What are the TMJ disorders?

What is the TMJ?

The temporomandibular joint (TMJ for short) acts like a sliding hinge that connects the jaw to the side of the head. There are two paired temporomandibular joints, one on each side of the head, located just in front of the ears. Each joint is made up of a cartilaginous disk, muscles, ligaments, blood vessels, nearby nerves and, of course, teeth.

When the temporomandibular joint works properly, it allows us to talk, chew and yawn. It is a very necessary and highly used joint in our daily lives. But if it doesn’t work as expected, it can lead to some pretty annoying and painful conditions.

TMJ disorders

What are the TMJ disorders?

The abbreviation “TMJ” literally refers to the name of the joint, but when talking about TMJ disorders, it’s often used to refer to any pathology or symptom of this region. Thus, temporomandibular muscles and joint disorders are problems that affect the joints and muscles of mastication that connect the lower jaw to the skull.

TMJ disorders are more common among women in their 20s or 40-50s. In exceptional cases, it can also affect babies, since it is possible to be born with anomalies in the temporomandibular joint.

There are three types of alterations:

  • Myofascial pain: It can appear in patients with a normal temporomandibular joint. The syndrome is caused by tension, tiredness, or spasms in the muscles of mastication, causes pain in the muscles that control the jaw, and often results in jaw mobility abnormalities.
  • Internal asymmetry: It is the most common form of joint alteration. It is caused by a displaced disc, misalignment, a dislocated jaw, or condyle injuries. The most frequent symptoms are localized joint pain and clicking sounds when moving the joint.
  • Degenerative and inflammatory changes

What causes this?

Many TMJ-related symptoms are caused by the effects of physical stress on the structures around the joint. These structures include:

For many people with TMJ disorders, it is often difficult to determine the cause of this condition. Pain can appear due to a combination of factors:

  • Congenital and developmental disorders: they give rise to aplasias, hypoplasia and hyperplasia.
  • Malocclusions: if we alter the balance of the occlusion, the cartilage of the temporomandibular joint can be affected, giving rise to muscle problems, headaches and, over time, jaw dysfunction.
  • Disorder of the condyle-disc complex: it involves anatomical, condylar alterations, anterior displacement of the disc and disc dislocations.
  • Metabolic diseases
  • Infections
  • Condylar subluxation: it is a dislocation with or without displacement of the disc due to the laxity and weakness of the ligaments. It can be caused by an excessive and sustained mouth opening over time. It causes pain and difficulty when closing the mouth.
  • Neurological pathologies
  • Muscular disorders: cause myofascial pain, myositis, spasms and contractures.
  • Dental loss: with the loss of dental pieces, the maxillofacial bone begins to lose bone. That, in the long term, can lead to joint problems.
  • Trauma: Fractures, tears, or breaks in the joint may occur due to trauma.
  • Neoplasms
  • Osteoarthritis
  • Disc-condylar and disc-fossa adhesions
  • Ankylosis: is the loss of joint movement due to the fusion of the bones that are inserted in the joint or due to calcification (calcium deposit in the tissues) of the ligaments that surround it. Most often, ankylosis is caused by injury or infection, but it can be present from birth or be caused by rheumatoid arthritis.
  • Physical overload
  • Stress or depression: can cause physical effects on the structure around the joint, leading to teeth grinding (also known as bruxism).
  • Inflammatory disorders: they can produce capsulitis and synovitis in the joint.

Other possible causes of TMJ-related symptoms include, but are not limited to: arthritis, fractures, dislocations, and structural problems present at birth.

What are the symptoms?

In people with temporomandibular dysfunction, problems with the joint and the muscles around it can cause symptoms, such as:

  • Pain in the face, jaw or neck.
  • Pain around, in front or in the ear.
  • Pain on both sides of the head.
  • Pain on one side of the head, which is activated by clenching the teeth.
  • Pain or tenderness in the muscles and/or jaw joint.
  • Limited movement or locking of the jaw.
  • Jaw lock
  • Stiffness in the jaw muscles.
  • Difficulty or discomfort biting or chewing.
  • A change in the way the teeth fit together.
  • Muscle spasms around the jaw.
  • TMJ disorders can also cause a clicking or grating sensation when opening the mouth or chewing. However, if there is no pain or limitation of movement, it is very likely that the person does not need specific treatment.

What tests and exams are necessary?

It may be necessary to see more than one specialist for TMJ pain and symptoms. This may include a health care provider, dentist, or ear, nose, and throat doctor, depending on your symptoms.

You will need a complete exam that involves:

  • A dental evaluation that can show if you have a misaligned bite.
  • Palpate the joint and muscles for tenderness.
  • Press around the head to locate tender or painful areas.
  • Slide your teeth from side to side.
  • Observe, feel and listen when opening and closing the jaw.
  • X-rays, CT scan, MRI, Doppler TMJ test.
  • Sometimes the results of the physical exam may appear normal.

Your provider will also need to consider other conditions, such as infections, nerve-related problems, ear infections, and headaches, that may be causing your symptoms.

How do we treat TMJ disorders?

Jaw pain may go away with little or no treatment. The treatment can go through the application of simple practices, for example, eating soft foods or applying ice. But it may also require the use of pain relievers or devices to be placed in the mouth. In ProDental Studio, we assess the situation of each patient to recommend the application of conservative treatments or the use of surgery:

Conservative treatments

  • Stabilization splints: These devices serve to deprogram, modify sensory stimulation, reduce activity and, therefore, muscle pain that is produced by constant mandibular pressure.
  • Physiotherapy: Some appropriate physiotherapy techniques associated with dental treatment can improve the quality of life of patients.

Surgical treatments

  • Arthrocentesis: Using two intra-articular needles, a joint lavage is performed to remove all microscopic particles and then inject a solution to help lubricate the joint.
  • Arthroscopy: An intra-articular camera (arthroscope) may be inserted to allow the surgeon to examine the joint, remove inflammatory tissue, and manipulate the structures.
  • Joint replacement: If the problem causes great functional disability and conservative measures fail to respond, the treatment suggests replacing the joint with an artificial prosthesis.
  • Open surgery: In the event that the patient presents a tumor in the joint, it may be necessary to perform open surgery on the joint so that the specialist can access the interior and remove the damaged tissue.

Do you want more information or have any doubts left? Contact us here and we will happily help you.

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