TMJ Disorders
The Frequency of Issues with the Temporomandibular Joints
Temporomandibular joint disorders (TMJ), also known as temporomandibular disorders (TMD), are the most common cause of chronic facial pain and jaw dysfunction, according to the National Institute of Dental and Craniofacial Research (NIDCR). It is estimated that temporomandibular joint issues affect over 10 million individuals in the US.
The Temporomandibular Joint: What Is It?
The human body possesses a pair of temporomandibular joints that serve as the connection between the lower jaw’s left and right sides and the temporal bone. These joints, along with the muscles, ligaments, and tendons associated with them, work harmoniously to facilitate a range of oral functions as the jaw moves vertically, horizontally, and laterally. At the core of these joints lies a soft, shock-absorbing disc that rests between the rounded condyles of the lower jaw and the corresponding concavities in the skull’s temporal bone. This dynamic structure, known as the TMJ, enables essential activities such as chewing, speaking, yawning, and various other jaw movements. Due to the TMJ’s complex nature, accommodating both hinge-like up and down movements as well as sliding motions from side to side and front to back, it is widely regarded as one of the most intricate joints within the human body. Consequently, addressing issues that arise within the TMJ proves to be remarkably challenging.
Different Types and Signs of TMJ Disorders
TMJ disorders encompass three distinct categories, each presenting unique characteristics and causes:
1. Myofascial pain: This type of TMJ disorder refers to the pain experienced in the jaw joint area. It occurs as a result of heightened muscle tension and spasms caused by various factors.
2. Internal derangement: In this category, the TMJ disorder arises due to the displacement of the disc within the joint, jaw dislocation, or trauma inflicted upon the condyles of the jaw.
3. Degenerative joint disease: Also known as arthritis, this form of TMJ disorder involves the gradual deterioration of the joint over time.
The risk of developing a problem with the temporomandibular joint (TMJ) increases when there is a long-term habit of grinding or clenching teeth, referred to as bruxism, or due to a jaw injury or certain types of arthritis like rheumatoid arthritis or osteoarthritis. Additionally, the symptoms and signs of a TMJ disorder can vary extensively from person to person, encompassing a wide range of possible manifestations. These may include earaches, a sensation of ringing in the ears (known as tinnitus), headaches, pain in the back and neck, dizziness or a feeling of spinning (vertigo), muscle spasms, tenderness in the joint, as well as jaw pain, noises like popping or grating with jaw movement, jaw locking, and limited jaw mobility. While some individuals may find resolution of their TMJ disorder within a relatively short period, others may continue to experience persistent symptoms despite undergoing extensive therapy.
Assessment and Management
When assessing the presence of a TMJ disorder, the dentist will conduct a comprehensive clinical examination of joint symptoms and functionality. Additional diagnostic tests, including specialized radiographic imaging, will be conducted as required. The treatment for a TMJ disorder may encompass the use of oral appliances such as night guards or stabilization splints to alleviate strain on the joints. Other therapeutic approaches may involve steroid injections, adjustments to the way the teeth fit together, as well as orthodontic or prosthodontic interventions to enhance the alignment of the teeth. In cases where TMJ problems persist and become severe, surgery may be recommended. Self-care methods can be beneficial in alleviating some TMJ disorder symptoms. Patients are commonly advised to consume soft foods, avoid excessive jaw movements such as wide yawning and gum chewing, practice stress reduction techniques, and apply ice packs or moist heat as directed. If advised, individuals should comply with the gentle stretching exercises prescribed by their dentist or therapist. Over-the-counter non-steroidal anti-inflammatory drugs and pain medications may provide temporary relief. If not, the dentist or physician may prescribe stronger pain or anti-inflammatory drugs, muscle relaxants, or antidepressants.