The TMJ (temporomandibular) joint connects to lower jaw and the upper jaw. This joint is entirely responsible for opening and closing your mouth. It does this in two ways, the first way is by working as a hinge and the second is through a sliding motion where the lower jaw is moved down and forward. The second movement allows for a variety of actions like yawning and even singing.
Causes of TMJ Disorders
TMJ disorders can be a result of many factors, including:
- Misalignment of the jaw or teeth
- Tooth or jaw trauma
- Inflammatory musculoskeletal disorders
Symptoms of TMJ Disorder
If you notice any of the following, it’s a good idea to see your dentist. Your dentist can check on the health of your TMJ:
- Tender or sore jaw, especially around the joint (which is close to the ear)
- Clicking jaw
- Cracking sensitive teeth, popping or grating in your ears
- Full or ringing ears
- Headaches or migraines
- Stiff neck or jaw muscles
- Jaw spasms
- Pain when chewing
- Jaw locking or dislocation
Diagnosing TMJ Disorders
When you visit your dentist, they will use several techniques to diagnose the problem. The first technique will involve a visual examination of the way your jaw opens and closes, as well as any sounds and the range of motion.
Pressing on certain areas of the jaw will also identify any areas where there is pain or discomfort. If your dentist feels as though there is a problem, dental x-rays will be required. Usually, a CT will be ordered to provide images of the bone, while an MRI will illuminate any issues in the joint’s disk.
An arthroscopy may also be used. This process involves sticking a thin tube into the joint space, a camera is then sent down the tube to image the area and create a diagnosis.
Treating TMJ Disorders
A common treatment option is an equilibration treatment. After your jaw has been assessed, your dentist can reshape the biting surfaces of the lower and upper joints to create a better bite. The procedure is entirely painless, and it is effective at treating minor cases of TMJ disorder.
Other therapies include:
- Occlusal Appliances: Oral splints can be used to provide relief. These devices fit over the teeth and stop the ‘trigger’ of a muscle contraction
- Behavioural Therapy: If clenching, bruxism or chewing and biting on fingernails and other objects create the pain, the best way to treat the issue is to provide methods for avoiding these behaviours.
- Physical Therapy: Using heat and ice, as well as exercises that stretch and strengthen the jaw muscles can be beneficial and may require a referral to a physiotherapist.
If these treatments aren’t useful, surgery will usually be required. Techniques include:
- Arthrocentesis: This surgical procedure is relatively non-invasive, and uses needles to flush fluid through the joint and remove any debris that could be causing any pain.
- Injections: Corticosteroid, and even botulinum toxin type A can help to relieve pain in the jaw muscles and joint.
- Modified Condylotomy: This refers to surgery on the mandible, but not the TMJ itself and is often used to relieve locking.
- Open-Joint Surgery: This is the most extreme treatment, and is used when the joint won’t respond to any other treatment. It is especially used when there is a structural problem with the joint.
- TMJ Arthroscopy: In this arthroscopy, small surgical instruments are inserted into a thin tube and it works as a less-invasive form of open-joint surgery, although it is limited.
Caring For Your TMJ
The best way to care for your TMJ is to avoid anything that puts unnecessary strain and stress on your joint. Stress can also cause you to clench or grind your teeth, so it’s essential that you look after yourself, get plenty of sleep and prioritise times of leisure and relaxation.
You also need to visit your dentist at least twice a year. Regular visits will ensure your dentist can pick up on any slight malfunctions and treat them before they cause any further issues, or get to a point where surgery is required. Regular visits will also ensure any dental problems caused by the TMJ disorder, like cracks and dental wear are treated.
Like any part of your body, your TMJ requires proper care and preventative medicine and therapy to remain in good condition. You use it for everything from eating, to smiling, talking and swallowing, so it really does deserve plenty of TLC.