TMJ Pain and Disorders

The temporomandibular joint connects the lower jaw, called the mandible, to the bone at the side of the head, the temporal bone. If you place your fingers just in front of your ears and open your mouth, you can feel the joint. Because these joints are flexible, the jaw can move smoothly up and down and side to side, enabling us to talk, chew and yawn. Muscles attached to and surrounding the jaw joint controls its position and movement.

Temporomandibular joint and muscle disorders, commonly called “TMJ disorders,” are a group of conditions that cause pain and dysfunction in the jaw joint and the muscles that control jaw movement. The temporomandibular joint is different from the body’s other joints. The combination of hinge and sliding motions makes this joint among the most complicated in the body. Also, the tissues that make up the temporomandibular joint differ from other load-bearing joints, like the knee or hip. Because of its complex movement and unique makeup, the jaw joint and its controlling muscles can pose a tremendous challenge to both patients and dentists when problems arise. People who have a rheumatic disease, such as rheumatoid arthritis, may develop TMJ dysfunction as a secondary condition.

TMJ disorders are also known as myofacial pain dysfunction and Costen’s syndrome. Because muscles and joints work together, a problem with either one can lead to stiffness, headaches, ear pain, bite problems (malocclusion), clicking sounds, or locked jaws.

Symptoms

  • Pain in the jaw, ear and face
  • Difficulty or discomfort for chewing
  • Locking of joint which makes in difficulty to open and close the mouth
  • Uneven and uncomfortable bite
  • Head ache
  • Jaw muscle stiffness
  • Clicking sound or grating sensation when you open your mouth or chew.
  • Dislocation of TMJ joint

Causes and risk factors

TMJ syndrome can occur if:

  • The disk moves out of its proper alignment
  • The joint’s cartilage is damaged due to rheumatic arthritis
  • The joint is damaged by a blow or other impact
  • The muscles that stabilize the joint become fatigued due to overwork to the jaw

Major risk factors are:

  • Teeth grinding and teeth clenching: Those who grind or clench their teeth may be unaware of this behaviour unless they are told by someone else.
  • Habituated to gum chewing or fingernail biting
  • Dental problems and misalignment of the teeth
  • Chewing on only one side of the jaw can lead to or be a result of TMJ problems.
  • Trauma to the jaws: Previous fractures in the jaw or facial bones can lead to TMJ disorders.
  • Stress: It is very common for people under stress to release this nervous energy by either consciously or unconsciously grinding or clenching their teeth.
  • Occupational tasks like holding the mobile between the head and shoulder may contribute to TMJ disorders.
  • Treatment for TMJ disorders and Pain

    In most of the cases pain in jaw joint can be temporary and self-care practices can ease your discomfort. A complete dental and medical evaluation is often necessary and recommended to evaluate patients with suspected TMJ disorders. The mainstay of treatment for acute TMJ pain is heat and ice, soft diet, and taking pain medications. If your symptoms persist, your dentist may recommend medications or a bite guard to help keep you from grinding your teeth at night. In very rare cases, surgery may be required to repair or replace the joint. Some of the self-care practices which can ease your symptoms are:

    • Use ice packs and heat in the face and jaw.
    • Eating soft foods
    • Reduce your stress
    • Practice gentle jaw stretching and relaxing exercises
    • Avoid extreme jaw movements

    If your symptoms and pain persists even after the self-care that you have taken you need to consult an orthodontist immediately. Orthodontist in our clinic has wide experience in correcting the TMJ disorders for past several years. He/ she may recommend the correct TMJ therapy that you require. Some of the treatment options available in our clinic are:

    • Pain Killers: If over-the-counter pain medications aren’t enough for jaw joint ache, TMJ specialist may prescribe strong medications.
    • Correction of bite abnormalities: Orthodontics or dental restorations to correct the bite abnormalities. Adjustments of your bridges or crowns act to ensure proper alignment of the teeth.
    • Neuromuscular orthodontics and Gnathology
    • Surgery: Surgery is indicated in those situations in which medical therapy has failed. It is done as a last resort. TMJ arthroscopy, ligament tightening, joint restructuring, and joint replacement are considered in the most severe cases of joint damage or deterioration.