biting.

Surgical or other procedures

When other methods don't help, your health care professional may be able to suggest procedures such as:

  • Arthrocentesis. Arthrocentesis (ahr-throe-sen-TE-sis) is a minimally invasive procedure that involves the insertion of small needles into the joint to which the fluid can flow through the joint to remove debris and inflammatory by-products.
  • Injections. In some people, corticosteroid injections into the joint can help. Rarely, injection of botulinum toxin type a (Botox, other) in the jaw muscles used for chewing may relieve the pain associated with TMJ disorders.
  • Arthroscopy of the TMJ. Sometimes the arthroscopic surgery can be as effective for the treatment of various types of disorders of the TMJ as open joint surgery. A small, thin tube, called a cannula is placed in the joint space. Then, an arthroscope is inserted, and small surgical instruments are used for the surgery. Arthroscopy of the TMJ has fewer risks and complications than open joint surgery. But it has some limitations.
  • Modified condylotomy. Modified condylotomy (kon-ihl-LOT-uh-mee) the address of the ATM indirectly, with surgery on the jaw, but not in the joint itself. You can relieve the pain and locking.
  • Open-joint surgery. If your jaw pain is not going with the most conservative treatment, and a structural problem in the set appears to be causing the pain, your health care professional may suggest open joint surgery to repair or replace the joint. But open-joint surgery carries more risks than other procedures. Think about this procedure, very carefully, after discussing the pros and cons with your health care professional.

If your healthcare provider recommends the surgery or other procedures, be sure to talk about the potential benefits and risks. Also, ask about all your options.

Lifestyle and home remedies

Be more aware of the habits associated with the stress — clenching your jaw, grinding your teeth or chewing pencils — so we don't do them as often. These tips may help you reduce symptoms of TMJ disorders:

  • Avoid overuse of jaw muscles. Eat soft foods. Cut food into small pieces. Get away from the sticky or chewy food. Do not chew gum.
  • Practice gentle stretching and massage. A physical therapist or another health professional can show you how to do exercises that stretch and strengthen your jaw muscles and how to massage the muscles yourself.
  • Apply heat or cold. The application of moist heat or ice pack to the side of your face may help relieve the pain. Acute pain is the best treatment with a bag of ice. Chronic dull pain is best treated with heat therapy. Apply heat or cold for 15 to 20 minutes several times a day. This approach, combined with stretching exercises, it has been found to be very effective.
  • Adjust your diet. Eat soft foods or small pieces of food, don't open your mouth too large, and eating foods with the use of utensils such as a spoon or fork can relieve the symptoms. The chewing of the food with both sides of the mouth, and not a single side it can also relieve the symptoms.

Alternative medicine

Complementary and alternative medicine techniques can help manage chronic pain often associated with TMJ disorders. Examples include:

  • Acupuncture. A specialist trained in acupuncture treats pain course through the insertion of hair-fine needles into specific locations in the body.
  • Relaxation techniques. Consciously slow down your breathing and taking deep, regular breaths can relax the tense muscles. This, in turn, can reduce the pain.
  • Biofeedback. Electronic devices for monitoring the tightness of the specific muscles can help to the effective practice of relaxation techniques.

Preparing for your appointment

Probably the first time you talk about your symptoms of TMJ with his family to the healthcare provider or dentist. If you suggested treatments do not provide enough relief, you may be referred to a health professional who specializes in disorders of the TMJ.

What you can do

Also you can prepare a list that answers these questions:

  • When did your symptoms begin?
  • Have you ever had this occur in the past?
  • Has your stress level has increased recently?
  • Do you have headaches, neck aches or pain from toothaches that occur often?
  • What medications and supplements that you take regularly?

What to expect from your doctor or dentist

Your health care professional may ask some of these questions:

  • Is the pain constant or do your symptoms come and go?
  • Does any activity seem to cause pain?
  • Does your jaw click or pop when you move it? Is that clicking painful?
  • It is difficult to open your mouth in the usual way?

Your health professional will ask more questions based on your responses, symptoms, and needs. Preparing and hoping questions will help you make the most of your time.

Symptoms and treatment of disorders of the TMJ