The temporomandibular joint (TMJ) is the small joint in front of the ear where the skull is met by the lower jaw (mandible).
The TMJ is the most constantly used joint in the body and the only joint that hinges and slides as part of its normal function.
It makes sense that a joint with such complex movements and is the most used will likely suffer from disorders during its lifetime if the balance and synchronisation of these moving parts are affected.
The left and right TMJs must work together to coordinate swallowing, opening and closing the jaws, aligning the teeth, chewing food and speaking.
Temporomandibular Disorders (TMD) is a collective term for various clinical symptoms and signs involving the muscles of mastication (chewing) and the internal structures of the temporomandibular joint itself.
The TMJ is close to the brain above, the external and internal ear structures behind, and the muscles involved with chewing on either side, so the presenting symptoms of TMJ disorders can involve any or all of these structures.
TMJ Disorders can cause various symptoms that can significantly impact your quality of life, making it difficult to enjoy everyday activities such as eating and speaking. In some cases, TMJ Disorders can also lead to long-term damage to the jaw joint and surrounding structures, making early diagnosis and treatment essential.
60-70% of the general population will have one symptom or sign of TMD, but that does not mean they all have a disorder. Of all the TMD presentations to the Dentist or Specialist, they will fall into four main categories:
The exact causes of TMD are not fully understood, but several factors can contribute to the development of these disorders. These factors include:
The symptoms of TMD can vary depending on the type and severity of the condition. Some common symptoms include
Having one or more of these symptoms is quite common. However, getting your dentist's review is still important to get the appropriate investigations and imaging to achieve the correct diagnosis.
TMD can progress through different stages, and the severity of symptoms can increase over time. The stages of TMD are as follows:
It's essential to seek treatment from a qualified dentist if you experience any symptoms of TMD. Early diagnosis and treatment can help prevent the progression of TMD and improve your oral health and quality of life.
Your dentist will ask you about your symptoms and medical history and perform a physical examination.
The physical exam involves:
Other tests your dentist may order:
You can apply warm compresses over the painful area. Exercise your lower jaw by moving it side to side and trying to open and close your mouth. Try this after you apply a warm compress for 20 minutes.
Muscle relaxant medicines are prescribed to help control muscle spasms and pain. Non-Steroidal Anti-inflammatory Drugs (NSAIDs) like aspirin or ibuprofen will reduce pain and swelling.
Low-dose antidepressants may also be given for pain modification.
Physical Therapy exercises help relax your muscles and improve jaw movements. Physiotherapists use the Transcutaneous Electrical Nerve Stimulation (TENS) unit and ultrasound, which promotes tissue healing and helps relax your muscles.
Include avoiding hard or chewy foods, practising stress reduction techniques, and avoiding jaw overuse.
This treatment is suggested to eliminate the effects of clenching or grinding the teeth. A splint is an appliance that fits over the chewing surfaces of your upper and lower teeth. It is worn for almost 1-3 months or more.
Surgery is the last resort when all other treatment methods have failed. Surgery may be necessary if muscle spasms increase in frequency, TMJ has become arthritic or when there is an injury to the joint.
Preventing TMJ disorders can include the following measures:
Bruxism is a condition characterised by the clenching and grinding of teeth, typically during sleep. It can also occur during waking hours, although this is less common. Bruxism can affect people of all ages but is most common in children and young adults.
Some of the symptoms of bruxism include:
The exact cause of bruxism is not always clear, but it is thought to be linked to a combination of factors, including stress, anxiety, an abnormal bite, and sleep disorders such as sleep apnea. In some cases, bruxism may also be a side effect of certain medications or substances, such as caffeine or alcohol.
While not always serious, bruxism can cause dental problems and discomfort over time. So, speaking with your dentist if you suspect you may have bruxism is important.
Here are some of the main reasons why bruxism should be promptly treated:
Several treatments for bruxism include
TMJ Disorder and bruxism are two conditions that can be closely related. Bruxism can contribute to the development or exacerbation of TMJ Disorder.
When a person with bruxism clenches or grinds their teeth, it puts pressure on the TMJ and surrounding muscles, leading to inflammation and pain. Over time, this can contribute to the development of TMJ Disorder.
On the other hand, TMJ Disorder can also contribute to bruxism. When the TMJ is misaligned or not functioning properly, it can cause a person to grind or clench their teeth to compensate for the discomfort or pain.
Therefore, it is important to treat both bruxism and TMJ Disorder to manage and prevent the progression of these conditions. Consult a dental or medical professional who can evaluate your case and recommend the most appropriate treatment option.
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