The temporomandibular joint (TMJ) connects the mandible (lower jawbone) to the skull and this joint can be found on both sides of the head in front of the ears. TMJ disorder is a type of disorder that can cause tenderness, pain in the jaw joint and in the muscles that regulate jaw movement. The temporomandibular joint unites a fulcrum action with sliding movements. The parts of the bones that interact in the joint are enclosed with cartilage and are separated by a small shock-absorbing disk, which maintains smooth movement of the jaw. Generally, pain may be due to a combination of factors like genetics, arthritis, or jaw injury. Some people with jaw pain may tend to tighten or grind teeth.
Some of the signs and symptoms associated with this disorder include:
Pain or tenderness of the jaw
Pain in both sides of temporomandibular joints
Aching pain in the ears
Locking of the joint, making it hard to open or close mouth
This disorder can cause a clicking sound when you open your mouth or chew. However, if there’s no pain or limitation of movement associated with jaw clicking, then you may don’t need treatment for TMJ disorder.
The exact cause of this disorder is often hard to determine. Painful TMJ disorders can develop if:
The disc moves out of its position
Joint cartilage is harmed by arthritis
Joint is damaged by a knock or other impact
Rheumatoid arthritis and osteoarthritis can elevate the risk for TMJ
Connective tissue diseases can cause problems, which may affect the temporomandibular joint.
The doctor or dentist will assess the symptoms and examine the jaw and would keenly listen to and feel the jaw when you open and close your mouth.
Observe the range of movement in the jaw.
Press on regions around the jaw to identify sites of pain or discomfort.
The healthcare provider upon suspecting a problem may suggest doing the following test:
Dental X-rays to examine teeth and jaw
CT scan to get a detailed picture of the bones involved in the joint
MRI to identify any issues with joint’s disk or adjacent soft tissue
TMJ arthroscopy is used in the diagnosis of this disorder. During the procedure, the doctor inserts a small thin tube into the joint space and a small camera (arthroscope) is then inserted to view the area and to help confirm the diagnosis.
In a few cases, the symptoms of TMJ settle without any treatment. But, if the symptoms persist, then the doctor may recommend certain treatment options which include:
Pain relievers and anti-inflammatory prescription medications are given to ease pain and discomfort.
Muscle relaxants are given for a few days or weeks to help ease muscle spasms.
Nonmedical therapies for TMJ disorders include:
Oral splints or mouth guards to ease jaw pain.
Physical therapy such as exercises to strengthen and stretch jaw muscles, and ultrasound moist heat and ice compression are also given.
Counselling can help patients understand the factors and behaviours that may worsen pain and may help patients to avoid such behaviours as teeth clenching, leaning on the chin or biting fingernails.
When all other treatment modes don’t work, the doctor might recommend procedures like:
Arthrocentesis: It is a minimally invasive technique that involves the insertion of small needles into the joint, which helps to clear out debris and other inflammatory by-products from the jaw.
Open joint surgery is done if the jaw pain does not resolve with conservative treatments. It is done to repair or replace the joint and involves more risks than other procedures. Hence, this surgery should be done after revealing the pros and cons about the procedure with the patient.